| Objective: Through understanding the health status,self-efficacy,family function and social support of patients with chronic diseases in Nanshan agricultural and pastoral areas,this study analyzed the current situation and influencing factors of nursing service demand and health service utilization of patients with chronic diseases,with a view to improving the quality of nursing service for patients with chronic diseases,improving the utilization of health services,and providing reference basis for improving the health outcomes of patients with chronic diseases.Methods:In this study,a multi-stage stratified cluster random sampling method was used.From January 2021 to February 2022,1320 chronic disease patients in Nanshan Agricultural and Pastoral Area who met the criteria for admission and discharge were selected for cross-sectional survey through the general data questionnaire,the health status questionnaire,the general self-efficacy scale,the family function index scale,the social support scale,the chronic disease patients’ nursing service demand questionnaire,and the health service utilization questionnaire.Maslow’s hierarchy of needs theory was applied to the demand for nursing services,and the utilization of health services was analyzed based on Anderson’s model.SPSS26.0 was used for statistical analysis,Chi-square test,t-test and multiple response analysis were used to analyze the current situation of nursing service demand and health service utilization and single factor analysis,multiple linear regression was used to analyze the multiple factors of nursing service demand,and logistic regression was used to analyze the influencing factors of health service utilization.Results:(1)The quality of life score of chronic disease patients in Nanshan Agricultural and Pastoral Area was 491.07 ± 131.16,general self-efficacy score was 24.68 ± 5.97,family function score was 7.73 ± 2.14,and social support score was 10.54 ± 1.53.(2)The first three items of nursing service demand for patients with chronic diseases in Nanshan Agricultural and Pastoral Area are: regular physical examination,rescue service in case of emergency,and chronic disease follow-up.The last three items of nursing service demand score are: home sickbed service,hospice care,and home care.(3)There were statistically significant differences between the number of chronic diseases and the preferred medical institutions,the satisfaction with local health services,the time spent by the nearest medical institutions,and the access to health knowledge(P<0.05).(4)The results of univariate analysis showed that marriage,self-rated health status,age,education background,living conditions,occupation,monthly income,number of chronic diseases and family function had an impact on the demand for nursing services,and the difference was statistically significant(P<0.005).Education level,living conditions,occupation,monthly income,payment method of medical expenses,self-rated health status and the number of chronic diseases have an impact on the utilization of health services,and the difference is statistically significant(P<0.05).(5)Multivariate analysis: The results of multiple stepwise regression analysis showed that marriage,self-evaluation of health status,age,living with children,living with others,technical staff,working in other jobs,monthly income,number of chronic diseases,and family function were the main factors affecting the nursing service needs of patients with chronic diseases in Nanshan agricultural and pastoral areas(P<0.05).By measuring the goodness of fit of the seven models built for the use of health services,it was found that demand factors had the greatest impact on the use of health services for patients with chronic diseases in Nanshan agricultural and pastoral areas,and the trend characteristics and enabling resources also had a certain impact.Logistic regression analysis showed that education background,residence status,occupation,monthly income,medical expense payment method and self-assessed health status affected the utilization of health services for chronic disease patients in Nanshan agricultural and pastoral areas of Xinjiang(P<0.05).Conclusion: The patients with chronic diseases in Nanshan agricultural and pastoral areas in Xinjiang have poor health conditions,high demand for nursing services and low utilization rate of health services.It is necessary to provide targeted disease prevention and health care,physical examination,health education and lectures in combination with the regional environment of the agricultural and pastoral areas and the special needs of the population,so as to improve the health awareness of patients and maintain the health of farmers and herdsmen. |
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