南京市浦口区围绝经期女性症状困扰与基层就医障碍调查

doi:10.12183/j.scjpm.2026.0189

摘要/Abstract

摘要： 目的调查围绝经期女性症状困扰及基层就医障碍。方法 2024年1—10月从南京市浦口区社区及基层医疗机构招募466名围绝经期女性,采用改良Kupperman量表及更年期生活质量评分量表（MRS）评估症状困扰,通过半结构访谈与潜在类别分析识别就医障碍类型,多因素logistic回归分析影响因素。结果 466名围绝经期女性中中重度症状困扰占54.94%（Kupperman）及66.31%（MRS）;就医障碍分为顾虑摇摆型（60.09%）、系统驱动型（21.89%）、忽视沉默型（18.03%）。多因素分析结果显示,农村居住（OR=5.775）、低教育程度（OR=3.163）、症状影响轻（OR=0.473）、从不关注健康信息（OR=5.008）、从不参与社区活动（OR=5.282）与忽视沉默型障碍相关（均P<0.05）;农村居住（OR=3.172）、症状影响中重度（OR=1.777）、网络为主要信息渠道（OR=2.513）与顾虑摇摆型障碍相关（均P<0.05）。结论超半数围绝经期女性受中重度症状困扰,就医障碍以顾虑摇摆型为主,受居住地区、教育程度及健康信息渠道显著影响。

关键词: 围绝经期, 症状困扰, 就医障碍, 基层医疗, 生活质量

Abstract: Objective To investigate symptom distress and barriers to seeking primary care among perimenopausal women. Methods A total of 466 perimenopausal women were recruited from communities and primary healthcare institutions in Pukou District, Nanjing from January to October 2024. Symptom distress was evaluated using the modified Kupperman Index and the Menopause Rating Scale (MRS). Barriers to seeking medical care were identified through semi-structured interviews and latent class analysis. Multinomial logistic regression was employed to analyze the associated factors. Results The prevalence of moderate to severe symptom distress was 54.94%(256/466) as measured by the Kupperman Index and 66.31%(309/466) by the MRS. Three distinct classes of barriers to seeking healthcare were identified: "hesitant and wavering" (60.09%), "system-driven" (21.89%), and "neglectful and silent" (18.03%). Multinomial logistic regression analysis revealed that rural residence (OR=5.775), lower educational attainment (OR=3.163), lower perceived symptom impact (OR=0.473), never seeking health information (OR=5.008), and non-participation in community activities (OR=5.282) were significantly associated with the "neglectful and silent" class. Rural residence (OR=3.172), moderate to severe symptom impact (OR=1.777), and primary reliance on the internet for health information (OR=2.513) were significantly associated with the "hesitant and wavering" class (all P<0.05). Conclusion A significant majority of perimenopausal women experience moderate to severe symptom distress. The predominant barrier to seeking healthcare is characterized by hesitation and indecisiveness, which is significantly influenced by factors such as residential area, educational level, and channels used to access health information.

Key words: Perimenopause, Symptom distress, Healthcare-seeking barriers, Primary care, Quality of life

中图分类号:

R173

胡红云, 应玉青. 南京市浦口区围绝经期女性症状困扰与基层就医障碍调查[J]. 华南预防医学, 2026, 52(2): 189-194.

Hu Hongyun, Ying Yuqing. An investigation of symptom distress and barriers to primary care seeking among perimenopausal women in Pukou District, Nanjing[J]. South China Journal of Preventive Medicine, 2026, 52(2): 189-194.

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