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通往糖尿病治疗目标的关键环节:加尔各答一家三级护理医院的经验

Junctures to the therapeutic goal of diabetes mellitus: Experience in a tertiary care hospital of Kolkata.

作者信息

Lahiri S K, Haldar D, Chowdhury S P, Sarkar G N, Bhadury S, Datta U K

机构信息

Department of Community Medicine, RG Kar Medical College, Kolkata, India.

出版信息

J Midlife Health. 2011 Jan;2(1):31-6. doi: 10.4103/0976-7800.83271.

Abstract

INTRODUCTION

The World Health Organization has declared India as the "diabetic capital" of the world. In controlling of such chronic, mostly asymptomatic disease, patients' role can't be overemphasized.

AIMS

To assess the level of compliance to anti-diabetic therapies and to ascertain the determinants of non-compliance, if any.

MATERIALS AND METHODS

A cross-sectional observational study was conducted for 3 months in a diabetic clinic of R G Kar Medical College and Hospital, Kolkata. Data were collected by interviewing the patients, examining their prescriptions and laboratory reports and anthropometry after obtaining informed consent.

RESULTS

Blood report at the point of data collection revealed controlled glucose homeostasis in 38.93% patients but evaluation of past 3 months report showed only 24.3% had control over hyperglycemia. Glycemic control was seen to be positively related to short duration of disease, compliance to therapies, and high knowledge about diabetes. Compliance to therapies found in 32.22% of study subjects was in turn associated with short duration of disease. House-wives showed poor compliance; insulin treatment with or without oral-anti-diabetic agent showed better compliance. Knowledge of diabetes was significantly high among higher educated; poor among women, house-wives, and rural people.

CONCLUSION

Patient-providers collaboration is to be developed through a patient-centered care model based on the mutual responsibility of both so that each patient is considered in the mesh of his/her other goals of life and helped to promote empowerment to take informed decision for behavioral change conducive to control the disease.

摘要

引言

世界卫生组织已将印度宣布为世界“糖尿病之都”。在控制这种慢性、大多无症状的疾病方面,患者的作用再怎么强调也不为过。

目的

评估抗糖尿病治疗的依从性水平,并确定不依从的决定因素(如有)。

材料与方法

在加尔各答R G Kar医学院和医院的糖尿病诊所进行了为期3个月的横断面观察研究。在获得知情同意后,通过询问患者、检查他们的处方和实验室报告以及进行人体测量来收集数据。

结果

在数据收集时的血液报告显示,38.93%的患者血糖稳态得到控制,但对过去3个月报告的评估显示,只有24.3%的患者控制了高血糖。血糖控制被认为与疾病病程短、治疗依从性以及对糖尿病的高知晓率呈正相关。在32.22%的研究对象中发现的治疗依从性又与疾病病程短有关。家庭主妇的依从性较差;使用或不使用口服抗糖尿病药物的胰岛素治疗显示出更好的依从性。在受过高等教育的人群中,对糖尿病的知晓率显著较高;在女性、家庭主妇和农村人群中则较差。

结论

应通过基于医患双方共同责任的以患者为中心的护理模式来发展医患合作,以便在患者生活的其他目标框架内考虑每个患者,并帮助促进其增强能力,以便做出有利于控制疾病的行为改变的明智决定。

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