Akale Mengesh, Tadesse Tirhas, Arega Balew
Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Department of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Diabetes Metab Syndr Obes. 2024 Feb 9;17:691-700. doi: 10.2147/DMSO.S441764. eCollection 2024.
Comprehensive high quality of care is critical in preventing diabetic complications and improving quality of life. This needs compliance with guidelines and focused therapy. There is no data in Ethiopia evaluating the quality of diabetes care using standard guidelines (American diabetic association and international diabetic federation) as a reference.
A cross-sectional study was conducted at Yekatit 12 Hospital Medical College (YHMC) to assess the process and outcome quality indicators of diabetic patients. Data were collected from outpatient clinics between May and July 2022 over a period of 3 months. Diabetic patients with at least one year since diagnosis were selected using systematic random sampling. Both the process and outcome of diabetic quality care indicators were measured and compared with standard guidelines (ADA and IDF). Both descriptive statistics and logistic regression were used for data analysis. The P-value <0.05 was used as statistical significance.
About 250 diabetic patients with a mean age of 53±15 were included. The majority were type 2 diabetes mellitus (83.2%). HbA1c was determined for 128 (51.2%) patients with the recent mean value of 8±1.6. Only 52 (40.6%) of patients achieved target HbA1c. Annual comprehensive feet examination, urine albuminuria test, and retinal examination were done for 54 (21.6%), 52 (20.8%), and 122 (48.8%), respectively. Single marital status (AOR = 5.76; 95% CI; 1.02-32.36) P = 0.047, determining HbA1c level at least twice a year (AOR = 6.27; 95% CI; 2.18-17.73) P = 0.001, and medication adherence (AOR = 7.1; 95% CI; 2.61-19.01)P = 0.001, were significantly associated with good glycemic control.
The overall quality of diabetic care was found suboptimal both in process and outcome quality indicators. Thus, awareness creation about quality indicators for caregivers, compliance with guidelines, wise resource utilization, and cooperation with different stakeholders like hospital management teams, and government officials is needed.
全面高质量的护理对于预防糖尿病并发症和改善生活质量至关重要。这需要遵循指南并进行针对性治疗。在埃塞俄比亚，尚无使用标准指南（美国糖尿病协会和国际糖尿病联盟）作为参考来评估糖尿病护理质量的数据。
在耶卡蒂特12医院医学院（YHMC）开展了一项横断面研究，以评估糖尿病患者的护理过程和结果质量指标。于2022年5月至7月的3个月期间从门诊收集数据。采用系统随机抽样选取确诊至少一年的糖尿病患者。对糖尿病优质护理指标的过程和结果进行测量，并与标准指南（美国糖尿病协会和国际糖尿病联盟）进行比较。数据分析采用描述性统计和逻辑回归。P值<0.05被用作具有统计学意义。
纳入了约250名平均年龄为53±15岁的糖尿病患者。大多数为2型糖尿病（83.2%）。为128名（51.2%）患者测定了糖化血红蛋白（HbA1c），近期平均值为8±1.6。仅52名（40.6%）患者达到了糖化血红蛋白目标值。分别为54名（21.6%）、52名（20.8%）和122名（48.8%）患者进行了年度足部全面检查、尿白蛋白尿检测和视网膜检查。单身婚姻状况（比值比[AOR]=5.76；95%置信区间[CI]：1.02 - 32.36）P = 0.047、每年至少测定两次糖化血红蛋白水平（AOR = 6.27；95% CI：2.18 - 17.73）P = 0.001以及药物依从性（AOR = 7.1；95% CI：2.61 - 19.01）P = 0.001与良好的血糖控制显著相关。
发现糖尿病护理的整体质量在护理过程和结果质量指标方面均未达到最佳水平。因此，需要提高护理人员对质量指标的认识、遵循指南、合理利用资源，并与医院管理团队和政府官员等不同利益相关者合作。
