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韩开益, 姚静静, 王海鹏, 孙强. 山东省农村糖尿病管理现状定性研究[J]. 中国公共卫生, 2017, 33(10): 1493-1497. DOI: 10.11847/zgggws2017-33-10-19
引用本文: 韩开益, 姚静静, 王海鹏, 孙强. 山东省农村糖尿病管理现状定性研究[J]. 中国公共卫生, 2017, 33(10): 1493-1497. DOI: 10.11847/zgggws2017-33-10-19
HAN Kai-yi, YAO Jing-jing, WANG Hai-peng.et al, . Diabetes management in rural areas of Shandong province:a qualitative analysis[J]. Chinese Journal of Public Health, 2017, 33(10): 1493-1497. DOI: 10.11847/zgggws2017-33-10-19
Citation: HAN Kai-yi, YAO Jing-jing, WANG Hai-peng.et al, . Diabetes management in rural areas of Shandong province:a qualitative analysis[J]. Chinese Journal of Public Health, 2017, 33(10): 1493-1497. DOI: 10.11847/zgggws2017-33-10-19

山东省农村糖尿病管理现状定性研究

Diabetes management in rural areas of Shandong province:a qualitative analysis

  • 摘要: 目的 了解山东省农村糖尿病管理现状及其与规范要求的差距,并探讨阻碍相关人群利用基本卫生服务的原因,为制定相应的政策提供参考依据。方法 根据《国家基本公共卫生服务规范2011年版》制定半结构化问卷,采用关键人物访谈法于2016年7月在山东省梁山县、平阴县和莒南县7个乡镇对当地县级疾病预防控制中心、乡镇卫生院、村卫生室整群抽取的24名相关工作人员以及方便抽取的56例糖尿病患者、糖尿病高危人群进行访谈。结果 定性研究结果显示,山东省农村糖尿病管理现状与国家基本公共卫生服务规范要求相比还存在一定差距,主要表现:(1)多数患者并未接受过相关健康教育;(2)部分地区患者未接受每季度的免费空腹血糖监测;(3)流动人口中的糖尿病患者无法接受相关服务;(4)患者缺乏明确转诊路径,转诊程序欠缺相应的制度性支持等。影响差距的主要因素包括:(1)乡镇层面开展健康教育的方式过于被动;(2)部分村民文化程度较低;(3)基本公共卫生服务项目人均经费较低等。结论 农村糖尿病相关基本公共卫生服务提供仍需改善,相关部门应通过更加主动、具有输出力度的健康教育方式以及将外来流动人口糖尿病患者纳入本地基本公共卫生服务慢性病患者健康管理服务等相关措施及政策来优化服务提供体系,满足广大农村糖尿病患者以及高危人群的需要。

     

    Abstract: Objective To examine the status quo of diabetes management and the gap between the current situation and standardized regulation among rural residents in Shandong province and to explore the factors hindering the utilization of basic health services among the population for providing references for formulating relevant policies.Methods We conducted key informant interviews among 24 health staff recruited with cluster sampling at county centers for disease control and prevention,township health care centers,and village clinics and 56 residents with diabetes or at a high risk of diabetes sampled conveniently in 7 towns of 3 counties in Shandong province in July 2016.A semi-structured questionnaire self-designed according to the “National Standard for Basic Public Health Service-2011” was used in the interviews.Results The results of qualitative analysis on collected information revealed that major gaps between the actual situation of diabetes management and requirements of national standard included:the majority of the patients had been not received health education; some patients did not take quarterly fasting blood glucose monitoring free of charge; migrant patients were unable to receive related health care service; and there were no clear referral pathways and appropriate institutional support for transfer treatment.The main factors contributed to those gaps were relevant health education programs being too passive at township level,relative low education level among some villagers,and low expenditure per capita on basic public health service.Conclusion Provision of basic public health services for diabetes in rural areas remains to be improved,and relevant departments should adopt more active and influential ways of health education and include migrant diabetic patients into local chronic diseases and health management service system to optimize the service system.

     

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