Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Lideta Sub City Kebele 16, Gondar, Ethiopia.
BMC Public Health. 2020 Oct 12;20(1):1537. doi: 10.1186/s12889-020-09622-4.
Insulin is an effective therapeutic agent in the management of diabetes, but also sensitive to the external environment. Consequently, diabetic patients' adherence to insulin delivery recommendations is critical for better effectiveness. Patients' lack of knowledge, skill and irrational practices towards appropriate insulin delivery techniques may end up in therapeutic failure and increase costs of therapy. The aim of this study was to evaluate patients' knowledge, skills and practices of insulin storage and injection techniques.
An interview-based cross-sectional study was conducted through purposive selection of participants in Northwest Ethiopian primary hospitals from March 1 to May 30, 2019. Levels of knowledge were assessed with right or wrong responses, while practice was measured by using a 4-point Likert scale structured questionnaire collected via face-to-face interviews. Likewise, a five-point observational (demonstration) techniques checklist employed to assess patients' skills.
Among 194 patients approached, 166 participants completed the survey giving a response rate of 85.6%. More than half of the respondents (54.8%) were males and the mean age (±SD) was 38.5 ± 13.8 years. The overall patients' median knowledge and practice levels on insulin storage and handling techniques were moderately adequate (64.3%) and fair (55.4%), respectively. In patients' skill assessments, 94.6% correctly showed injection sites, 70% indicated injection site rotations, and 60.75% practiced injection site rotations. Education (P < 0.001), duration of insulin therapy (P = 0.008), and duration of diabetes (P = 0.014) had significant impact on knowledge level. Education (P < 0.001), occupation (P < 0.001), duration of insulin therapy (P = 0.001), duration of diabetes (P = 0.036) and patients' knowledge level (P < 0.001) were found to have a significant effects on the patients' practice levels. A Mann-Whitney U test also disclosed that residency, ways to get insulin and mocked injection technique during the first training had significant effects on patients' knowledge levels.
The current study revealed that patients had moderately adequate knowledge and fair practice levels on insulin storage and handling techniques. However, patients missed important insulin administration skills. This study highlights the need of regular public health education so as to enhance the patients' knowledge, skill and practice levels on insulin handling techniques.
胰岛素是治疗糖尿病的有效治疗药物，但对外界环境也很敏感。因此，糖尿病患者对胰岛素给药建议的坚持对于提高疗效至关重要。患者对胰岛素给药技术的知识、技能和不合理操作可能导致治疗失败并增加治疗成本。本研究旨在评估患者在胰岛素储存和注射技术方面的知识、技能和实践情况。
这是一项基于访谈的横断面研究，通过在 2019 年 3 月 1 日至 5 月 30 日期间在埃塞俄比亚西北部的初级医院中选择参与者进行有针对性的选择。通过正确或错误的回答来评估知识水平，而实践则通过使用 4 分李克特量表结构问卷通过面对面访谈进行测量。同样，使用五分制（演示）技术检查表来评估患者的技能。
在接触的 194 名患者中，有 166 名参与者完成了调查，应答率为 85.6%。超过一半的受访者（54.8%）为男性，平均年龄（±SD）为 38.5±13.8 岁。患者对胰岛素储存和处理技术的总体知识和实践水平中等（64.3%）和中等（55.4%）。在患者技能评估中，94.6%的患者正确显示了注射部位，70%的患者表示注射部位旋转，60.75%的患者进行了注射部位旋转。教育（P<0.001）、胰岛素治疗时间（P=0.008）和糖尿病病程（P=0.014）对知识水平有显著影响。教育（P<0.001）、职业（P<0.001）、胰岛素治疗时间（P=0.001）、糖尿病病程（P=0.036）和患者知识水平（P<0.001）对患者的实践水平有显著影响。曼-惠特尼 U 检验还表明，居住地、获得胰岛素的方式以及首次培训时的模拟注射技术对患者的知识水平有显著影响。
本研究表明，患者在胰岛素储存和使用技术方面具有中等的知识水平和中等的实践水平。然而，患者错过了重要的胰岛素给药技能。本研究强调需要定期开展公共卫生教育，以提高患者对胰岛素处理技术的知识、技能和实践水平。
