Rhee Mary K, Cook Curtiss B, El-Kebbi Imad, Lyles Robert H, Dunbar Virginia G, Panayioto Rita M, Berkowitz Kathy J, Boyd Barbara, Broussard Sandra, George Christopher D
The Department of Medicine, Emory University, Atlanta, Georgia (Dr Rhee, Dr El-Kebbi)
The Division of Endocrinology, Mayo Clinic, Scottsdale, Arizona (Dr Cook)
Diabetes Educ. 2005 May-Jun;31(3):410-7. doi: 10.1177/0145721705277022.
This study explored patients' perceptions of barriers to diabetes education among a mostly African American population of adults with diabetes.
A survey was conducted among 605 new patients attending an urban outpatient diabetes clinic. The questionnaire gathered information on issues patients believed would adversely affect their ability to learn about diabetes. The type and frequency of education barriers were evaluated, and variables associated with reporting an obstacle were analyzed.
Average patient age was 50 years, diabetes duration was 5.6 years, body mass index was 32 kg/m2, and hemoglobin A1C was 9.1%. The majority (56%) were women, 89% were African American, and 95% had type 2 diabetes. Most respondents (96%) had received some prior instruction in diabetes care; however, 53% anticipated future difficulties learning about diabetes. The most commonly cited concerns were poor vision (74%) and reading problems (29%). Patients with a perceived barrier to diabetes education were older (P < .001) than were persons without a barrier, and they differed in both employment and educational status (both P < .001). In adjusted analyses, older age, male gender, being disabled, and having an elementary education or less were associated with a significantly increased likelihood of having a barrier to diabetes education, whereas having a college education decreased the odds. Higher hemoglobin A1C levels also tended to be associated with a greater chance of reporting an education barrier (P = .05).
A substantial number of persons anticipated a barrier to diabetes education. Interventions at multiple levels that address the demographic and socioeconomic obstacles to diabetes education are needed to ensure successful self-management training.
本研究探讨了以非裔美国成年人为主的糖尿病患者群体对糖尿病教育障碍的看法。
对一家城市门诊糖尿病诊所的605名新患者进行了一项调查。问卷收集了患者认为会对其学习糖尿病知识的能力产生不利影响的问题信息。评估了教育障碍的类型和频率，并分析了与报告障碍相关的变量。
患者平均年龄为50岁，糖尿病病程为5.6年，体重指数为32kg/m²，糖化血红蛋白为9.1%。大多数（56%）为女性，89%为非裔美国人，95%患有2型糖尿病。大多数受访者（96%）之前曾接受过一些糖尿病护理方面的指导；然而，53%的人预计未来学习糖尿病会有困难。最常提到的担忧是视力差（74%）和阅读问题（29%）。认为存在糖尿病教育障碍的患者比没有障碍的患者年龄更大（P < .001），并且在就业和教育状况方面也存在差异（均P < .001）。在调整分析中，年龄较大、男性、残疾以及接受过小学及以下教育与糖尿病教育障碍的可能性显著增加相关，而接受过大学教育则降低了这种可能性。较高的糖化血红蛋白水平也往往与报告教育障碍的可能性更大相关（P = .05）。
相当多的人预计会存在糖尿病教育障碍。需要采取多层次干预措施来解决糖尿病教育的人口统计学和社会经济障碍，以确保成功的自我管理培训。
