巴巴多斯接受糖尿病和高血压初级卫生保健患者报告的知识、态度、实践和障碍：一项焦点小组研究。
Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study.
机构信息
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, St, Michael, Barbados.
出版信息
BMC Fam Pract. 2011 Dec 2;12:135. doi: 10.1186/1471-2296-12-135.
BACKGROUND
Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies.
METHODS
Five structured focus groups were conducted for randomly selected people with diabetes and hypertension.
RESULTS
Twenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases) with a mean age of 59 years attended 5 focus group sessions.Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work.Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended.
CONCLUSIONS
Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.
背景
巴巴多斯已证实糖尿病和高血压的初级保健质量和结果存在缺陷。本研究旨在探索巴巴多斯的糖尿病和高血压患者的知识、态度和实践，以及他们所面临的障碍，这些因素可能导致这些缺陷。
方法
对随机选择的糖尿病和高血压患者进行了 5 次结构化焦点小组讨论。
结果
共有 21 名患者（5 名糖尿病患者，5 名高血压患者，11 名同时患有两种疾病）参加了 5 次焦点小组会议，平均年龄为 59 岁。影响护理的患者因素包括难以保持行为改变。从业人员因素包括不考虑“整个人”和患者的期望，以及对患者缺乏足够的尊重。医疗保健系统因素主要围绕着因公共部门诊所和药店的长时间等待而获得护理的时间量。与社会相关的障碍包括适当食物的高成本和有限可用性、锻炼设施的可用性、疾病耻辱感以及难以请假。与会者对糖尿病和高血压管理指南不熟悉，但欢迎详细说明记录结果的位置、检查频率以及血压和血糖目标的患者版指南。建议从业人员在咨询时、在诊所等候时、通过支持和教育团体以及通过学校、大众媒体和广告牌向公众提供适当的教育。
结论
初级保健提供者应采取更以患者为中心的方式来护理糖尿病和高血压患者。护理系统应通过减少等待时间来提供更好的服务。通过提供患者版护理指南和更多的教育工作，可以鼓励患者进行自我管理。
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