Factors Influencing Medical Seeking Intention Of Perimenopausal And Postmenopausal Women:A Study Based On An Integrated Model

Objective:This study is based on the integrated model of the Health Belief Model(HBM)and the Theory of Planned Behavior(TPB)so as to grasp the situation of medical seeking intention of perimenopausal and postmenopausal women,to explore the influencing factors of medical seeking intention and the interaction mechanism,which can provide the basis for formulating comprehensive intervention strategy on the intention to seek medical help of perimenopausal and postmenopausal women,consequently improving the treatment rate and health status.Methods:Based on the integrated model of HBM and TPB,this paper investigated the female residents over 40 years old in changchun community by questionnaire survey.The survey tools included the general information questionnaire,Menopause Rating Scale,Medical Seeking Attitude Scale,Perceived Social Support-Family Support Subscale,General Self-Efficacy Scale and Medical Seeking Intention Scale.The original data was entered into Epidata 3.1 software to establish a database,and then imported into SPSS 25.0 software for statistical analysis.Using the mean,standard deviation,frequency,percentage,median and quartile to describe the socio-demographic characteristics,menopausal symptoms,medical seeking intention of perimenopausal and postmenopausal women and seven dimensions of the integrated model;Nonparametric test and multiple linear regression were conducted to compare and analyze the medical seeking intention,socio-demographic variables and menopausal symptoms of perimenopausal and postmenopausal women;Spearman correlation analysis was applied to explore the correlation between the medical seeking intention of perimenopausal and postmenopausal women and the scores of each dimension of the integrated model;Applying path analysis to explore the psychosocial factors of the medical seeking intention of perimenopausal and postmenopausal women based on the integrated model.Results:1.The prevalence of chronic diseases in perimenopausal and postmenopausal women was 50.3%,and the three most common chronic diseases included cardiovascular and cerebrovascular diseases(13.3%),bone and joint diseases(12.3%)and endocrine diseases(12.1%).2.The respondents' average age of natural menopause was(48.81±3.27)years.The incidence of menopausal symptoms was 89.7%,mostly with mild to moderate symptoms(68.4%).According to the incidence classification,the top three symptoms were physical and mental fatigue(83.3%),sleep disturbance(70.3%)and hot flashes(68.5%).According to the severity classification,the top three symptoms were physical and mental fatigue(mean: 1.47),sleep disorders(mean: 1.22)and joint and muscle discomfort(mean: 1.17).3.The total score of the respondents' medical seeking intention was 11(8,14),and less than 40% of the participants expressed their intention to seek medical services.In addition,perimenopausal and postmenopausal women had higher cognitive levels of perceived susceptibility(6.46±2.06),perceived severity(3.46±0.99)to menopause-related symptoms or diseases and medical seeking benefits in this period(7.58±1.88),as well as higher levels of medical seeking disorders(13.29±3.99).The attitude towards seeking medical treatment(7.36±1.74)was positive,the level of family support(21.64±4.50)was high,and the score of self-efficacy(26.29±5.68)was above the meddle level.4.Non-parametric test showed that there were statistically significant differences between the medical seeking intention of perimenopausal and postmenopausal women and economic status,previous chronic medical history,current chronic diseases,smoking,physical exercise,the demand for climacteric related knowledge and medical personnel guidance(P < 0.05).The results of multiple linear regression suggested that smoking(?=-0.082,P=0.047),physical exercise(?=0.221,P<0.001),the demand for medical personnel guidance(?=-0.209,P=0.048)and menopausal symptoms(?=0.296,P<0.001)entered the regression equation and had certain explanatory power for their intention to seek medical help.5.Spearman correlation analysis showed that perceived susceptibility(?= 0.293,P < 0.01),perceived severity(?= 0.489,P < 0.01),medical seeking benefits(?= 0.443,P < 0.01),medical seeking attitude(?= 0.529,P < 0.01),family support(?= 0.194,P < 0.01)and self-efficacy(?= 0.132,P < 0.01)were positively correlated with medical seeking intention,and medical seeking barriers(?=-0.059,P = 0.046)was negatively correlated with medical seeking intention.6.According to the results of path analysis,perceived susceptibility(?=0.132,P=0.007)and medical seeking attitude(?=0.347,P<0.001)could directly predict the intention to seek medical help.Perceived susceptibility(indirect effect: 0.044),perceived severity(indirect effect: 0.288)and medical seeking benefit(indirect effect: 0.175)indirectly promoted the medical seeking intention through medical seeking attitude.Meanwhile,as a mediating variable,medical seeking benefit was able to adjust the predictive power of perceived susceptibility(indirect effect: 0.181)and perceived severity(indirect effect: 0.218)on the attitude towards medical-seeking.The integrated model could explain 28% variation in the medical seeking intention of perimenopausal and postmenopausal women.Conclusion:1.The health status of perimenopausal and postmenopausal women is poor,and the occurrence of menopausal symptoms is relatively common.Therefore,health care personnel should take intervention measures according to individual conditions to improve their physical and mental health during this period.2.The medical seeking intention of perimenopausal and postmenopausal women is generally low,which needs to attract the attention of medical personnel,timely formulate and adopt intervention strategies to improve the medical seeking intention of this population and improve the status of medical treatment.3.Lifestyle,medical personnel's guidance needs and the severity of menopausal symptoms are the main biological and social factors for women's medical seeking intention during and after perimenopausal period.Therefore,medical personnel can formulate comprehensive intervention measures according to those factors to improve the medical seeking intention of perimenopausal and postmenopausal women,so as to improve their medical treatment status.4.The integrated model performed a better explanation about psychosocial factors in medical seeking intention among perimenopausal and postmenopausal women,and perceived susceptibility as well as medical seeking attitude can directly predict women's active medical seeking intention,meanwhile perceived susceptibility,perceived severity and medical seeking benefit can indirectly promote their intention to seek medical help through medical seeking attitude,prompting that medical personnel and perimenopausal and postmenopausal women should pay attention to the forecast factors,to strengthen their medical seeking intention,promote women's physical and mental health in the special period of life as well as improve quality of life.