Current status and influencing factors of patient delay in patients with advanced hepatocellular carcinoma / 中国实用护理杂志

ABSTRACT

Objective To investigate current status and influencing factors of patient delay in patients with advanced hepatocellular carcinoma and provide a theoretical evidence for the early diagnosis of HCC. Methods All patients with a primary diagnosis of advanced HCC admitted at Department of Hepatobiliary Medicine I, Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2015 to October 2015 were investigated prospectively. The current status of patient delay was assessed by medical records and influencing factors of patient delay were analyzed by the self-designed questionnaires. Results Rate of patient delay in the patients with advanced HCC was 27.7%(53/191). The univariate analysis demonstrated that significant influencing factors for patient delay included age, education levels, economic status, place of residence, medical insurance, knowledge about follow-up examination for chronic viral hepatitis. The rate of patient delay was high in these patients with older age, lower income, less education, place of residence (countryside or small towns), new rural insurance, lack of the knowledge about follow-up examination for chronic viral hepatitis. Multivariate analysis showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR (odd ratio) and 95%CI (confidence interval) were 2.770 and 1.424-5.388, 7.867 and 1.669-37.092, respectively. According to place of residence, the univariate analysis demonstrated that significant influencing factors for patient delay included marital status, age, economic status, and knowledge about follow-up examination for chronic viral hepatitis in the countryside or small towns. Multivariate analysis also further showed that age and lack of the knowledge about follow-up examination for chronic viral hepatitis were significantly independent predictors for patient delay. Their OR and 95% CI were 3.812 and 1.550-9.373, 15.400 and 1.793-132.245, respectively. Patient delay of HCC patients in county seat and city was not significantly associated with all of above mentioned influencing factors. Conclusions Patient delay of the patients with advanced HCC in countryside or small towns was comparatively common. To early find high risk factors of HCC, government should be intensified screening to chronic hepatitis B, hepatitis C in the middle and elderly population. To reduce the rate of patient delay in advanced HCC and improve results of treatment for advanced HCC, health care workers should popularize medicine-associated knowledge, especially about chronic hepatitis and its complications.