叙利亚危机期间，在大马士革主要公立医院的一组糖尿病患者中对糖尿病和糖尿病性视网膜病变的认识。
Awareness of diabetes and diabetic retinopathy among a group of diabetic patients in main public hospitals in Damascus, Syria during the Syrian crisis.
机构信息
Department of Ophthalmology, Al-Mouwassat University Hospital, Damascus, Syria.
Faculty of Medicine, Damascus University, Damascus, Syria.
出版信息
BMC Health Serv Res. 2019 Aug 5;19(1):549. doi: 10.1186/s12913-019-4375-8.
BACKGROUND
The awareness of diabetes mellitus (DM) and its complications, especially diabetic retinopathy (DR), is the key to reducing their burden. This study aimed to assess both the awareness of diabetic outpatients and their action towards periodic eye exam, and to determine the causes of non-compliance amongst patients who were aware. Because the Syrian Crisis affected all aspects of Syrians' life, the study aimed to determine the crisis' effects on patients' care-seeking behavior. Our study was the first step in paving the way of prevention strategies.
METHODS
This observational cross-section study was conducted on 260 patients with DM who were visiting the four main hospitals in the Syrian capital, Damascus between August and November 2017.
RESULTS
The mean (±SD) age of participants was 54.3(±12.8) years. Females were more than half (56.2%). The majority were from areas outside Damascus (72.3%). The mean (±SD) DM duration was 10.6 (±7.1) years. Almost all patients (93.8%) thought that DM could affect the eye. 67.3% believed that it could cause blindness. 86.9% of the patients conceived that DM patients should visit an ophthalmologist regularly. 37% did not visit any ophthalmologists at all, while 63% reported they had visited their ophthalmologists. Only 21.5% had a regular eye exam. Gender, educational level, economic status, province, and family history of DM had statistically an insignificant relation with an ophthalmologist visit. The preponderance of the patients who haven't visited regularly did not appreciate the necessity of regular eye exam. Diabetic neuropathy was the most common complication of DM that patients were aware of (92%) and suffered from (56.5%). Meanwhile, regarding the effects of the Syrian Crisis: 41.2% of diabetic patients had stopped their medications for at least one month, mainly because the drugs were unavailable (74.7% of them), as some drug companies had been destroyed. Half of the patients had struggled to reach a medical care center. Half of the patients had been displaced, two-third of them were from outside Damascus.
CONCLUSION
A screening program for DR should be initiated. Also, awareness about DM and its complications, especially DR, should be raised through doctors and media.
背景
糖尿病（DM）及其并发症的认知，特别是糖尿病视网膜病变（DR），是减轻其负担的关键。本研究旨在评估糖尿病门诊患者对自身疾病的认知程度及其定期进行眼部检查的行为，并确定已了解自身病情但仍未遵医嘱进行眼部检查的患者的未遵医原因。由于叙利亚危机影响了叙利亚人民生活的方方面面，因此本研究旨在确定这场危机对患者求医行为的影响。我们的研究是制定预防策略的第一步。
方法
本观察性横断面研究于 2017 年 8 月至 11 月在叙利亚首都大马士革的四家主要医院对 260 名糖尿病患者进行。
结果
参与者的平均（±SD）年龄为 54.3(±12.8)岁。女性超过一半（56.2%）。大多数来自大马士革以外的地区（72.3%）。平均（±SD）糖尿病病程为 10.6(±7.1)年。几乎所有患者（93.8%）都认为糖尿病会影响眼睛。67.3%的患者认为糖尿病会导致失明。86.9%的患者认为糖尿病患者应定期看眼科医生。37%的患者根本没有看任何眼科医生，而 63%的患者报告他们看过眼科医生。只有 21.5%的患者有定期的眼部检查。性别、教育水平、经济状况、省份和糖尿病家族史与看眼科医生之间无统计学意义的关系。大多数未定期就诊的患者不认为定期眼部检查是必要的。糖尿病神经病变是患者最了解（92%）和最常见的糖尿病并发症（56.5%）。同时，关于叙利亚危机的影响：41.2%的糖尿病患者至少停止服用药物一个月，主要是因为药物不可用（其中 74.7%），因为一些制药公司已经被摧毁。一半的患者难以到达医疗中心。一半的患者流离失所，其中三分之二来自大马士革以外的地区。
结论
应启动 DR 筛查计划。此外，应通过医生和媒体提高对糖尿病及其并发症（特别是 DR）的认识。
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