Benjamin Horvath Lajos, Böhm Markus, Kuniss Nadine, Bleidorn Jutta, Schulz Sven
Universitätsklinikum Jena, Institut für Allgemeinmedizin, Jena, Deutschland.
Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und Datenwissenschaften, Jena, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2022 Sep;173:49-55. doi: 10.1016/j.zefq.2022.04.004. Epub 2022 Jun 14.
Structured education programs for patients with diabetes mellitus are an important and effective component of therapy. The aim of this survey is to assess the rate of participation in education programs in selected practices in Thuringia. Furthermore, we intend to identify factors that influence participation in order to derive strategies to increase participation.
Survey of patients with diabetes in Thuringian general practices and a diabetology practice using a newly developed questionnaire regarding "patient characteristics", "diabetes characteristics", "DMP and education programs" as well as reasons for non-participation in education programs and the wishes of non-educated patients. Data were analyzed using binary logistic regression analysis and other descriptive statistics in SPSS (IBM).
Of the 1,254 questionnaires sent out, 637 (51%) were returned. Participation rate in education programs was 68% (n=405). HbA > 7.5%, diabetes sequelae, DMP participation and the awareness of education programs were significantly associated with participation in education programs. Recommendation/invitation to education programs, complex treatment regimes, long diabetes duration and urban practice led to a significant increase in the odds of attending an education program. Non-educated patients subjectively mentioned lack of need for training, lack of information, logistical reasons, and lack of time as reasons for non-participation. They expressed the wish for more information and recommendations from their general practitioner, shorter duration of education programs and online offerings.
The participation rate in education programs was in the range of the evaluation reports on DMP programs for diabetes. Lower participation rates in rural areas may be explained by the lower physician density and especially education program offers as well as the more difficult accessibility. The factors and reasons for non-participation underline the need for comprehensive care and the general practitioner's key role in motivating, coordinating and educating patients.
General practitioners play a central role in the care of patients with diabetes, and there is a need for comprehensive care and education programs. Telemedicine and digital applications can complement DMP and education programs.
糖尿病患者的结构化教育项目是治疗的重要且有效组成部分。本次调查旨在评估图林根州特定医疗机构中教育项目的参与率。此外，我们旨在确定影响参与的因素，以便制定提高参与率的策略。
使用一份新开发的问卷，对图林根州普通医疗机构和一家糖尿病专科医疗机构中的糖尿病患者进行调查，问卷内容涉及“患者特征”“糖尿病特征”“糖尿病管理计划（DMP）与教育项目”，以及未参与教育项目的原因和未接受教育患者的愿望。在SPSS（IBM）中使用二元逻辑回归分析和其他描述性统计方法对数据进行分析。
共发放1254份问卷，回收637份（51%）。教育项目参与率为68%（n = 405）。糖化血红蛋白（HbA）> 7.5%、糖尿病后遗症、参与DMP以及对教育项目的认知与参与教育项目显著相关。收到教育项目的推荐/邀请、复杂的治疗方案、糖尿病病程长以及城市医疗机构导致参加教育项目的几率显著增加。未接受教育的患者主观提到缺乏培训需求、信息不足、后勤原因和时间不足是未参与的原因。他们表示希望从全科医生那里获得更多信息和建议，缩短教育项目时长并提供在线课程。
教育项目的参与率处于糖尿病DMP项目评估报告的范围内。农村地区参与率较低可能是由于医生密度较低，尤其是教育项目提供较少以及可及性较差。未参与的因素和原因凸显了全面护理的必要性以及全科医生在激励、协调和教育患者方面的关键作用。
全科医生在糖尿病患者护理中发挥核心作用，需要全面的护理和教育项目。远程医疗和数字应用可以补充DMP和教育项目。
