上海市社区糖尿病患者居家胰岛素规范化注射知信行现状及影响因素分析  

Status quo and influencing factors of knowledge,attitude and practice of standardized insulin injection at home in Shanghai community diabetic patients

作　　者：倪小英 路辉 许洁 高婷 刘宇馨 赵慧华[2] 梁玮 Ni Xiaoying;Lu Hui;Xu Jie;Gao Ting;Liu Yuxin;Zhao Huihua;Liang Wei(Nursing Department,Xidu Street Community Health Service Center,Fengxian District,Shanghai 201401,China;Office of Cancer Prevention and Treatment Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Nethersole School f Nursing,the Chinese University of Hong Kong,Hong Kong 999017,China)

机构地区：[1]上海市奉贤区西渡街道社区卫生服务中心护理部,上海201401 [2]复旦大学附属中山医院肿瘤防治中心办公室,上海200032 [3]香港中文大学那打素护理学院,中国香港999077

出　　处：《中华现代护理杂志》2022年第29期4046-4051,共6页Chinese Journal of Modern Nursing

基　　金：2020年度上海市卫生健康委员会卫生行业临床研究专项面上项目(202040103);2018年度上海市奉贤区科委(社会类)科技发展基金项目(奉科20181921)。

摘　　要：目的:调查上海市社区糖尿病患者居家胰岛素规范化注射知信行现状,并分析其影响因素。方法:本研究为横断面研究。采用连续入组法,选取2020年5—10月在上海市奉贤区21家社区卫生服务中心签约管理的1947例使用胰岛素笔居家注射的糖尿病患者为研究对象。采用一般资料调查表和胰岛素规范注射知信行问卷对糖尿病患者进行调查。采用单因素分析和多重线性回归分析患者居家胰岛素规范化注射知信行的影响因素。共发放问卷1947份,回收有效问卷1697例,有效回收率为87.2%(1697/1947)。结果:1697例糖尿病患者的胰岛素规范注射知信行总分为(51.01±6.81)分,处于中等水平。问卷所有条目中达标率最低的3个条目分别为:注射胰岛素前每次检查注射部位(14.4%)、认同并执行把丢弃的胰岛素针头放入加盖的硬壳容器(16.1%)和认同并执行胰岛素笔用针头一用一换(20.6%)。多重线性回归分析发现,年龄、学历、医保类型、是否接受过胰岛素注射指导是居家胰岛素规范化注射知信行的影响因素(P<0.01),共解释胰岛素规范化注射知信行总变异的8.6%。结论:社区医务人员应重视糖尿病患者居家胰岛素注射的健康教育,基于社区人群特点,完善教育内容与形式,从而提高注射部位检查、胰岛素笔用针头一用一换和规范处置废弃针头的达标率,进一步规范胰岛素注射行为,改善患者血糖控制等临床结局。Objective To investigate the status quo of the knowledge,attitude and practice(KAP)of standardized insulin injection at home in Shanghai community diabetic patients and analyze its influencing factors.Methods In this cross-sectional study,totally 1947 diabetic patients who signed to be managed by 21 community health service centers in Fengxian District,Shanghai from May to October 2020 who used insulin pen injections at home were selected by continuous enrolment.They were investigated with a general information questionnaire and a questionnaire on KAP of standardized insulin injection.Univariate analysis and multiple linear regression were used to analyze the influencing factors of patients'KAP of standardized insulin injection at home.A total of 1947 questionnaires were distributed,and 1697 valid questionnaires were recovered,with an effective recovery rate of 87.2%.Results The total KAP score of insulin standard injection in the 1697 diabetic patients was(51.01±6.81),which was at a moderate level.Among all the items in the questionnaire,the 3 items with the lowest compliance rate were:checking the injection site every time before insulin injection(14.4%),agreeing to put the discarded insulin needles into the capped hard-shell container(16.1%),agreeing to and implementing insulin pen needle replacement after each use(20.6%).Multiple linear regression analysis showed that age,education,type of medical insurance,and whether they had received insulin injection guidance were the influencing factors to the KAP of standardized insulin injection at home(P<0.01),which accounted for 8.6%of the total variation.Conclusions Community medical staff should pay attention to the health education of insulin injection at home for diabetic patients,improve the content and form of education based on the characteristics of the community population,thereby improving the compliance rate of injection site inspection,replacement of insulin pen needles and standardized disposal of discarded needles,further standardizing insulin injectio

关 键 词：糖尿病 社区卫生服务 胰岛素注射 知信行 影响因素 

分 类 号：R473.2[医药卫生—护理学]