糖尿病门诊患者网络续药需求意愿及其影响因素研究

发布时间：2018-06-30 09:45

  本文选题：糖尿病患者 + 门诊　； 参考：《天津医科大学》2016年硕士论文

【摘要】：目的:调查分析糖尿病患者当前日常续药及复查现状,了解糖尿病患者网络续药的需求意愿及其影响因素,初步分析其实施可行性,进一步调查广大患者对网络续药的部分关注意向,为糖尿病的防治提供参考依据。方法:采用自行设计的问卷于2014年11~12月对天津医科大学代谢病医院门诊320名糖尿病单纯取药患者进行随机问卷调查,最终收回有效问卷304份,分析患者目前的取药、检查现况、对网络续药的需求意愿及其实施可行性。结果:对自行设计的问卷中内部同质性较高的适合做信度分析的部分分析得其整体分半信度(Split-half系数)为0.785,克朗巴赫α系数为0.872,问卷可信度比较理想,效度检验中对所有条目进行因子分析,最终得到13个公因子,其累计贡献率为71.17%。一般情况:被调查者中男性占到50.99%,女性占到49.01%,人群年龄中位数为60.97岁;文化程度主要集中在“初中”和“高中/中专”两类,分别占到调查总人数的29.28%、37.17%;家庭月人均收入2000-2999元的占到44.74%,3000-4999元的占到26.65%;其中2型糖尿病患者296人,占到被调查总数的97.37%,病程中位数为10年;在医院完成一次续药的总耗时中位数为2.60小时,四分位数为P25:2.03小时,P75:3.58小时。取药及检查现状:不到3周便得到医院续一次药的患者占到被调查者总数的74.30%,而被调查者中只有15.96%的糖尿病患者需要在半年内进行处方调整,有135人即44.41%的被调查者“续药需有人陪伴或代拿”,仍有30.88%被调查者表示有过断药现象;对于“药物用法用量”,80.59%的被调查者表示非常清楚,“用药注意事项”只有43.09%的人非常清楚,而对于“推荐的检查间隔时间”表示非常清楚的只有2.00%;而且糖尿病患者日常续药、复查分别有86.20%、85.90%的人选择“三级/专科医院”。糖尿病门诊患者对网络续药需求意愿及影响因素分析:“非常期待”、“期待”网络续药服务开展组的被调查者分别有174人、103人,共占被调查总数的91.12%,“没兴趣”、“不怎么感兴趣”或“一般”期待网络续药服务开展组共27人,共有8.88%;“对该院目前取药流程满意度”中有237人不满意,占到53.95%,有227人即74.67%的人表示可以实现“自己/请他人帮忙操作电脑上网”;对于“感觉该方式风险大小”方面,只有8人认为其风险很大或比较大;对被调查者的一般人口学特征、续药检查现状及网络续药的可及性中可能影响糖尿病患者网络续药需求意愿的诸因素进行单因素分析发现,只有对“推荐的检查间隔”清楚度、“对该院目前取药流程满意度”和“自己/请他人帮忙操作电脑上网的方便程度”3项在两组人群中差别有统计学意义,进一步做二分类Logistic回归分析,最终得到“自己或请他人帮忙通过电脑上网操作的方便程度”及“对推荐的检查间隔时间的清楚度”两项有统计学意义,OR值依次等于4.642(95%CI:1.978-10.893)、4.978(95%CI:2.067-11.985)。对网络续药的部分关注意向:对于“网络续药及复查预约的实现形式”,被调查的糖尿病门诊患者选择打电话的最多,有48.66%的人,其次是通过电脑客户端形式实现,占34.90%;“希望该服务可以实现的功能”中,304名被调查者中有284人希望该系统能实现“续药”功能,之后依次是“检查预约”、“续药及复查提醒”、“(历史查询)查询以往诊疗记录及检查结果”,分别有255人、252人、251人选择。结论当前的糖尿病门诊续药给患者及社会都带来诸多不便,浪费了医患双方大量时间及资源,整个过程体验亦不尽如人意;而且在整个糖尿病用药治疗过程中,患者基本比较被动,用药安全也存在一定隐患。然而糖尿病患者对网络续药的热情及心理接受度普遍较高,当下也具备一定的实施可行性;该系统中的功能应该能提高糖尿病患者的自我健康意识及自我管理水平,能一定程度弥补当前糖尿病患者门诊续药的不足,最后广大患者对其相关服务费用及个人信息安全问题比较关注。
[Abstract]:Objective: To investigate and analyze the current status of daily reexamination and reexamination of diabetic patients, to understand the desire and influencing factors of diabetic patients' demand for Internet continued drugs, to analyze the feasibility of its implementation, and to further investigate the interest of the patients on the network, and to provide reference for the prevention and treatment of diabetes. In 11~12 month of 2014, a questionnaire survey was conducted on 320 patients in the outpatient department of metabolic disease hospital of Medical University Of Tianjin. 304 effective questionnaires were collected, the current drug withdrawal was analyzed, the current situation was examined, the desire for the demand for the network continued and the feasibility of its implementation. Results: the internal homogeneity of the self-designed questionnaire was made. The partial analysis of the higher reliability analysis showed that the partial half reliability (Split-half coefficient) was 0.785, the Krone Bach alpha coefficient was 0.872, the reliability of the questionnaire was ideal, and all the items were analyzed by factor analysis in the validity test, and finally 13 public factors were obtained. The cumulative contribution rate was 71.17%. general situation: the male accounted for 50 of the respondents. .99%, women accounted for 49.01%, the median age of the population was 60.97 years, and the cultural level was mainly concentrated in two categories: "junior high school" and "high school / secondary school", accounting for 29.28%, 37.17% of the total number of respondents, 2000-2999 yuan per month per capita of family 44.74% and 3000-4999 yuan accounting for 26.65%; of which 2 diabetes patients accounted for the total number of respondents. 