北京市朝阳区糖尿病患者糖尿病管理APP使用现状及影响因素研究

Study on the use status and influencing factors of diabetes management APP for type 2 diabetes mellitus patients in Beijing Chaoyang district

目的了解北京市朝阳区糖尿病患者糖尿病管理APP知晓情况及使用现状,分析其影响因素,为糖尿病管理APP技术开发及推广使用提供依据。方法于2017年11月至2018年1月,在北京市朝阳区2个城市社区和2个农村社区中采用单纯随机抽样方法抽取610名2型糖尿病患者,通过面对面问卷调查收集调查对象的一般情况、糖尿病管理APP知晓情况、知晓途径、使用情况,分析糖尿病管理APP不同使用情况的原因。采用SPSS19.0软件进行χ^2检验,糖尿病管理APP知晓及使用的影响因素采用多因素logistic回归进行分析。结果共608名2型糖尿病患者纳入研究,糖尿病管理APP知晓率为8.2%,知晓率随糖尿病患者的年龄增加而降低,城镇高于农村,商业服务人员高于其他职业人群,高中及以上人群高于初中及以下人群,未婚或离婚或丧偶者高于已婚者,差异均有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,18~44岁年龄组糖尿病管理APP知晓情况是60岁及以上年龄组3.106倍(OR=3.106,95%CI:1.059~9.109)。糖尿病管理APP的使用率为2.1%,城镇高于农村,商业服务人员高于其他职业人群,高中及以上人群高于初中及以下人群,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,从事商业服务的患者糖尿病管理APP使用情况是从事其他劳动者的15.645倍(OR=15.645,95%CI:1.737~137.664)。糖尿病管理APP知晓途径占比从高到低依次为网络或电视、朋友或亲人、医护人员、报纸或杂志及其他,分别占47.8%、43.5%、39.1%、26.1%和4.3%。在知晓糖尿病管理APP的患者中,不使用者、使用者分别占74.0%(37/50)、26.0%(13/50)。13例使用者中8例中途放弃使用(61.5%)。糖尿病管理APP不使用的原因主要为“感觉没有用处”,占54.1%(20/37);使用的原因主要为“能提供糖尿病疾病相关知识”、“能记录血糖值”和“能提供饮食指导”,分别占53.8%(7/13)、53.8%(7/13)和46.2%(6/13);中途放弃使用的主要原因为“咨询需要付费”,占50.0%(4/8)。结论北京市朝阳区2型糖尿病患者糖尿病管理APP的知晓率及使用率均较低,将糖尿病管理APP用于患者自我管理需加强宣传教育,尤其是对中老年患者的宣传教育。

Objective To understand the situation of the diabetes patients using diabetes management APP and its influencing factors,and to provide the basis for developing and popularizing diabetes management APP technology in the future. Methods From November 2017 to January 2018,610 type 2 diabetes mellitus(T2 DM) patients were randomly selected from 2 urban and 2 rural communities in Beijing Chaoyang district as the subjects. The investigation was performed by face to face questionnaire to collect the information about general condition,the diabetes management APP awareness,awareness way and usage. The different use reasons of diabetes management APP was analyzed. The χ^2 test was used to analyze the data. Multiple factors logistic regression analysis was used to analyze the influencing factors of awareness and usage of diabetes management APP. The used software was SPSS 19.0. Results There were 608 subjects in this study,the awareness rate of diabetes management APP was 8.2%,and decreased with age. The awareness rates in urban subjects,commercial service personnel,subjects with high education level(≥high school) and unmarried,divorced or widowed subjects were significantly higher than those in rural subjects,other occupational subjects,subjects with lower education level,married subjects,respectively,P <0.05,P <0.01. Multivariate logistic regression analysis showed that the awareness rate of diabetes management APP in the 18-44 years old group was 3.106 times of that in ≥ 60 years old group(OR =3.106,95% CI:1.059-9.109). The usage rate of diabetes management APP was 2.1%,the usage rates of diabetes management APP in urban subjects,commercial service personnel,subjects with high education level(≥ high school)were significantly higher than those in rural subjects,other occupational subjects,subjects with lower education level,respectively,P <0.05. Also the multivariate logistic regression analysis showed that the use rate of diabetes management APP in commercial service subjects was 15.645 times of that in other workers(OR =15.645,95% CI:1.737-137.664). The order of awareness way proportions of diabetes management APP was the internet or TV,friends or relatives,medical personnel,newspapers or magazines and others,which were 47.8%,43.5%,39.1%,26.1% and 4.3%,respectively. Among subjects with awareness of diabetes management APP,the proportions of non-users and users were 74.0%(37/50) and 26.0%(13/50),respectively. Among the 13 users,8 gave up the use(61.5%). The main reason for not using the diabetes management APP was "feeling useless"(54.1%,20/37).The main reasons for use were "to provide knowledge related to diabetes disease", "to record blood glucose" and "to provide dietary guidance",which were 53.8%(7/13),53.8%(7/13) and 46.2%(6/13),respectively. The main reason for giving up halfway was "consultation requires payment",which was 50.0%(4/8). Conclusion The rates of awareness and utilization of diabetes management APP were both lower in diabetes patients of Beijing Chaoyang district. It is necessary to strengthen publicity and education to improve the application of diabetes management APP in patients’ self-management,especially for elderly patients.