Wang Z Z, Yin X J, Yang J S, Li J, Liu Q L, Wei G X, Chen M, Jing B, Shao R T, Feng L Z
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Chronic Diseases, Wugang Center for Disease Control and Prevention, Pingdingshan 462599, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 May 6;58(5):615-621. doi: 10.3760/cma.j.cn112150-20231229-00513.
Employing the cascade care model, this qualitative study explores determinants influencing the cascading care stages of hypertension and diabetes by interviewing various stakeholders. In July 2023, purposive sampling was employed to recruit participants from Gongyi and Wugang cities in Henan Province, and Linqu County in Weifang City, Shandong Province. Semi-structured in-depth interviews were conducted with representatives of policymakers, healthcare institution managers, providers, and patients with hypertension and diabetes.And thematic analysis was performed using both inductive and deductive approaches. A total of 82 individuals were interviewed, with an age range of (53.8±12.0) years, among which 48 (58.5%) were male; including 5 policymakers, 10 institutional managers, 20 healthcare providers, and 47 patients with hypertension and diabetes. The study identified both barriers and facilitating factors at the patient, healthcare provider, and system levels across various stages: awareness, screening, diagnosis, treatment, long-term management, and control of hypertension and diabetes. By delineating and analyzing the barriers and facilitators at each stage of hypertension and diabetes care, this study lays the groundwork for the development of effective, feasible, and sustainable implementation pathways, with significant implications for the enhanced management of hypertension and diabetes in China.
本定性研究采用级联护理模式，通过采访不同利益相关者，探讨影响高血压和糖尿病级联护理阶段的决定因素。2023年7月，采用目的抽样法从河南省巩义市和舞钢市以及山东省潍坊市临朐县招募参与者。对政策制定者、医疗机构管理人员、医护人员以及高血压和糖尿病患者的代表进行了半结构化深度访谈。并采用归纳和演绎方法进行了主题分析。共访谈了82人，年龄范围为（53.8±12.0）岁，其中男性48人（58.5%）；包括5名政策制定者、10名机构管理人员、20名医护人员以及47名高血压和糖尿病患者。该研究在患者、医护人员和系统层面的各个阶段（高血压和糖尿病的知晓、筛查、诊断、治疗、长期管理和控制）确定了障碍因素和促进因素。通过描绘和分析高血压和糖尿病护理各阶段的障碍和促进因素，本研究为制定有效、可行和可持续的实施途径奠定了基础，对加强中国高血压和糖尿病的管理具有重要意义。
