基于健康信念模型的龋齿患者延迟就诊行为影响因素分析

doi:10.12183/j.scjpm.2026.0902

摘要/Abstract

摘要： 目的基于健康信念模型探讨龋齿患者延迟就诊行为影响因素。方法采用便利抽样法选取阜阳临泉县级医院2022年6月至2025年9月就诊的成年龋齿患者为研究对象,统计延迟就诊情况;统计一般人口学信息与临床信息,并自行编制基于健康信念模型的龋齿健康信念问卷,通过多因素logistic回归分析探讨龋齿患者延迟就诊行为影响因素。结果 430例龋齿患者延迟就诊时间<3个月133例（30.93%）;延迟就诊时间≥3个月者297例（69.07%）。延迟就诊组深龋占比显著高于非延迟就诊组,差异有统计学意义（P<0.05）。受教育程度（OR=2.938）、医保类型（城乡居民医保OR=1.463,自费OR=3.728）、龋齿数量（3颗及以上OR=3.191）、月收入（OR=0.953）、感知易感性（OR=0.857）、感知严重性（OR=0.818）、感知益处（OR=0.747）、感知障碍（OR=3.992）、自我效能（OR=0.811）、行动线索（OR=0.751）是龋齿患者延迟就诊行为的影响因素（均P<0.05）。经结构方程分析,感知障碍对延迟就诊行为有显著正向直接效应（β=0.421）;感知障碍负向影响自我效能（β=-0.380）,而自我效能负向影响延迟行为（β=-0.350）（均P<0.01）。行动线索正向影响感知严重性（β=0.293）、负向影响感知障碍（β=-0.221）;感知严重性负向影响延迟行为（β=-0.150）（均P<0.01）。结论龋齿患者延迟就诊行为发生率较高,基于健康信念模型各维度（感知障碍、自我效能、感知严重性、行动线索、感知易感性、感知益处）可通过直接及间接路径共同影响龋齿患者延迟就诊行为。

关键词: 龋齿, 延迟就诊行为, 健康信念模型, 影响因素分析, 感知障碍, 自我效能

Abstract: Objective To explore the influencing factors on delayed healthcare seeking behavior in adult patients with dental caries based on the health belief model. Methods A convenience sampling method was employed to select adult patients with dental caries who visited a county-level hospital in Linqun County, Fuyang, from June 2022 to September 2025. Data were collected via questionnaires on general demographic characteristics, clinical information, and a self‑designed Caries Health Belief Questionnaire. Multivariate logistic regression analysis was conducted to identify the factors associated with delayed healthcare seeking behavior. Results among the 430 participants, 133 (30.93%) delayed their dental healthcare seeking by less than three months, while 297 (69.07%) delayed by three months or more. The delayed healthcare seeking group had a significantly higher proportion of deep caries compared to the non-delayed group, with statistically significant differences (P<0.05). Factors identified as significant predictors of delayed healthcare seeking behavior included educational level (OR=2.938), type of medical insurance (resident medical insurance OR=1.463, self-paid OR=3.728), number of carious lesions (2 lesions OR=1.084, 3 or more lesions OR=3.191), monthly income (OR=0.953), perceived susceptibility (OR=0.857), perceived severity (OR=0.818), perceived benefits (OR=0.747), perceived barriers (OR=3.992), self-efficacy (OR=0.811), and cues to action (OR=0.751) (all P<0.05). Structural equation modeling revealed that perceived barriers had a significant positive direct effect on delayed healthcare seeking behavior (β=0.421). Perceived barriers also negatively influenced self-efficacy (β=-0.380), which in turn negatively affected delayed behavior (β=-0.350) (all P<0.01). Cues to action positively predicted perceived severity (β=0.293) and negatively predicted perceived barriers (β=-0.221). Perceived severity was found to have a negative effect on delayed behavior (β=-0.150), all with statistical significance (all P<0.01). Conclusion The incidence of delayed healthcare seeking behavior is high among patients with dental caries. And various dimensions of the health belief model, including perceived barriers, self-efficacy, perceived severity, cues to action, perceived susceptibility, and perceived benefits, collectively exert both direct and indirect influences on this behavior.

Key words: Dental caries, Delayed healthcare seeking behavior, Health belief model, Influencing factor analysis, Perceived barriers, Self‑efficacy

中图分类号:

R195

时丽红, 李震. 基于健康信念模型的龋齿患者延迟就诊行为影响因素分析[J]. 华南预防医学, 2026, 52(8): 902-906.

Shi Lihong, Li Zhen. Determinants of delayed healthcare seeking behavior in patients with dental caries based on the health belief model[J]. South China Journal of Preventive Medicine, 2026, 52(8): 902-906.

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