电话教育对糖尿病视网膜病变筛查的影响

目的 研究电话教育和邮寄教育材料对糖尿病患者完成视网膜病变筛查的影响.方法 300例既往未进行过糖尿病视网膜病变筛查的门诊2型糖尿病患者采用计算机完全随机法分为对照组、邮寄组和电话组,每组各100例.对照组患者进行常规诊疗,邮寄组与电话组患者除常规诊疗外,分别予邮寄糖尿病教育材料1次、电话进行糖尿病教育1次,比较3组患者在纳入研究后6个月内完成糖尿病视网膜病变筛查的情况.所有入组对象均完成人口与社会学资料登记并且记录在整个研究过程中的平均空腹血糖、餐后血糖及糖化血红蛋白情况.结果 3组患者性别、年龄、常住地、受教育程度、经济收入、就诊难易程度、自身对血糖控制的满意程度、对糖尿病视网膜病变的知晓情况、体重指数、糖尿病病程、空腹血糖、餐后血糖、糖化血红蛋白、慢性并发症情况均无统计学差异（P＞0.05）.3组患者视网膜病变筛查的完成率分别为26.0％（25/96）、16.2％（16/99）、45.7％（43/94）,差异具有统计学意义（x2=21.105,P＜0.05）.与对照组相比,电话组视网膜病变筛查完成率提高了75.8％（P＜0.01）,邮寄组的完成率较低,尚未达统计学差异（P＞0.05）.女性、受教育程度较高、糖尿病病程较长的患者更可能完成视网膜病变筛查.结论 电话教育是一种有效的促进糖尿病患者完成视网膜病变筛查的方法.

Effect of telephone education on diabetic retinopathy screening

Objective To observe the effects of telephone education and mail education on diabetic patients undertaking diabetic retinopathy screening.Methods Three hundred outpatients with type 2 diabetes who never having done diabetic retinopathy screening were divided into control group,mail group and telephone group by computer random method,100 patients per group.Patients in control group were given conventional treatment while patients in mail group and telephone group were given additional mail education or telephone education once respectively.The number of patients finishing diabetic retinopathy screening during following 6 months in these three groups was compared.Demographic data of all patients and average fast blood glucose,postprandial blood glucose,glycosylated hemoglobin in the whole study were recorded.Results No significant differences were found in sex,age,abode,education,income,convenience of visit,contentment of blood glucose control,awareness of diabetic retinopathy,body mass index,duration of diabetes,fast blood glucose,postprandial blood glucose,glycosylated hemoglobin and chronic complications among three groups （P〉0.05）.Ratio of finishing diabetic retinopathy screening was 26.0% （25/96）,16.2% （16/99）,45.7% （43/94） in three groups respectively,difference was significant （x2=21.105,P 〈 0.05）.Compared with control group,completion rate of diabetic retinopathy in telephone group increased 75.8% （P〈0.01）,completion rate was lower in mail group,but difference was not significant （P 〉0.05）.Female with higher education and longer duration of diabetes were more possible to finish the diabetic retinopathy screening.Conclusion Telephone education is an effective method to promote diabetic retinopathy screening in patients with type 2 diabetes.