Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, 410008, Changsha, China.
Department of Nursing, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi Province, China.
BMC Prim Care. 2023 Mar 13;24(1):68. doi: 10.1186/s12875-023-02027-3.
Diabetic foot is a serious complication of diabetes with a high disability and mortality rate, which can be prevented by early screening. General practitioners play an essential role in diabetic foot risk screening, yet the screening behaviors of general practitioners have rarely been studied in primary care settings. This study aimed to investigate foot risk screening behaviors and analyze their influencing factors among general practitioners.
A cross-sectional study was conducted among 844 general practitioners from 78 community health centers in Changsha, China. A self-designed and validated questionnaire was used to assess the general practitioner's cognition, attitude, and behaviors on performing diabetic foot risk screening. Multivariate linear regression was conducted to investigate the influencing factors of risk screening behaviors.
The average score of diabetic foot risk screening behaviors among the general practitioners was 61.53 ± 14.69, and 271 (32.1%) always or frequently performed foot risk screening for diabetic patients. Higher training frequency (β = 3.197, p < 0.001), higher screening cognition (β = 2.947, p < 0.001), and more positive screening attitude (β = 4.564, p < 0.001) were associated with more diabetic foot risk screening behaviors, while limited time and energy (β=-5.184, p < 0.001) and lack of screening tools (β=-6.226, p < 0.001) were associated with fewer diabetic foot screening behaviors.
The score of risk screening behaviors for the diabetic foot of general practitioners in Changsha was at a medium level. General practitioners' diabetic foot risk screening behaviors may be improved through strengthening training on relevant guidelines and evidence-based screening techniques, improving cognition and attitude towards foot risk screening among general practitioners, provision of more general practitioners or nurse practitioners, and user-friendly screening tools.
糖尿病足是糖尿病的一种严重并发症，具有较高的致残率和死亡率，可以通过早期筛查来预防。全科医生在糖尿病足风险筛查中发挥着至关重要的作用，但在基层医疗环境中，全科医生的筛查行为很少被研究。本研究旨在调查全科医生的足部风险筛查行为，并分析其影响因素。
采用横断面研究方法，对中国长沙 78 家社区卫生服务中心的 844 名全科医生进行调查。使用自行设计并验证的问卷评估全科医生对执行糖尿病足风险筛查的认知、态度和行为。采用多元线性回归分析来探讨风险筛查行为的影响因素。
全科医生的糖尿病足风险筛查行为平均得分为 61.53±14.69，271 名（32.1%）医生经常或总是对糖尿病患者进行足部风险筛查。更高的培训频率（β=3.197，p<0.001）、更高的筛查认知（β=2.947，p<0.001）和更积极的筛查态度（β=4.564，p<0.001）与更多的糖尿病足风险筛查行为相关，而有限的时间和精力（β=-5.184，p<0.001）和缺乏筛查工具（β=-6.226，p<0.001）与更少的糖尿病足筛查行为相关。
长沙市全科医生对糖尿病足风险筛查行为的评分处于中等水平。通过加强相关指南和循证筛查技术的培训、提高全科医生对足部风险筛查的认知和态度、增加全科医生或护士的数量以及提供更便于使用的筛查工具，可以改善全科医生的糖尿病足风险筛查行为。
