社区医务人员提供糖尿病自我管理支持的现况调查研究  

Status of Diabetes Self-management Supports to Patients Provided by Community Medical Professionals

作　　者：刘薇薇[1] 王媛媛[1] 高妍[2] 陈君逸[2] 

机构地区：[1]北京大学第三医院第二门诊部,北京市100191 [2]北京大学医学部

出　　处：《中国全科医学》2013年第13期1533-1535,共3页Chinese General Practice

基　　金：国家自然科学基金资助项目(81150001)

摘　　要：目的了解北京社区医务人员提供糖尿病自我管理支持的现状。方法采取定量和定性相结合的方法,在北京3个社区(街道)对240名糖尿病患者进行问卷调查,另对其中18名糖尿病患者和8名社区医务人员进行个人深入访谈。结果 14人(5.8%)表示从未接受过任何饮食建议。27人(11.3%)表示从未接受过任何运动建议。29人(12.1%)表示从未接受过任何血糖监测建议。13人(5.4%)表示从未接受过任何药物治疗建议。70人(29.2%)表示从未接受过任何足部护理建议。在被问及最近一次就医过程中社区医务人员是否询问过吸烟情况时,128人(53.3%)表示询问过,112人(46.7%)表示未询问过。不同糖化血红蛋白水平患者接受来自社区医务人员提供的自我管理建议条数间差异有统计学意义(F=10.407,P<0.001)。结论社区医务人员在针对糖尿病患者的自我管理教育方面,药物治疗和饮食控制教育做得较好,运动和血糖监测次之,而控烟和足部护理较差。影响糖尿病患者自我管理行为依从性的因素除了社区医务人员针对糖尿病患者的教育行为之外,还涉及社区医务人员提供建议的个性化及可行性、针对患者的定期随访管理行为、医患之间的沟通质量和信任程度、患者对糖尿病的认知和控制疾病的信念以及经济和时间负担等方面。Objective To assess the status of diabetes self - management supports to the patients provided by commu- nity medical professionals in Beijing. Methods The combined quantitative and qualitative method was taken to conduct question- naire survey among 240 patients with diabetes meUitus from three communities of Beijing, and 18 patients of the 240 were in depth interviewed by 8 community medical professionals. Results There were 14 patients （5.8%） who said never reception of any diet suggestion, 27 （ 11.3% ） who said never reception of any exercise suggestion, 29 （ 12. 1% ） who said never reception of any blood monitoring suggestion, 13 （5.4%） who said never reception of any medication suggestion, 70 （29.2%） who said never reception of any foot -care suggestion. There were 128 patients （53.3%） who said that the medical professional had in- quired the smoking condition in their latest visits, but 112 （46. 7% ） who said no. The difference in numbers of suggestion on self - management to patients with different levels of glycosylated hemoglobin provided by the medical professional revealed a sta- tistically significance （F = 10. 407, P 〈 0. 001 ）. Conclusion In education on diabetic self - management it is better in medi- cation and diet control, next in exercise and blood - sugar monitoring, and bad in smoking control and foot care. The factors im- pacting the diabetic compliance of self - management, besides the education, involve the personality and feasibility of the sugges- tions and regular follow - up provided by community medical professionals, quality of the communication and degree of trust be- tween patients and doctors, patients＇ cognition of diabetes, confidence in control of the illness, and burdens of economy and tine.

关 键 词：社区卫生服务 糖尿病 自我管理支持 

分 类 号：R197[医药卫生—卫生事业管理] R587.1[医药卫生—公共卫生与预防医学]