社区医务人员对糖尿病患者足病风险筛查行为现状及影响因素分析

Analysis on the status and influencing factors of foot risk screening behavior of community health personnel in diabetic patients

目的调查社区医务人员对糖尿病患者足病风险筛查行为现状并分析其影响因素。方法采用便利抽样法,于2021年4月12至20日选取长沙市辖区内具备简易糖尿病足筛查工具的全部社区卫生服务中心(站)共78家,将符合纳入标准的医务人员列为研究对象。采用问卷星进行线上横断面调查,了解研究对象的一般资料、足病风险筛查行为现状及其影响因素。组间比较采用独立样本t检验或单因素方差分析,采用多元线性回归法分析糖尿病患者足病风险筛查行为的影响因素。结果本研究最终实际调查社区医务人员1954名,共发放问卷1954份,回收有效问卷1910份,有效回收率为97.75%。社区医务人员对糖尿病患者足病风险筛查行为得分为(54.67±11.86)分(满分为100分),67.07%(1281/1910)的社区医务人员总是或经常对患者进行足病风险筛查。多元线性回归分析结果显示,社区医务人员对糖尿病患者足病风险筛查行为的影响因素为筛查认知程度、筛查态度、文化程度、参与培训、工作岗位、收费未纳入医保、患者配合度(β=-1.870、1.341、-1.644、1.884、4.303、3.430、0.216、0.941,均P<0.05)。结论社区医务人员对糖尿病患者足病风险筛查现状较差,相关筛查认知程度、筛查态度、培训力度、医疗保障、患者配合度等还有待进一步提高。

Objective To investigate the current situation of foot risk screening of diabetic patients by community medical staffs and analyze its influencing factors.Methods The convenience sampling method was used,and a total of 78 community health service centers(stations)were selected to be included in the investigation from April 12 to 20,2021,with at least simple diabetic foot screening tools within the jurisdiction of Changsha city.And all medical staffs meeting the inclusion criteria were included as research objects.An online cross-sectional survey was conducted using a self-designed questionnaire via the WJX platform,the general information of the study participants,the status of foot disease risk screening behavior,and its influencing factors were collected and analyzed.Independent sample t test or one-way analysis of variance were used to analyze the general data and screening behavior,and multiple linear regression was used to analyze the influencing factors of foot disease risk screening behavior in diabetic patients.Results A total of 1954 questionnaires weredistributed,and 1910 were effectively received with effective recovery rates of 97.75%.The score of diabetes foot risk screening behaviors of community medical staff was(54.67±11.86)points(full score was 100 points),and 1281 patients(67.07%)always or often underwent foot risk screening.Multiple linear regression analysis showed that the influencing factors of community medical staff on foot disease risk screening behavior of diabetic patients were screening cognition degree,screening attitude,education level,participation in training,work position,charges not included in medical insurance,patient cooperation degree,hospital equipment(β=-1.870,1.341,-1.644,1.884,4.303,3.430,0.216,0.941,all P<0.05).Conclusions The current situation of diabetes foot screening among the community medical staff is poor,and the relevant screening awareness,attitude,training,medical security,and patient cooperation need to be further improved.