社区糖尿病患者足部护理行为现况及影响因素分析  

The analysis of foot care behaviors and influencing factors among diabetic patients in communities

作　　者：王君[1] 周正元[2] 张宁[2] 任世成[3] 朱慈华 吕红艳 周金意[5] 张庆军[3] 盛红艳[2] 王占国 牛静雅 王文绢[1] WANG Jun, ZHOU Zheng-yuan, ZHANG Ning, REN Shi-cheng, ZHU Ci-hua, LV Hong-yan, ZHOU Jin-yi, ZHANG Qing-jun, SHENG Hong-yan, WANG Zhan-guo, NIU Jing-ya, WANG Wen-juan(National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, Chin)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [2]常熟市疾病预防控制中心 [3]湖北省疾病预防控制中心 [4]武汉市江岸区疾病预防控制中心 [5]江苏省疾病预防控制中心

出　　处：《中国慢性病预防与控制》2018年第4期254-261,共8页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：世界糖尿病基金会项目

摘　　要：目的了解社区糖尿病患者足部护理行为现况及影响因素,为预防和控制糖尿病足的发生提供科学依据。方法于2015年8-9月,在常熟市和武汉市各随机抽取4个调查社区,各社区卫生服务机构从社区管理的糖尿病患者中随机抽取符合纳入标准的糖尿病患者进行一般资料、生活方式、糖尿病及相关慢性病史、糖尿病足防控知识、态度和行为等方面的面对面问卷调查。共调查2 528例糖尿病患者,计算足部护理行为正确率,并用非条件logistic回归模型分析足部护理行为的影响因素。结果调查对象足部护理各行为正确率差异较大,在8.23%~86.08%之间。每年到医院进行足部检查和每天自我检查足部的正确率仅为8.23%和30.15%,足部出现问题时的就医率为14.85%,每天洗脚后擦干双脚及脚趾、剪趾甲从不受伤及从不赤足的正确率均在60%以上。多因素分析显示,足部护理行为的影响因素各不相同。文化程度对10个足部护理行为都有影响,随着文化程度的升高,足部护理行为实施较好;每天自我检查足部、测水温、擦干双脚及脚趾、穿鞋前检查鞋内异物及从不赤足等行为,男性实施情况差于女性;病程<15年是不能坚持每天自我检查足部的危险因素(OR=1.554),病程<5年者每年到医院做足部检查的不正确率是病程≥15年者的2.614倍。结论社区糖尿病患者足部护理行为正确率较低,应特别关注男性、低年龄、低文化程度和新发糖尿病人群,强化糖尿病足预防知识和技能的健康教育。Objective To investigate the current status and influential factors of foot care behaviors among diabetic patients in communities and to provide evidence for prevention and control of diabetic foot development. Methods During August to September of 2015, the random sampling was used to select four communities from Changshu and Wuhan cities, respectively. The diabetes patients with inclusion criteria were selected randomly from community health service centers as the subjects. The investigation was performed with face-to-face questionnaires which included the general information, life style, the history of diabetes and related chronic diseases, and the knowledge, attitude and behavior on diabetic foot. The correct rate of foot self-care behavior for 2 528 cases was calculated, and the unconditional logistic regression model was applied to analyze the influential factors related to foot care behaviors. Results The correct rate range of foot care behaviors for subjects of different communities was 8.23% to 86.08% with significant difference.The correct rates of diabetic foot examination and daily self-examination were only 8.23% and 30.15%, respectively.The foot treatment rate was only 14.85% when foot problems appeared. The percentage of patients who had performed daily drying feet and toes, cutting toenails correctly and never barefoot was more than 60%. The multivariate analysis showed that there were more different influencing factors for foot care behaviors. The education level could influence 10 foot care behaviors, and the good foot care behaviors increased with education level. The foot care behaviors（such as the daily foot self-examination, measuring water temperature, drying feet and toes, checking the shoes before wearing and never barefoot） in females were better than those in males; The lower diabetes duration（〈15 years） was a risk factor for daily foot selfexamination（OR=1.554）.The incorrect rate of foot screening among diabetes patients with short duration（〈5 years） increased to 2.

关 键 词：糖尿病 足部护理 行为 影响因素 

分 类 号：R587.1[医药卫生—内分泌]