Objective To analyze the current status of blood pressure control and influencing factors among hypertensive patients under community management in the Sanluo area of Shanghai, and to provide evidence-based support for hypertension prevention and treatment in this region. Methods A cross-sectional study was conducted from October to December 2021, employing a multi-stage sampling method. Hypertensive patients managed under the national basic public health services were recruited to participate in a questionnaire survey, physical measurements, and laboratory examinations. Participants were stratified into three groups based on the duration of their hypertension diagnosis: a short-duration group (≤5 years), a medium-duration group (6-<11 years), and a long-duration group (≥11 years). Univariate and multivariate logistic regression analyses were performed to identify the factors associated with blood pressure control across these different disease duration cohorts. Results A total of 2 894 hypertensive patients under management were included in the study, comprising 1 317 males and 1 577 females. The blood pressure control rates were 48.36% (295/610), 40.86% (257/629), and 39.21% (649/1 655) for the short-, medium-, and long-duration groups, respectively, with the differences among the groups being statistically significant (P<0.01). Statistically significant differences (P<0.01 or P<0.05) were also observed among the three groups with respect to age, educational attainment, marital status, history of cardiovascular and cerebrovascular diseases, history of diabetes, adherence to antihypertensive medication, and blood pressure control. Binary logistic regression analysis revealed that for the short-duration group, annual income (OR=0.553), overweight/obesity (OR=1.513), and total cholesterol (OR=1.563) were significant influencing factors. In the medium-duration group, marital status (OR=0.395) and total cholesterol (OR=1.585) were significant predictors. For the long-duration group, home blood pressure monitoring (OR=0.801) and blood glucose levels (OR=1.699) were identified as key determinants of blood pressure control. Conclusion The rates of blood pressure control among community-managed hypertensive patients with varying disease durations in the Sanluo area of Shanghai are suboptimal. Factors such as home blood pressure monitoring, overweight/obesity, total cholesterol, and blood glucose are major determinants influencing blood pressure control across different stages of hypertension. It is recommended that healthcare professionals develop targeted prevention and treatment strategies tailored to the specific disease duration of patients in order to improve population-level blood pressure control rates.

Objective To investigate the epidemiological characteristics and influencing factors of falls among the elderly in the urban and rural areas of Neijiang, so as to provide a scientific basis for fall prevention strategies. Methods A multi-stage, stratified, cluster random sampling method was employed to select individuals aged 60 years and older from urban and rural communities in Neijiang as study participants for an epidemiological survey on falls. Univariate and multivariate logistic regression analyses were conducted to identify the associated risk factors for falls. Results A total of 1 009 elderly individuals aged 60 and above were included in the study, comprising 503 males and 506 females, with a mean age of 73.12±7.67 years. The sample consisted of 505 participants from urban communities and 504 from rural areas. Over the preceding year, 263 individuals experienced a total of 351 fall events, yielding a fall incidence rate of 26.07%. The incidence of falls was significantly higher in rural areas (29.76%) compared to urban communities (22.37%) (P<0.01). Multivariate logistic regression analysis indicated that female gender (OR=1.649) and the use of medication for chronic diseases (OR=2.813) were significant risk factors for falls among the urban elderly population. In the rural cohort, significant predictors of falls included female gender (OR=1.548), education level below primary school (OR=1.992), sleep duration of less than 6 hours (OR=2.105), and the use of medication for chronic diseases (OR=2.458). Conclusion The incidence of falls among the elderly in urban and rural Neijiang is considerable. The risk factors for falls are more numerous among the rural elderly population when compared to their urban counterparts. It is imperative to direct particular attention towards the rural elderly, elderly women, and individuals afflicted with chronic conditions. Comprehensive intervention strategies should be implemented, focusing on enhancing health education and fall prevention training, actively managing chronic diseases, providing guidance on rational drug use, and fostering the development of healthy sleep habits to mitigate the risk of falls in the elderly population.