97.37%, the median of the course of the disease was 10 years; the median time of total consumption of a continuous drug in the hospital was 2.60 hours, the four digits was P25:2.03 hours, P75:3.58 hours, and the status of taking medicine and examination: 74.30% of the total number of the respondents were received in the hospital less than 3 weeks, while only 15.96% of the respondents were required. In half a year, 135 people, or 44.41% of the respondents, "continued drug need to be accompanied or taken", and 30.88% of the respondents said they had the phenomenon of excessive drugs; for "drug usage and consumption", 80.59% of the respondents were very clear, "medication attention" only 43.09% people are very clear, and for "recommended" The interval time of examination was very clear only 2%, and 86.20% of the daily reexaminations of diabetic patients, 85.90% of the people selected "grade three / specialist hospital". There were 174 people and 103 people, which accounted for 91.12% of the total number of respondents, "no interest", "not very interested" or "general" expected network drug service to carry out a total of 27 people, a total of 8.88%. "To the hospital's current drug extraction process satisfaction", 237 people are not satisfied, 53.95%, there are 227 people that can achieve "self / invite him". "People help to operate computer Internet"; only 8 people think that the risk of this way is very large or relatively large, and a single factor analysis of the factors of the general demographic characteristics of the respondents, the current status of the continued drug examination and the possibility of the Internet continued drug demand in the accessibility of Internet continued drugs Only the "recommended interval" clarity, "the hospital's current drug recovery process satisfaction" and "the convenience of your own / ask for help to operate the Internet" 3 items in two groups of people with statistical significance, further to do two classification of Logistic regression analysis, the final "oneself or ask for help through the computer Internet access to the Internet." The convenience of operation and the two items of "clarity for recommended interval time" were statistically significant. The OR value was equal to 4.642 (95%CI:1.978-10.893), 4.978 (95%CI:2.067-11.985). At the top of the phone, there are 48.66% of them, followed by a computer client, accounting for 34.90%. "Hope that the service can be realized", and 284 of the 304 respondents hope that the system can implement the "continued drug" function, followed by "check reservations", "continuation and review reminders", "(historical inquiry) inquiries There were 255 people, 252 people and 251 choice, respectively. Conclusion the current diabetic outpatient medicine continued to bring a lot of inconvenience to the patients and the society, waste a lot of time and resources between the doctors and patients, and the whole process experience is not satisfactory, and the patients are basically passive in the course of the treatment of diabetes. However, there are some hidden dangers in the safety of drug use. However, the enthusiasm and psychological acceptance of the diabetic patients are generally high, and the present also has a certain implementation feasibility. The function of the system should be able to improve the self health awareness and self management level of the diabetic patients, and to a certain extent make up for the current diabetes patients in the outpatient clinic. In the end, the majority of patients are concerned about their related service fees and personal information security.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1
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本文编号：2085864