高血压、糖尿病照护级联效应促进与阻碍因素的定性研究

Influencing factors of hypertension and diabetes care cascade:a qualitative study

目的运用定性研究方法,基于级联照护模型对不同利益相关者进行访谈,了解高血压、糖尿病照护中各阶段的促进与阻碍因素。方法于2023年7月,选取河南省巩义市、舞钢市和山东省潍坊市临朐县,通过目的性抽样招募符合研究纳入条件的政策制定者、医疗机构管理者、卫生服务提供者以及高血压和糖尿病患者进行个人深度访谈。结合归纳法与演绎法对访谈资料进行主题分析。结果本研究共访谈82名,年龄为(53.8±12.0)岁,男性48名(58.5%);其中政策制定者、机构管理者、卫生服务提供者、高血压和糖尿病患者分别5、10、20和47名;在高血压和糖尿病意识、筛查、诊断、治疗、长期管理与控制各阶段都存在患者、医疗服务提供者和系统层面的阻碍和促进因素。结论本研究揭示并分析了高血压、糖尿病照护中各阶段的阻碍与促进因素,为制定有效、可行和可持续的实施路径奠定了基础。

Objective Employing the cascade care model,this qualitative study explores determinants influencing the cascading care stages of hypertension and diabetes by interviewing various stakeholders.Methods In July 2023,purposive sampling was employed to recruit participants from Gongyi and Wugang cities in Henan Province,and Linqu County in Weifang City,Shandong Province.Semi-structured in-depth interviews were conducted with representatives of policymakers,healthcare institution managers,providers,and patients with hypertension and diabetes.And thematic analysis was performed using both inductive and deductive approaches.Results A total of 82 individuals were interviewed,with an age range of(53.8±12.0)years,among which 48(58.5%)were male;including 5 policymakers,10 institutional managers,20 healthcare providers,and 47 patients with hypertension and diabetes.The study identified both barriers and facilitating factors at the patient,healthcare provider,and system levels across various stages:awareness,screening,diagnosis,treatment,long-term management,and control of hypertension and diabetes.Conclusion By delineating and analyzing the barriers and facilitators at each stage of hypertension and diabetes care,this study lays the groundwork for the development of effective,feasible,and sustainable implementation pathways,with significant implications for the enhanced management of hypertension and diabetes in China.