Objective To analyze the periodontal status and its associated factors in 6- to 12-year-old children in the Nanjing area, with the aim of providing a reference for the prevention and treatment of periodontal disease in this demographic. Methods A multi-stage stratified random sampling method was employed to select primary school children aged 6-12 years from three districts (Jiangning, Xuanwu, and Pukou) in Nanjing for an oral health survey. The periodontal health status and oral health behaviors of the children were assessed in accordance with the methodology and standards of the 4th National Oral Health Epidemiological Survey, supplemented by a questionnaire. Results A total of 3 612 children were included in the study, comprising 1 927 males (53.35%) and 1 685 females (46.45%). The prevalence of gingival bleeding was 43.13% (1 558 cases), dental calculus was 42.52% (1 536 cases), and periodontal pockets were detected in 0.69% (25 cases). A state of periodontal health was observed in 2 044 children, corresponding to a periodontal health rate of 56.59%. Multivariate logistic regression analysis revealed that age (OR=0.570, 95% CI: 0.378-0.860), parental education level (OR=1.473, 95% CI: 1.182-1.834), daily tooth brushing frequency (OR= 3.808, 95% CI: 1.921-7.546), duration of each brushing session (OR=2.869, 95% CI: 1.096-7.511), time since the last dental examination (OR=0.439, 95% CI: 0.220-0.873), use of fluoridated toothpaste (OR=2.032, 95% CI: 1.751-2.358), use of dental floss (OR=1.499, 95% CI: 1.216-1.849), malocclusion (OR=0.460, 95% CI: 0.293-0.724), frequency of sweet food consumption (OR=0.325, 95% CI: 0.126-0.833), as well as oral health knowledge (OR=1.790, 95% CI: 1.236-2.592) and attitude (OR=1.878, 95% CI: 1.137-3.101) were independent factors correlated with periodontal health in children aged 6-12 years (all P<0.05). Conclusion The periodontal health status of 6- to 12-year-old children in the Nanjing area requires further improvement. Gingival bleeding and dental calculus are particularly prevalent, indicating significant periodontal health challenges. To enhance the periodontal well-being of children, it is imperative to promote better dietary habits and oral hygiene practices, advocate for the use of fluoridated toothpaste and dental floss, and intensify oral health education initiatives.

Objective To analyze the level of occupational health literacy and its determinants among four key occupational populations in Lu'an City, thereby providing an evidentiary basis for the formulation of targeted intervention policies. Methods A stratified, multi-stage cluster random sampling method was employed between 2022 and 2024 to survey frontline workers from 33 enterprises representing four key populations in Lu'an City. Data on demographic information and occupational health literacy were collected via an online questionnaire. Logistic regression analysis and a nomogram prediction model were utilized to identify influencing factors. Results The survey covered 1 087 frontline workers, who were predominantly male (76.54%) with a mean age of 38.55 ± 10.25 years. Participants were mainly from the non-metallic mineral mining and dressing industry (69.73%), small and micro-sized enterprises (44.89%), and private enterprises (55.29%). The overall occupational health literacy level was 52.53%. Literacy levels for the four dimensions, ranked from highest to lowest, were: basic knowledge of occupational health protection (89.97%), healthy work practices and behaviors (72.95%), knowledge of occupational health laws (59.25%), and basic skills for occupational health protection (28.15%). Logistic regression analysis indicated that industry category, economic ownership type, age, and educational attainment were significant determinants of overall occupational health literacy. Workers in the textile and apparel industry (OR=0.126) and the non-metallic mineral products industry (OR=0.253) had lower literacy levels compared to those in the non-metallic mineral mining and dressing industry. Private enterprise employees showed lower literacy than their counterparts in state-owned enterprises (OR=0.542). The ≥50 years age group had lower literacy than the <30 years age group (OR=0.541). Individuals with a college degree or higher had significantly greater literacy than those with a primary school education or below (OR=3.576) (all P<0.05). The nomogram model revealed that industry category and educational attainment were the most significant predictors of overall occupational health literacy. Conclusion The overall level of occupational health literacy among the four key populations in Lu'an City requires substantial improvement. Interventions should prioritize targeted training on basic occupational health protection skills and legal knowledge. These efforts should specifically focus on workers in the textile and apparel industry and individuals with lower educational levels, employing precise and differentiated strategies.

