全科医疗核心特征功能对糖尿病患者自我管理效能影响

目的探究全科医疗核心特征功能对签约家庭医生的糖尿病患者自我管理效能及其分维度的影响,为提升糖尿病患者自我管理效能提供针对性作用环节。方法采用便利抽样方法,于2019年8—9月在广州市沙园社区卫生服务中心对签约家庭医生的2型糖尿病患者进行面对面问卷调查,收集相关数据。采用多重线性回归方法分析全科医疗核心特征功能对糖尿病患者总体自我效能及分维度的影响。结果共收集224名2型糖尿病患者数据,其自我效能总分为(76.24±12.31)分,全科医疗核心特征功能总分为(72.95±11.40)分。多重线性回归分析结果显示,第一线照护能够提高糖尿病患者总体自我效能(β=0.081,P<0.1);第一线照护(β=0.088,P<0.1)、可及性(β=0.207,P<0.1)、连续性(β=0.133、P<0.1)、协调性(β=0.275,P<0.1)及以病人为中心(β=0.187,P<0.1)可提高患者药物治疗效能;未发现全科医疗核心特征功能与患者血糖与足检查、饮食管理及运动管理效能之间存在关系。结论全科医疗核心特征功能可在总体上提升糖尿病患者自我管理效能和药物治疗效能,但对患者血糖与足检查、饮食管理及运动管理自我效能的作用尚未发现,提升这三个方面的自我效能,还需借鉴健康教育和健康促进理论,提供促成因素和强化因素,例如资源支撑和环境支撑等。

The Influence of Primary Care on Self-efficacy of Diabetic Patients

Objective To explore the influence of core domains of primary care on self-efficacy and its sub-dimensions among diabetic patients with contracted family doctors,and to provide a targeted link for improving the self-management efficiency of diabetic patients.Methods From August to September 2019,a questionnaire survey of type 2 diabetes patients with contracted family doctors was conducted at Shayuan Community Health Service Center in Guangzhou.Using multiple linear regression to analyze the impact of the core domains of primary care on self-efficacy and its sub-dimensions.Results The total self-efficacy score was(76.24±12.31),and the total ASPC score was(72.95±11.40).The results of multiple linear regression analysis showed that the first-contact could improve total self-efficacy(β=0.081,P<0.1).Some could improve the efficacy of medicine treatment,which was specifically manifested in the first-contact(β=0.088,P<0.1),accessibility(β=0.207,P<0.1),continuity(β=0.133,P<0.1),coordination(β=0.275,P<0.1),patient-centered(β=0.187,P<0.1).But the core domains of primary care had not been effective in glucose and foot examination,diet management and exercise management.Conclusion The core domains of primary care can improve self-management efficacy and drug treatment efficacy,but the effect for glucose and foot examination efficacy,the diet management efficacy and exercise management efficacy has not yet been found.To improve above three aspects,health education and health promotion theories should be used for reference to provide enabling factors and reinforcing factors,such as resource support and environmental support.