糖尿病自我管理教育干预和低资源环境中的自我管理;混合方法研究
Roberta Lamptey1,2,3, Mary Amoakoh-Coleman3,4, Babbel Djobalar5
1Polyclinic/ Family Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana.
PloS one
|July 14, 2023
概括
结构化糖尿病自我管理教育 (DSME) 在非洲很少. 虽然有限的知识与更好的自我护理行为有关,但受到了加纳的资源限制和耻辱的影响.
科学领域:
- 公共卫生 公共卫生
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 糖尿病自我管理对于护理结果至关重要,但结构化的糖尿病自我管理教育 (DSME) 在非洲环境中基本上是不可用的.
- 在非洲,缺乏资源的初级保健机构在提供全面的糖尿病护理方面面临重大挑战.
- 了解糖尿病自我管理知识和这些背景下的行为细微差别对于改善患者的治疗结果至关重要.
研究的目的:
- 在加纳阿克拉的两个城市低资源初级保健机构中描述现有的DSME干预措施.
- 在这些环境中探索糖尿病患者的糖尿病自我管理知识和行为.
- 在资源有限的环境中识别影响糖尿病自我管理的障碍和促进因素.
主要方法:
- 一个融合的并行混合方法研究于2021年1月至2月在加纳阿克拉进行.
- 从425个PLD采用调查收集了定量数据,多变量回归分析了自我管理知识和行为之间的关联.
- 通过与医疗保健专业人员和PLD进行深入采访,以及与PLD进行焦点小组讨论,收集了定性数据,并使用诱导性内容分析进行分析.
主要成果:
- 该研究包括425名PLD (70.1%的女性,平均年龄58岁,平均血糖9.4 mmol/l).
- 糖尿病自我管理知识得分的中位数为40%;增加的知识与改善的饮食,运动和葡萄糖监测行为有关.
- 自主管理的障碍包括财务限制,相互矛盾的健康信息,文化信仰和耻辱;DSME的干预是无结构的和资源有限的.
结论:
- 在研究的低资源环境中,DSME的干预措施是无结构的,资源不足的.
- 有限的糖尿病自我管理知识与自我管理行为积极相关.
- 针对文化而定制的DSME干预措施应对财务限制和耻辱,建议用于资源有限的环境,需要结构化计划.
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