Objective To investigate the willingness of patients with pulmonary tuberculosis in Linquan County to adhere to standard treatment and to identify its associated determinants. Methods A cohort of 270 patients initiating standard treatment for pulmonary tuberculosis in the county between August 2021 and August 2025 were enrolled in this study. Data were collected through face-to-face interviews. Willingness to undergo standard treatment was operationalized as medication adherence, which was evaluated at treatment initiation (T0), the one-month follow-up (T1), and at the completion of therapy (T2) using pill counts and WeChat-based check-in records. A comparative analysis was conducted between patients with high and low treatment willingness. Lasso regression was employed to screen for potential predictors of treatment willingness, followed by a multivariate logistic regression analysis to identify the definitive influencing factors. Results Among the 270 participants, 68 (25.19%) exhibited a medication adherence rate of ≤90%, and were thus classified as having a low willingness to accept standard treatment. The Lasso and subsequent multivariate logistic regression analyses revealed that a junior high school education or lower (OR=3.358), unawareness of tuberculosis cure rates (OR=3.264), a monthly family income below 5 000 RMB (OR=4.646), a self-administered supervision model (OR=4.547), and the presence of severe adverse drug reactions (OR=3.945) were significant factors associated with a lower willingness to accept standard treatment (all P<0.05). Conclusion To enhance adherence to standard treatment for pulmonary tuberculosis, health education initiatives should be prioritized for patients with lower educational attainment, those unaware of treatment efficacy, individuals from low-income households, patients on self-administered therapy, and those experiencing severe adverse drug reactions. Strengthening supervision and therapeutic guidance through multifaceted, comprehensive interventions is critical for improving treatment willingness among pulmonary tuberculosis patients at the county level.

Objective To compare the clinical efficacy and health economic outcomes of different urinary protein screening frequencies in patients with early-stage diabetic kidney disease (DKD). Methods Based on electronic medical records of patients with early-stage DKD at Peking University Third Hospital from 2023 to 2024, this study stratified patients by screening frequency into a standard screening group (biannually) and a low-frequency screening group (annually). Cox regression analysis was employed to assess the risk of disease progression, while a generalized linear model was utilized to analyze medical costs. The incremental cost-effectiveness ratio (ICER) was subsequently calculated. Results A total of 206 patients were included in each group. The disease progression rate was significantly lower, and the progression-free survival time was significantly longer in the standard screening group compared to the low-frequency screening group (P<0.05). After adjusting for confounding factors using a Cox proportional hazards model, the risk of disease progression remained significantly lower in the standard screening group (HR=1.768, 95% CI: 1.136-2.751, P=0.012). Various medical expenditures and the cumulative direct medical costs were higher in the standard screening group (P<0.05). Following adjustment with a generalized linear model, standard screening was identified as an independent predictor of increased per capita cumulative direct medical costs (OR=1.332, 95% CI: 1.320-1.345, P<0.001). The ICER estimation indicated that for each additional percentage point reduction in progression risk, an extra medical cost of approximately 988 RMB was incurred. The total incidence of the composite renal endpoint was significantly lower in the standard screening group, whereas overall screening compliance, glycemic control rates, and blood pressure control rates were significantly higher (P<0.05). Conclusion Among patients with early-stage DKD, regular biannual urinary protein screening, despite elevating short-term direct medical costs, significantly reduces the risk of disease progression, delays its rate, diminishes the incidence of composite renal endpoints, and contributes to the enhancement of glycemic and blood pressure control.

