山东省农村糖尿病管理现状定性研究

发布时间：2019-06-27 16:02

【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 understand the present situation of diabetes management in rural areas of Shandong Province and its gap with the standard requirements, and to explore the reasons that hinder the utilization of basic health services by the relevant population, so as to provide reference for the formulation of corresponding policies. Methods according to the 2011 edition of the National basic Public Health Service Standard, a semi-structured questionnaire was developed. In July 2016, 24 related staff from local county-level disease prevention and control centers, township health centers, village health centers, 56 diabetes patients and high risk groups of diabetes mellitus were interviewed in 7 townships of Liangshan County, Pingyin County and Junan County, Shandong Province. Results the results of qualitative study showed that there was still a certain gap between the current situation of diabetes management in rural areas of Shandong Province and the requirements of the national basic public health service standards, the main manifestations were as follows: (1) most patients did not receive relevant health education; (2) patients in some areas did not receive quarterly free fasting blood glucose monitoring; (3) Diabetes patients in floating population could not receive relevant services; (4) the patients lack a clear route of referrals and lack of corresponding institutional support in the procedure of referrals. The main factors affecting the gap include: (1) the way of carrying out health education at the township level is too passive; (2) the educational level of some villagers is low; (3) the per capita expenditure of basic public health service projects is low, and so on. Conclusion the provision of basic public health services related to diabetes in rural areas still needs to be improved. The relevant departments should optimize the service delivery system through more active and export health education and the inclusion of migrant diabetic patients in local basic public health services, such as health management services for patients with chronic diseases, so as to meet the needs of rural diabetic patients and high-risk groups.
【作者单位】：山东大学医药卫生管理学院;
【分类号】：R197.1;R587.1

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