某农村地区老年糖尿病患者的就医行为

目的了解台州市农村老年糖尿病患者的就医现状,探讨其就医存在的问题,为推进台州市农村老年人控制糖尿病和医疗卫生改革提供参考和依据。方法 2011年1-12月,采用多阶段随机抽样方法,抽取登记在册的台州市农村户籍老年糖尿病患者192例为研究对象,采用自制的"台州市农村老年糖尿病患者对糖尿病的认知及行为调查问卷"对其进行一般情况(如年龄、性别、病程、文化程度、医疗保障方式等)、糖尿病相关知识知晓情况、就医态度(糖尿病的确诊情况、对于复诊的态度以及不配合复诊的原因)、就医目标、遵医行为(遵医嘱改变生活及行为方式、服药情况及不遵医服药的原因等)等调查。结果 50.5%的老年糖尿病患者当"出现身体明显不适时才检出糖尿病";且58.9%的患者诊断后"当身体出现不适时,才再次复诊"。44.8%的患者认为"病情轻,不复诊没关系"而选择放弃复诊。89.6%的患者得到医护人员改变生活方式的指导,未按医嘱改变行为、生活方式最主要的原因是多年的习惯改不了(44.3%)。69.0%的患者能够按照医嘱规律服药,但有20.0%的患者存在误服、漏服现象;在不遵医嘱服药的原因调查中,有31.7%的患者因为"感觉症状轻,没必要"而不遵医服药。结论患者健康意识和防治意识亟待提高,需要进一步开展健康教育,提升基层医疗服务机构的管理和干预措施。

A Survey of Health-seeking Behaviors in Elderly Patients with Diabets in Certain Rural Area

Objective To investigate the current situation of hospital attendance rate of elderly patients with diabetes in rural area of Taizhou,and to explore their problems,so as to provide reference and basis for diabetes control and medical reform. Methods From january to December 2011,200 elderly patients with diabetes in rural area of Taizhou were selected through stratified random sampling method. A self- designed questionnaire of diabetes awareness and behavior in elderly patients with diabetes in rural area of Taizhou was used to investigate their general information （age, gender, disease duration, education level, medical support methods）, diabetes-related knowledge ,the attitude of medical care （diagnosis of diabetes, referral attitudes and not with the reasons for referral）, medical treatment goals,compliance behavior （the prescribed life-changing behavior, drug administration and reasons of non-compliance with medical medication） Results Totally 50.5% of the elderly patients detected diabetes when physical discomforts occurred to them158.9% of the patients revisited doctors when physical discomforts occurred to theme44.8% of the patients refused further consultation in views of mild disease will not hurt without reconsultation;89.6% of the patients received the guidance to change their lifestyle from medical staff and the major causes （44.3 %） refered to unchangeable long-lasting habits for failures of changing lifestyles and behaviors in accordance with medical suggestions;69. 0% of the patients took drugs regularly following medical advices, but 20. 0% of them misused or missed the drugs; 31.7% of the patients disobeyed the medical advices due to their neglect to the mild symptoms. Conclusion The health consciousness in disease prevention and treatment be enhanced. Further health education can enhance management and interventions for basic medical services.