Objective To analyze the survival status and associated factors among patients aged ≥50 years with human immunodeficiency virus (HIV) and tuberculosis (TB) coinfection (HIV-TB coinfection) in Baise City from 1997 to 2023. Methods Data of patients with HIV infection in Baise from 1997 to 2023 were extracted from the Basic Information System for AIDS Prevention and Control within the Chinese Information System for Disease Control and Prevention. These data were matched with reported pulmonary tuberculosis cases from the Comprehensive Information System for Tuberculosis Prevention and Control to identify HIV-TB coinfected individuals aged ≥50 years. The life table method was utilized to calculate survival rates, the Kaplan-Meier method was employed to plot survival curves, and the Cox proportional hazards regression model was used to analyze the factors influencing the survival time of this patient cohort. Results A total of 445 cases of HIV-TB coinfection in individuals aged ≥50 years were identified in Baise City from 1997 to 2023. Among these, 199 deaths were attributed to AIDS-related illnesses, resulting in a case fatality rate of 44.72%. The median age at diagnosis of HIV-TB coinfection was 60 (Interquartile Range:54, 67) years, and the median survival time was 78 months (95% CI:61.687-93.423). The cumulative survival rates for years 1 through 6 were 78.70%, 70.62%, 62.51%, 56.97%, 54.44%, and 52.27%, respectively. Multivariate Cox proportional hazards model analysis indicated a higher risk of mortality among HIV-TB coinfection patients who were male (HR=1.545, 95% CI:1.019-2.345), aged ≥70 years (HR=1.543, 95% CI:1.023-2.322), had an educational level below junior high school (HR=1.448, 95% CI:1.068-1.964), and had not received antiretroviral therapy (HR=5.627, 95% CI:4.150-7.629). Conclusion Middle-aged and elderly individuals with HIV-TB coinfection exhibit short survival times, particularly those who are male, aged ≥70 years, have a low educational level, or have not received antiretroviral therapy. It is imperative to implement targeted health education campaigns, enhance health monitoring and management for the middle-aged and elderly population to ensure early detection, diagnosis, and treatment. These measures are crucial for reducing the mortality risk and extending the survival duration of older patients with HIV-TB coinfection.

Objective To investigate the current status and analyze the influencing factors of inpatient service utilization among middle-aged and elderly individuals in China with hypertension, hyperglycemia, and dyslipidemia. Methods Based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), residents aged ≥45 years who were diagnosed with at least one of the following conditions—hypertension, hyperglycemia, or dyslipidemia—were selected for this study. Employing the Andersen Health Behavior Model, a binary logistic regression analysis was conducted to identify the determinants of inpatient service utilization within this "three-highs" population. Results Among the 8 227 middle-aged and elderly individuals with at least one of the "three-highs", 1 919 (23.33%) had utilized inpatient services in the preceding year. The logistic regression analysis revealed that several factors were significantly associated with inpatient service utilization (P<0.05). These included age (≥65 years OR=1.336), type of medical insurance (Urban and Rural Resident Basic Medical Insurance OR=0.757; Other/No Insurance OR=0.676), number of "three-highs" conditions (2 conditions: OR=1.287; 3 conditions: OR=1.892), limitations in Activities of Daily Living (ADL) (Yes OR=1.387), limitations in Instrumental Activities of Daily Living (IADL) (Yes OR=1.410), depressive symptoms (Present OR=1.248), presence of pain (Present OR=1.481), utilization of physical examination services (Utilized OR=1.225), duration of midday napping (60 to <120 min OR=1.230; ≥120 min OR=1.266), and alcohol consumption (OR=0.780). Conclusion The utilization rate of inpatient services among the middle-aged and elderly population with "three-highs" in China is relatively low. The primary influencing factors include age, type of medical insurance, number of comorbidities, ADL and IADL limitations, depressive symptoms, presence of pain, utilization of physical examinations, midday nap duration, and alcohol consumption. It is recommended that multifaceted interventions be implemented to effectively enhance the health management level of this population.

