Schunk Michaela, Stark Renée, Reitmeir Peter, Meisinger Christa, Holle Rolf
Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munich, 85764 Neuherberg, Germany.
Institute of Epidemiology II, Helmholtz Zentrum Munich, 85764 Neuherberg, Germany ; German Center for Diabetes Research (DZD e.V.), 85764 Neuherberg, Germany.
J Diabetes Res. 2015;2015:368570. doi: 10.1155/2015/368570. Epub 2015 Mar 17.
This study aims to examine the relationship of diabetes care processes and patient outcomes with an expanded set of indicators regarding patient-oriented care delivery, such as treatment satisfaction, the quality of patient-physician relationship, and a wider range of patient outcomes such as self-management, health behaviour, disease-related burden, and health-related quality of life (HRQL).
The study population consisted of 486 participants with type 2 diabetes in two population-based follow-up surveys, conducted in 2003 to 2005 and 2006 to 2008 in Southern Germany. Data were self-reported and questionnaire-based, including the SF-12 for HRQL. Multiple regression models were used to identify associations between care processes and outcomes with adjustment for confounders.
Frequent medical examinations increased the likelihood of self-monitoring activities, such as foot care. A positive patient experienced relationship with their physician is associated with higher adherence to medical recommendations, such as medication intake, and the score of the SF-12 mental component. Participants with diabetes-related complications reported higher levels of medical examinations and multiprofessional care.
Indicators of patient-oriented care should become an indispensable part of diabetes clinical practice guidelines with the aim of striving for more effective support of patients.
本研究旨在探讨糖尿病护理过程和患者结局与一系列更广泛的以患者为导向的护理提供指标之间的关系，这些指标包括治疗满意度、医患关系质量，以及更广泛的患者结局，如自我管理、健康行为、疾病相关负担和健康相关生活质量（HRQL）。
研究人群包括在2003年至2005年以及2006年至2008年于德国南部进行的两项基于人群的随访调查中的486名2型糖尿病患者。数据通过自我报告和问卷调查收集，包括用于评估HRQL的SF-12量表。使用多元回归模型来确定护理过程与结局之间的关联，并对混杂因素进行调整。
频繁的医学检查增加了自我监测活动（如足部护理）的可能性。患者与医生之间积极的关系与更高的医嘱依从性（如药物摄入）以及SF-12精神健康分量表得分相关。患有糖尿病相关并发症的参与者报告的医学检查和多专业护理水平更高。
以患者为导向的护理指标应成为糖尿病临床实践指南中不可或缺的一部分，以更有效地支持患者为目标。
