The Ophthalmology Department, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China.
State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China.
Br J Ophthalmol. 2021 Jun;105(6):806-811. doi: 10.1136/bjophthalmol-2020-316105. Epub 2020 Jul 31.
To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake.
Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression.
A total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. 'Very likely' or 'likely' acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%).
Improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.
评估中国农村糖尿病患者的糖尿病知识和眼保健服务接受度，以提高服务利用率。
对中国广东的糖化血红蛋白 A1c≥6.5%和/或已知糖尿病病史的人群进行基于人群的研究。2014 年 8 月至 11 月期间，参与者根据德尔菲流程/之前的焦点小组回答了一份关于医疗史、人口统计学特征、自我评估的健康和视力、糖尿病和糖尿病视网膜病变相关知识、当地医疗质量、治疗障碍、接受眼部检查和治疗的可能性，以及提高服务利用率最有可能的干预措施的问卷。评估了参与者的视力，进行了眼底照相，并由经过培训的分级员对图像进行分级。使用逻辑回归评估了接受治疗的潜在预测因素，并对混杂因素进行了调整。
共有 562 人（5825 人中有 9.6%（256/5825），平均年龄 66.2±9.84 岁，207 人（36.8%）为男性）患有糖尿病，118 人（22.3%）为既往诊断。对激光治疗（140/530=26.4%）的“非常可能”或“可能”接受程度低于对眼部检查（317/530=59.8%，p<0.001）。接受检查和激光治疗的预测因素包括年龄较小（p<.001）和以前意识到糖尿病诊断（p=0.004 和 p=0.035）。接受糖尿病治疗的主要障碍是不知道自己的诊断（409/454，97.2%），而提高接受眼部检查的服务接受度最有可能的干预措施包括报销旅行费用（387/562，73.0%）、视频或其他健康教育（359/562，67.7%）和电话提醒（346/562，65.3%）。
在这种情况下，提高糖尿病的诊断率，加上激励措施、教育和沟通策略，最有可能提高对糖尿病眼部护理的接受度。
