摘要： 背景 近年來我國雖然重視中醫(yī)藥發(fā)展，但在學(xué)術(shù)研究領(lǐng)域缺少縱向視角下基于全國樣本的中國居民對中西醫(yī)態(tài)度行為的比較研究。目的 對比分析2011年和2021年中國居民對中醫(yī)的態(tài)度與行為及其影響因素，為改善居民對中醫(yī)藥態(tài)度和行為，促進中醫(yī)藥優(yōu)質(zhì)服務(wù)體系建設(shè)提供實證依據(jù)。方法 利用2011年和2021年中國綜合社會調(diào)查（CGSS）數(shù)據(jù)，篩選出2011年和2021年有效回答居民中醫(yī)態(tài)度與行為相關(guān)問題的樣本共4 326份，其中2011年和2021年樣本分別為2 879人和1 447人。從人口特征、社會環(huán)境和醫(yī)療服務(wù)3個維度分析影響居民中醫(yī)藥態(tài)度與行為的因素。采用多因素多分類Logistic回歸模型對居民中醫(yī)態(tài)度與行為的影響因素進行分析。結(jié)果 在對中醫(yī)的態(tài)度方面，2011年認(rèn)同"中醫(yī)更有效"的人群占比最高（34.5%，994/2 879）；而2021年，對該觀點持中立態(tài)度的人群占比最高（44.8%，649/1 447）。相比于2011年，2021年對"中醫(yī)更有效"說法持中立態(tài)度的人群占比明顯上升，同時認(rèn)同和反對該觀點的人群占比均有所下降。從就診頻率來看，2011年和2021年居民中醫(yī)和西醫(yī)的就診頻率均有所降低，"有時看中醫(yī)"降幅7.3%，"有時看西醫(yī)"降幅16.1%；"經(jīng)常看中醫(yī)"降幅8.9%，"經(jīng)?？次麽t(yī)"降幅18.8%。多因素多分類Logistic回歸分析結(jié)果顯示：以不認(rèn)同"中醫(yī)更有效"為參照，年份、受教育程度、地區(qū)、近期就醫(yī)滿意度、醫(yī)療衛(wèi)生系統(tǒng)滿意度是居民認(rèn)同"中醫(yī)更有效"的影響因素（P<0.05）；年份、地區(qū)是居民對"中醫(yī)更有效"持中立態(tài)度的影響因素（P<0.05）。以從不就診中醫(yī)為參照，性別、戶籍、年齡、地區(qū)、是否患慢性病或殘疾、自評健康狀況、近期就醫(yī)滿意度是居民經(jīng)常就診中醫(yī)行為的影響因素（P<0.05）；年份、年齡、是否患慢性病或殘疾、自評健康狀況、社交頻率、優(yōu)質(zhì)醫(yī)療可及性是居民有時就診中醫(yī)行為的影響因素（P<0.05）。結(jié)論 2011年和2021年我國居民對中醫(yī)認(rèn)可度略有變化，中西醫(yī)就診頻率差距減小。居民對中醫(yī)的態(tài)度和行為存在地區(qū)差異，中部地區(qū)的居民中醫(yī)認(rèn)同度更高，但中醫(yī)就診頻率相對較低；受教育程度低的居民更認(rèn)同中醫(yī)比西醫(yī)有效，老年、城市、患慢性病或殘疾的居民中醫(yī)就診頻率更高，近期就醫(yī)滿意度是居民對中醫(yī)的態(tài)度與就診行為的主要影響因素。

關(guān)鍵詞: 中醫(yī)藥, 態(tài)度, 行為, 影響因素

Abstract:

Background

In recent years, China has emphasized the development of traditional Chinese medicine (TCM), yet there is a lack of longitudinal comparative studies on Chinese residents' attitudes and behaviors towards TCM and Western medicine based on national samples in the academic research field.

Objective

To comparatively analyze Chinese residents' attitudes and behaviors towards TCM and their influencing factors in 2011 and 2021, provide empirical evidence for improving residents' attitudes and behaviors towards TCM and promoting the construction of a quality TCM service system.

Methods

A total of 4 326 samples that effectively answered questions related to residents' attitudes and behaviors toward TCM in 2011 and 2021 were screened using data from the 2011 and 2021 Chinese General Social Surveys (CGSS), of which the samples in 2011 and 2021 were 2 879 and 1 447, respectively. Factors affecting residents' attitudes and behaviors toward TCM were analyzed from three dimensions: demographic characteristics, social environment and medical services. A multifactor multicategorical Logistic regression model was used for the analysis of factors influencing residents' attitudes and behaviors toward TCM.

Results

In terms of attitudes toward TCM, the proportion of people who agreed that "TCM is more effective" was the highest in 2011 (34.5%, 994/2 879), and the proportion of people who held a neutral attitude toward this view was the highest in 2021 (44.8%, 649/1 447). Compared with 2011, the proportion of people with a neutral attitude towards the statement that "Chinese medicine is more effective" increased significantly in 2021, while the proportion of people agreeing and disagreeing with the statement decreased. In terms of the frequency of consultation, the frequency of consultation for both TCM and Western medicine decreased between 2011 and 2021, with "sometimes consulting TCM practitioners" decreased by 7.3% and "sometimes consulting Western medicine practitioners" decreased by 16.1%, and "often consulting TCM practitioners" decreased by 8.9%, "Frequently consulting Western medicine practitioners" decreased by 18.8%. The results of the multifactorial multicategory Logistic regression analysis showed that: with the reference of not agreeing that "Chinese medicine is more effective", year, education level, region, satisfaction with recent medical treatment, and satisfaction with the health care system were the factors influencing residents' agreement with "Chinese medicine is more effective" (P<0.05) ; the year and region were the factors influencing residents' neutral attitude towards "Chinese medicine is more effective" (P<0.05). Year, education level, region, satisfaction with recent medical treatment, and satisfaction with the health care system were the factors influencing residents' agreement with "Chinese medicine is more effective" (P<0.05) ; Year and region were the factors influencing residents' neutral attitude towards "Chinese medicine is more effective" (P<0.05). Taking "never consulting TCM" as a reference, gender, household registration, age, region, whether suffering from chronic diseases or disabilities, self-assessed health status, and satisfaction with recent medical treatment were the factors influencing residents' frequent consulting of TCM (P<0.05) ; year, age, whether suffering from chronic diseases or disabilities, self-assessed health status, frequency of socialization, and accessibility to high-quality medical treatment were the factors influencing residents' sometimes consulting of TCM (P<0.05) .

Conclusion

The recognition of Chinese medicine by Chinese residents changed slightly between 2011 and 2021, and the gap between the frequency of Chinese and Western medicine visits decreased. There are regional differences in residents' attitudes and behaviors toward TCM; residents in the central region have a higher recognition of TCM but a relatively lower frequency of TCM visits; residents with lower education levels agree that TCM is more effective than Western medicine; residents who are elderly, urban, and suffer from chronic illnesses or disabilities have a higher frequency of TCM visits; and recent satisfaction with medical care is the main influencing factor on residents' attitudes toward TCM and their visiting behaviors.

Key words: Traditional Chinese medicine, Attitude, Behavior, Influencing factors

中圖分類號: 

R 2

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