Objective To analyze the epidemiological characteristics, incidence trends, and spatiotemporal clustering of human brucellosis in Changji Hui Autonomous Prefecture (hereafter "Changji Prefecture"), Xinjiang Uygur Autonomous Region, from 2011 to 2023, in order to provide a scientific basis for the prevention and control of the disease. Methods Case data for human brucellosis reported in Changji Prefecture from 2011 to 2023 were collected. Descriptive epidemiological methods were employed to analyze distribution by time, place, and person. Joinpoint regression analysis was utilized to assess long-term incidence trends. Spatial autocorrelation and spatiotemporal scan statistics were applied to explore the spatiotemporal clustering of human brucellosis. Results A total of 8 291 cases of human brucellosis were reported in Changji Prefecture from 2011 to 2023, with an average annual incidence of 45.71 per 100 000 population. Peak incidence occurred between March and August. The overall incidence rate demonstrated an upward trend from 2011 to 2023 (AAPC=32.52%, 95% CI: 27.56%-42.45%). Specifically, the incidence rate increased from 2011 to 2015 (APC=151.88%, 95% CI: 123.90%-214.47%), showed a decreasing trend from 2015 to 2020 (APC=-23.11%, 95% CI: -32.17%- -18.18%), and reverted to an upward trend from 2020 to 2023 (APC = 39.44%, 95% CI: 17.35%-83.62%). The incidence rate in males was higher than in females (P<0.01). Cases were concentrated in the 40-<60 age group (50.79%), with primary occupations being farmers (81.39%) and herdsmen (5.48%). Analysis of spatial distribution revealed that the three counties (cities) with the highest average annual incidence rates were Qitai County (66.00/100 000), Mulei Kazakh Autonomous County (63.61/100 000), and Manas County (58.80/100 000). Spatial autocorrelation analysis indicated that Moran's I values were greater than 0 for each year from 2012 to 2023 (all P<0.05), confirming the existence of spatial clustering. High-High (H-H) clusters were primarily located in Manas and Hutubi counties from 2011 to 2016, shifting to Qitai and Mulei Kazak Autonomous counties from 2017 to 2023. High-Low (H-L) clusters were mainly observed in Manas County and Changji City, Low-High (L-H) clusters in Manas, Hutubi, and Mulei Kazak Autonomous counties, and Low-Low (L-L) clusters were concentrated in Manas County and Changji City. Spatiotemporal scan statistics identified a primary cluster centered in Que'ergou Town, Hutubi County, and two secondary clusters centered in Banjiegou Town and Laoqitai Town of Qitai County, respectively. Conclusion The incidence of human brucellosis in Changji Prefecture is increasing and exhibits significant spatiotemporal clustering. It is imperative to closely monitor the epidemiological trends of brucellosis in both human and animal populations, adjust prevention and control strategies in a timely manner, and enhance surveillance of cases in high-incidence areas and identified hotspots.

Objective To analyze the temporal trends in the disease burden of pertussis from 1990 to 2021 in China, globally, and across regions with varying Socio-demographic Index (SDI) levels, thereby providing an evidence base for the formulation of pertussis prevention and control strategies. Methods Data on the burden of pertussis for the period 1990-2021 for China, global regions, and different SDI quintiles were extracted from the Global Burden of Disease 2021 (GBD 2021) study. A Joinpoint regression model was employed to analyze the long-term temporal trends in the disease burden metrics. Results In 2021, the age-standardized incidence rate, prevalence rate, mortality rate, and Disability-Adjusted Life Years (DALY) rate of pertussis in China were 18.07, 2.48, 0.15, and 12.97 per 100 000 population, respectively. Over the period from 1990 to 2021, the age-standardized incidence, prevalence, mortality, and DALY rates for pertussis in China all demonstrated a significant declining trend, with Average Annual Percent Changes (AAPC) of -8.32% (95% CI: -9.15% to -7.49%), -8.33% (95% CI: -9.16% to -7.50%), -8.70% (95% CI: -11.14% to -6.20%), and -8.89% (95% CI: -11.58% to -6.13%), respectively. The disease burden of pertussis exhibited a trend of initially decreasing and subsequently increasing with age. The highest burden was observed in the under-5 age cohort, reaching its nadir in the 25-<30 age group, and then gradually increasing from the 30-<35 age group onwards. From 1990 to 2021, the overall burden of pertussis in China consistently surpassed that of high-SDI regions, while remaining lower than the global average as well as the burdens in middle, low-middle, and low-SDI regions. Conclusion Although the overall disease burden of pertussis in China exhibits a significant downward trend, it remains a considerable public health concern. It is imperative to enhance surveillance systems and deepen etiological research to more effectively control and prevent the transmission of pertussis.

