中国糖尿病管理护理中卫生专业人员绩效的决定因素研究。

Study on the determinants of health professionals' performance on diabetes management care in China.

机构信息

College of Health Sciences, Shandong University of Traditional Chinese Medicine, 4655 Da Xue Road, University Science Park, Changqing District, Jinan, 250355, Shandong, China.

China Center for Health Development Studies, Peking University, Xue Yuan Road 38, Haidian District, Box 505, Beijing, 100191, China.

出版信息

BMC Prim Care. 2023 Sep 2;24(1):172. doi: 10.1186/s12875-023-02136-z.

DOI:10.1186/s12875-023-02136-z

PMID:37660002

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10474730/

Abstract

BACKGROUND

As the direct providers of diabetes management care in primary health care facilities (PHFs) in China, health professionals' performance on management care of diabetes determines the quality of services and patients' outcomes. This study aims to analyze the key determinants of health professionals' performance on diabetes management care in PHFs in China.

METHODS

We conducted a cross-sectional study in 72 PHFs in 6 cities that piloted the contracted family doctor service (CFDS). Self-developed questionnaire was used to measure three kinds of factors (capacity, motivation and opportunity) potentially influencing the performance of health professionals. The performance of diabetes management care in the study was measured as whether health professionals delivered 7 service items required by the National Basic Public Health Service Guideline with a total of 7 points and was divided into three grades of good, medium and bad. The questionnaire is self-administered by all the health professionals involved in the study with the number of 434. The Chi-square tests were used to compare differences of performance on diabetes management care among health professionals with different characteristics. The ordinal logistic regression was used to analyze the determinants on the performance of diabetes management care.

RESULTS

Health professionals who got higher score on diabetes knowledge test had odds of better performance on diabetes management care (OR = 1.529, P < 0.001). health professionals with higher degree of self-reported satisfaction on training (OR = 1.224, P < 0.05) and perception of decreasing workload (OR = 3.336, P < 0.01) had odds of better performance on diabetes management care. While health professionals with negative feeling on information system support had odds of worse performance on diabetes management care (OR = 0.664, P < 0.01).

CONCLUSIONS

Attention should be paid to the training of health professionals' knowledge on diabetes management capacity. Furthermore, measures to improve training for health professionals could satisfying their needs for self-growth and improve the motivation of health professionals. The information system supporting management care should be improved continuously to improve the health professionals' working opportunities and decrease the workload.

摘要

背景

在中国基层医疗卫生机构（PHF）中，卫生专业人员直接提供糖尿病管理护理，他们在糖尿病管理护理方面的表现决定了服务质量和患者的治疗效果。本研究旨在分析影响中国 PHF 卫生专业人员糖尿病管理护理表现的关键决定因素。

方法

我们在 6 个城市的 72 个试点家庭医生签约服务（CFDS）的 PHF 中进行了一项横断面研究。使用自行设计的问卷来衡量可能影响卫生专业人员表现的三种因素（能力、动机和机会）。研究中糖尿病管理护理的表现是通过卫生专业人员提供国家基本公共卫生服务规范要求的 7 项服务项目来衡量的，总分为 7 分，并分为优、中、差三个等级。由参与研究的所有卫生专业人员自填问卷，共 434 份。采用卡方检验比较不同特征的卫生专业人员在糖尿病管理护理表现上的差异。采用有序逻辑回归分析糖尿病管理护理表现的决定因素。

结果

糖尿病知识测试得分较高的卫生专业人员，其糖尿病管理护理表现较好的可能性更高（OR=1.529，P<0.001）。自我报告对培训满意度较高（OR=1.224，P<0.05）和感觉工作量减少（OR=3.336，P<0.01）的卫生专业人员，其糖尿病管理护理表现较好的可能性更高。而对信息系统支持持负面感觉的卫生专业人员，其糖尿病管理护理表现较差的可能性更高（OR=0.664，P<0.01）。