印度中部一家三级眼科保健机构中威胁视力的糖尿病视网膜病变患者就诊延迟的知识、态度、行为模式及推测原因：一项基于问卷调查的研究。
Knowledge, attitude, and practice patterns and the purported reasons for delayed presentation of patients with sight-threatening diabetic retinopathy at a tertiary eyecare facility in Central India: A questionnaire-based study.
机构信息
Vitreo-retina and Uvea Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India.
出版信息
Indian J Ophthalmol. 2021 Nov;69(11):3118-3122. doi: 10.4103/ijo.IJO_1503_21.
PURPOSE
To identify the reasons for delayed presentation among patients with sight-threatening diabetic retinopathy (STDR) and to assess their knowledge, attitude, and practice (KAP) patterns in context to diabetes mellitus (DM) and diabetic retinopathy (DR).
METHODS
Single-center, cross-sectional, questionnaire-based KAP survey. All consecutive cases of STDR who presented to our tertiary eye care facility from June 2020 to November 2020 were recruited. The KAP scoring survey tool was incorporated into the questionnaire to help evaluate and represent the patient's disease.
RESULTS
170 patients with STDR were enrolled in the study. The mean age of patients was 54 ± 9.34 years (Range: 21-70 years); 110 patients (64.7%) were between 41 and 60 years; 131 patients (76%) had DM for more than 5 years. The STDR changes were more prevalent in patients with an educational qualification of high school or less (n = 142; 83.5%). Fifty-two patients (30.6%) had been informed regarding the detrimental effect of diabetes on the eyes and were recommended to consult an ophthalmologist by the treating physician. Of these, 24 (46.15%) patients were educated about retinal changes due to diabetes. Eighty-five (50%) patients in our study had good knowledge about DM; 13 (7.6%) patients had good knowledge about DR. For patients not compliant for follow-ups with the treating physician, the use of "home glucometers for self-monitoring (n = 60, 35.3%) was the most prevalent reason. The main reason for poor compliance for undergoing a dilated fundus examination by the ophthalmologist was "Had good vision, so didn't feel the need" in 143 (90.5%) patients.
CONCLUSION
The absence of visual complaints, lack of knowledge, and failure to undergo a dilated fundus examination in the past were the prevalent risk factors in patients presenting with STDR. Knowledge/practice about DR was poor among the patients with STDR. The treating physicians and ophthalmologists were the most common sources for patient education.
目的
确定出现威胁视力的糖尿病视网膜病变（STDR）的患者延迟就诊的原因，并评估他们在糖尿病（DM）和糖尿病视网膜病变（DR）方面的知识、态度和实践（KAP）模式。
方法
单中心、横断面、基于问卷的 KAP 调查。我们从 2020 年 6 月至 2020 年 11 月招募了所有到我们三级眼科保健机构就诊的 STDR 连续病例。KAP 评分调查工具被纳入问卷，以帮助评估和代表患者的疾病。
结果
研究共纳入 170 例 STDR 患者。患者的平均年龄为 54 ± 9.34 岁（范围：21-70 岁）；110 例（64.7%）患者年龄在 41-60 岁之间；131 例（76%）DM 病史超过 5 年。在具有高中或以下学历的患者中，STDR 变化更为普遍（n = 142；83.5%）。52 例（30.6%）患者被告知糖尿病对眼睛的有害影响，并被治疗医生建议咨询眼科医生。其中，24 例（46.15%）患者接受了有关糖尿病引起视网膜变化的教育。在我们的研究中，85 例（50%）患者对 DM 有很好的认识；13 例（7.6%）患者对 DR 有很好的认识。对于不遵医嘱进行随访的患者，最常见的原因是“家用血糖仪进行自我监测（n = 60，35.3%）”。143 例（90.5%）患者因“视力良好，因此觉得没必要”而不愿接受眼科医生进行散瞳眼底检查，这是导致依从性差的主要原因。
结论
出现 STDR 的患者中，无视觉主诉、缺乏知识以及过去未进行散瞳眼底检查是主要的危险因素。STDR 患者对 DR 的知识/实践了解甚少。治疗医生和眼科医生是患者教育的最常见来源。
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