基层医生和糖尿病患者掌握糖尿病知识程度调查及改进糖尿病防治现况初探  

Survey on the knowledge of primary hospital doctors and diabetes patients on diabetes and exploration on the improvement of diabetes prevention and treatment

作　　者：黎瑶[1] 邱平[1] 兰天[1] 唐明薇[1] 梅希[1] 

机构地区：[1]成都医学院第一附属医院内分泌科,成都610500

出　　处：《华西医学》2017年第3期387-391,共5页West China Medical Journal

基　　金：四川省卫生厅科研课题(120484)

摘　　要：目的调查基层医生及糖尿病患者掌握糖尿病知识的现状,探索提高基层糖尿病患者防治能力的方法。方法 2013年1月—2014年6月成都市新都区辖区内的15家乡镇卫生院及2家社区卫生服务中心内科医生及全科医师共328人,其中慢病管理人员43人;村卫生室医生共152人。其辖区内糖尿病患者共575例。设置医生问卷,对乡镇卫生院/社区卫生服务中心及村卫生室医生进行调查;设置患者问卷,调查2型糖尿病患者对糖尿病知识的了解情况及血糖控制情况。根据调查结果对基层医生进行规范化培训。结果发放乡镇医生问卷328份,回收有效问卷319份,有效问卷回收率为97.3%;发放乡村医生问卷152份,回收有效问卷149份,有效问卷回收率为98.0%;发放糖尿病患者问卷575份,回收有效问卷539份,有效问卷回收率为93.7%。基层医院药品品种不齐。乡镇医生本科学历占7.8%,大专学历占53.6%,中专学历占38.6%;乡村医生大多未受医学专业教育,其中89.9%取得乡村医师资格证,10.1%取得助理医师资格证;基层医生糖尿病知识问卷调查得分低,其中慢病管理人员得分相对较高(P<0.05)。糖尿病患者整体医疗投入不足,治疗率低,就医频次低,缺乏糖尿病常识,糖化血红蛋白控制达标仅13.5%。结论基层糖尿病患者病情控制现状不佳,可能与基层医生宣教不足有关。对各级基层医生开展糖尿病培训是必要的。提倡由慢病管理人员对基层的糖尿病患者进行规范诊治,但有待接受系统、长期的培训。Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher （P〈0.05）. For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated

关 键 词：糖尿病 基层医生 问卷调查 培训 

分 类 号：R587.1[医药卫生—内分泌]