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香港公立基层医疗环境中糖尿病视网膜病变的知晓情况及其与接受系统筛查的相关性:一项横断面研究

Awareness of diabetic retinopathy and its association with attendance for systematic screening at the public primary care setting: a cross-sectional study in Hong Kong.

作者信息

Lian JinXiao, McGhee Sarah M, Gangwani Rita A, Lam Cindy L K, Yap Maurice K H, Wong David S H

机构信息

School of Optometry, The Hong Kong Polytechnic University, Hong Kong.

Department of Ophthalmology, The University of Hong Kong, Hong Kong.

出版信息

BMJ Open. 2018 Apr 13;8(4):e019989. doi: 10.1136/bmjopen-2017-019989.

DOI:10.1136/bmjopen-2017-019989
PMID:29654021
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5905753/
Abstract

OBJECTIVE

To assess the association between awareness of diabetic retinopathy (DR) and actual attendance for DR screening.

DESIGN

Cross-sectional study.

SETTING

Two public general outpatient clinics.

PARTICIPANTS

The subjects were people with diabetes mellitus (DM) who participated in a randomised controlled trial, set up in 2008, to test the impact of a copayment on attendance for DR screening.

PRIMARY AND SECONDARY OUTCOME MEASURES

The subjects' awareness of DR was evaluated using a structured questionnaire conducted via a telephone interview. The attendance for screening was from the actual attendance data. Association between awareness and attendance for screening was determined using multivariate logistic regression model and was reported as ORs.

RESULTS

A total of 2593 participants completed the questionnaire. A total of 42.9% (1113/2593) said they would worry if they had any vision loss and 79.6% (2063/2593) knew that DM could cause blindness. Only 17.5% (453/2593) knew that treatment was available for DR and 11.5% (297/2593) knew that early DR could be asymptomatic. The importance of having a regular eye examination was acknowledged by 75.7% (1964/2593), but 34% (881/2593) did not know how frequently their eyes should be examined. Worry about vision loss (OR=1.72, P<0.001), awareness of the importance of regular eye examination (OR=1.83, P=0.002) and awareness of the frequency of eye examinations ('every year' (OR=2.64, P<0.001) or 'every 6 months' (OR=3.27, P<0.001)) were the most significant factors associated with attendance.

CONCLUSIONS

Deficits in knowledge of DR and screening were found among subjects with DM, and three awareness factors were associated with attendance for screening. These factors could be targeted for future interventions.

摘要

目的

评估糖尿病视网膜病变(DR)知晓率与DR筛查实际就诊率之间的关联。

设计

横断面研究。

地点

两家公立普通门诊诊所。

参与者

研究对象为2008年参与一项随机对照试验的糖尿病(DM)患者,该试验旨在测试自付费用对DR筛查就诊率的影响。

主要和次要结局指标

通过电话访谈使用结构化问卷评估受试者对DR的知晓情况。筛查就诊率来自实际就诊数据。使用多变量逻辑回归模型确定知晓情况与筛查就诊率之间的关联,并以比值比(OR)表示。

结果

共有2593名参与者完成了问卷。共有42.9%(1113/2593)的人表示如果他们有任何视力丧失会担心,79.6%(2063/2593)的人知道DM可导致失明。只有17.5%(453/2593)的人知道DR有治疗方法,11.5%(297/2593)的人知道早期DR可能无症状。75.7%(1964/2593)的人认可定期进行眼部检查的重要性,但34%(881/2593)的人不知道他们的眼睛应该多久检查一次。担心视力丧失(OR = 1.72,P < 0.001)、认识到定期眼部检查的重要性(OR = 1.83,P = 0.002)以及知道眼部检查的频率(“每年”(OR = 2.64,P < 0.001)或“每6个月”(OR = 3.27,P < 0.001))是与就诊率最相关的因素。

结论

在DM患者中发现了对DR和筛查知识的欠缺,并且三个知晓因素与筛查就诊率相关。这些因素可作为未来干预的目标。

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