Objective To investigate the influencing factors of malnutrition in preschool children, so as to provide a reference and basis for improving their nutritional status. Methods A total of 2 286 preschool children (3-6 years old) who underwent child health care and kindergarten enrollment physical examinations at the Longquanyi District Maternal and Child Health Hospital in Chengdu from September 2022 to September 2024 were selected as study subjects. The nutritional status of the children was evaluated according to the child growth standards recommended by the World Health Organization. A questionnaire survey on the children's basic information and feeding-related situations was conducted with the children's guardians. Univariate and multivariate analysis methods were used to analyze the factors affecting malnutrition in children. Results Among the 2 286 preschool children, there were 104 cases of malnutrition, and the detection rate of malnutrition was approximately 4.55% (104/2 286). The results of the multivariate logistic regression analysis showed that low birth weight (OR=2.016), birth asphyxia (OR=1.647), being easily distracted during meals (OR=1.704), picky eating (OR=1.791), daily sleep duration of ≤10 hours (OR=2.036), frequent consumption of sugary drinks (OR=1.809), frequent consumption of puffed foods (OR=1.895), frequent illness (OR=1.680), fixed meal times (OR=0.570), and regular nutritional monitoring (OR=0.539) were all correlated factors for malnutrition in preschool children (all P<0.05). Conclusion The detection rate of malnutrition among preschool children is relatively high, and its influencing factors are numerous. Clinically, targeted interventions for preschool children can be strengthened based on these findings to reduce the risk of malnutrition.

Objective To investigate the temporal trends in the disease burden of chronic obstructive pulmonary disease (COPD) attributable to tobacco exposure in China from 1990 to 2021, thereby providing an evidence base for public health authorities to formulate targeted prevention and control strategies and tobacco control policies. Methods Data on COPD attributable to tobacco in China, Asia, various Socio-Demographic Index (SDI) regions, and globally from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021). A descriptive analysis was conducted using metrics such as age-standardized mortality rates and age-standardized Disability-Adjusted Life Year (DALY) rates. The Estimated Annual Percentage Change (EAPC) was calculated to quantify trends in the disease burden metrics. An Age-Period-Cohort (APC) model was employed to analyze the respective effects of age, period, and cohort. Furthermore, a Bayesian Age-Period-Cohort (BAPC) model was utilized to forecast the age-standardized mortality and DALY rates for tobacco-attributable COPD in the Chinese population from 2022 to 2035. Results In China, the age-standardized mortality rate and age-standardized DALY rate for tobacco-attributable COPD decreased from 111.74 and 1 884.73 per 100 000 in 1990 to 35.46 and 589.75 per 100 000 in 2021, respectively. Compared to global, Asian, and other SDI regional counterparts, China demonstrated the most substantial decline in both the age-standardized mortality rate (EAPC=-4.20%, 95% CI: -4.40% to -4.00%) and the age-standardized DALY rate (EAPC=-4.20%, 95% CI: -4.37% to -4.04%). Between 1990 and 2021, the age-standardized mortality and DALY rates for tobacco-attributable COPD in China increased with advancing age, peaking in the ≥80 years age group. The age-standardized mortality rate (and DALY rate) for males decreased from 193.55 (3 117.39) per 100 000 in 1990 to 70.91 (1 079.53) per 100 000 in 2021, while for females, the corresponding rates declined from 59.65 (967.21) per 100 000 to 12.50 (225.11) per 100 000. Over the study period, the age-standardized mortality rate exhibited a positive correlation with age, whereas both period and cohort effects demonstrated a declining trend. Projections from the BAPC model indicate a continued, gradual downward trend in age-standardized mortality and DALY rates from 2022 to 2035, with the rates anticipated to reach 29.43 and 455.00 per 100 000, respectively, by 2035. Conclusion Although the burden of COPD attributable to tobacco in China has decreased significantly from 1990 to 2021, it remains severe in comparison to other nations and regions, with a particularly pronounced burden among the male population. It is therefore imperative to intensify tobacco control interventions, especially targeting males, promote healthy lifestyles, and elevate public awareness regarding COPD prevention and management.

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.