David Annette M, Rubio Joel Marc C, Luces Patrick S, Zabala Rose V, Roberto J Peter
Health Partners, LLC, Tamuning, Guam 96913.
Hawaii Med J. 2010 Jun;69(6 Suppl 3):45-9.
The prevention and control of diabetes is a major public health priority for the US Territory of Guam. As part of a strategic planning process, a survey of diabetes patients was conducted to determine patients' perceptions of the availability and adequacy of preventive and clinical services to control diabetes. A total of 125 survey questionnaires were distributed to diabetes patients attending either one of the Guam Department of Public Health and Social Services Community Health Centers or a private Internal Medicine/Endocrinology clinical practice of the only endocrinologist on the island. All 125 questionnaires were returned. Respondents were highly aware of the duration of their diabetes, and almost 75% have had the opportunity to discuss the chronic nature of the illness and the importance of key lifestyle changes to help prevent or retard the progression of the disease. However, almost 40% of patients were not aware of the type of diabetes they had, and one in five have not received diabetes self-management education from their health care providers. Key interventions, such as nutritional counseling, brief tobacco cessation interventions, regular eye and foot examinations and immunization services were not being provided to 30% to 60% of patients, despite clinical practice guidelines that recommend these interventions for all diabetics. While over half of respondents were generally satisfied with the quality of preventive and routine medical care that they receive from their service providers, they identified the need for better quality diabetes self-management education, preventive services, enhanced access to specialists and specialized care, especially for diabetes-related complications, and better financial support to assist them in meeting the costs of chronic care and medications. The feedback from these respondents should provide guidance regarding service gaps and needs as the Department of Public Health and Social Services and its community partners collaboratively develop a strategic plan to better address diabetes prevention and control on Guam. The information should also serve to direct quality improvement efforts to enhance existing diabetes services on the island.
糖尿病的预防与控制是美国关岛地区公共卫生的一项重大优先事项。作为战略规划过程的一部分，开展了一项针对糖尿病患者的调查，以确定患者对控制糖尿病的预防和临床服务的可及性与充足性的看法。总共向关岛公共卫生和社会服务部社区卫生中心之一或该岛唯一内分泌科医生的私人内科/内分泌临床诊所就诊的糖尿病患者发放了125份调查问卷。所有125份问卷均被收回。受访者对自己患糖尿病的时长高度了解，近75%的人有机会讨论该疾病的慢性性质以及关键生活方式改变对预防或延缓疾病进展的重要性。然而，近40%的患者不知道自己患的是哪种糖尿病，五分之一的患者未从医疗服务提供者那里接受过糖尿病自我管理教育。尽管临床实践指南建议对所有糖尿病患者进行这些干预，但仍有30%至60%的患者未得到关键干预措施，如营养咨询、简短戒烟干预、定期眼部和足部检查以及免疫接种服务。虽然超过一半的受访者总体上对从服务提供者那里获得的预防和常规医疗服务质量感到满意，但他们指出需要更好质量的糖尿病自我管理教育、预防服务、增加获得专科医生和专科护理的机会，尤其是针对糖尿病相关并发症的护理，以及更好的财政支持以帮助他们支付慢性病护理和药物费用。这些受访者的反馈应为公共卫生和社会服务部及其社区合作伙伴共同制定一项战略计划以更好地应对关岛糖尿病预防与控制方面的服务差距和需求提供指导。这些信息还应用于指导质量改进工作，以加强该岛现有的糖尿病服务。
