老年人基层中医预防保健服务利用的影响因素及重要性排序OA

Background Traditional Chinese medicine(TCM)plays a preventive healthcare role and is valuable for chronic disease management and active aging.Community health service centers(CHCs)are key places for promoting TCM preventive healthcare services,yet elderly utilization remains unsatisfactory.Objective To examine the factors influencing the elderly's utilization of TCM preventive healthcare services in CHCs and evaluate their importance.Methods A face-to-face questionnaire survey was conducted from July to September 2022 using a multi-stage stratified cluster random sampling method in a total of 12 communities of older adults in six cities selected from Zhejiang and Guangxi Provinces.The questionnaire was designed based on an integrated framework of Andersen and Social Cognitive Theory(SCT)dual models,aiming to comprehensively collect data on the utilization of TCM preventive healthcare services and their influencing factors among the elderly.A binary Logistic regression model was used to analyze the factors influencing the utilization of TCM preventive healthcare services used by older adults,and Logistic dominance analysis was applied to determine the importance of these factors.Results A total of 2 081(94.33%)valid questionnaires were retrieved,among them,only 369(17.73%)indicated that they had participated in TCM preventive healthcare services in the past year,and the frequency of utilization was mainly concentrated in 1-2 times per year[196 cases(53.11%)].The results of binary Logistic regression model analysis showed that:the educational level in predisposing characteristics,the situation of suffering from chronic diseases and the situation of pain/discomfort in need factors,the score of perceived service environment in enabling resources,as well as the scores of cognitive status and self-control in individual factors are the influencing factors for the utilization of primary-level traditional Chinese medicine preventive and health care services(P<0.05).Further Logistic dominance analysis showed that the weights of the importance of the influencing factors,in descending order,were:individual factors(belief and knowledge,self-regulation)>enabling resources(perceived environment)>predisposing characteristics(educational level)>need factors(chronic disease,pain,or discomfort).Conclusion Individual factors play a crucial role in the decision-making process of elderly individuals regarding the use of primary care TCM preventive healthcare services.Enhancing the health literacy and self-control abilities of the elderly,along with improving the TCM service environment in CHCs,is expected to promote the widespread adoption of TCM preventive health services among the elderly population.