發(fā)布時(shí)間：2018-06-30 09:45

  本文選題：糖尿病患者 + 門診�。� 參考：《天津醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:調(diào)查分析糖尿病患者當(dāng)前日常續(xù)藥及復(fù)查現(xiàn)狀,了解糖尿病患者網(wǎng)絡(luò)續(xù)藥的需求意愿及其影響因素,初步分析其實(shí)施可行性,進(jìn)一步調(diào)查廣大患者對網(wǎng)絡(luò)續(xù)藥的部分關(guān)注意向,為糖尿病的防治提供參考依據(jù)。方法:采用自行設(shè)計(jì)的問卷于2014年11~12月對天津醫(yī)科大學(xué)代謝病醫(yī)院門診320名糖尿病單純?nèi)∷幓颊哌M(jìn)行隨機(jī)問卷調(diào)查,最終收回有效問卷304份,分析患者目前的取藥、檢查現(xiàn)況、對網(wǎng)絡(luò)續(xù)藥的需求意愿及其實(shí)施可行性。結(jié)果:對自行設(shè)計(jì)的問卷中內(nèi)部同質(zhì)性較高的適合做信度分析的部分分析得其整體分半信度(Split-half系數(shù))為0.785,克朗巴赫α系數(shù)為0.872,問卷可信度比較理想,效度檢驗(yàn)中對所有條目進(jìn)行因子分析,最終得到13個公因子,其累計(jì)貢獻(xiàn)率為71.17%。一般情況:被調(diào)查者中男性占到50.99%,女性占到49.01%,人群年齡中位數(shù)為60.97歲;文化程度主要集中在“初中”和“高中/中�！眱深�,分別占到調(diào)查總?cè)藬?shù)的29.28%、37.17%;家庭月人均收入2000-2999元的占到44.74%,3000-4999元的占到26.65%;其中2型糖尿病患者296人,占到被調(diào)查總數(shù)的97.37%,病程中位數(shù)為10年;在醫(yī)院完成一次續(xù)藥的總耗時(shí)中位數(shù)為2.60小時(shí),四分位數(shù)為P25:2.03小時(shí),P75:3.58小時(shí)。取藥及檢查現(xiàn)狀:不到3周便得到醫(yī)院續(xù)一次藥的患者占到被調(diào)查者總數(shù)的74.30%,而被調(diào)查者中只有15.96%的糖尿病患者需要在半年內(nèi)進(jìn)行處方調(diào)整,有135人即44.41%的被調(diào)查者“續(xù)藥需有人陪伴或代拿”,仍有30.88%被調(diào)查者表示有過斷藥現(xiàn)象;對于“藥物用法用量”,80.59%的被調(diào)查者表示非常清楚,“用藥注意事項(xiàng)”只有43.09%的人非常清楚,而對于“推薦的檢查間隔時(shí)間”表示非常清楚的只有2.00%;而且糖尿病患者日常續(xù)藥、復(fù)查分別有86.20%、85.90%的人選擇“三級/�？漆t(yī)院”。糖尿病門診患者對網(wǎng)絡(luò)續(xù)藥需求意愿及影響因素分析:“非常期待”、“期待”網(wǎng)絡(luò)續(xù)藥服務(wù)開展組的被調(diào)查者分別有174人、103人,共占被調(diào)查總數(shù)的91.12%,“沒興趣”、“不怎么感興趣”或“一般”期待網(wǎng)絡(luò)續(xù)藥服務(wù)開展組共27人,共有8.88%;“對該院目前取藥流程滿意度”中有237人不滿意,占到53.95%,有227人即74.67%的人表示可以實(shí)現(xiàn)“自己/請他人幫忙操作電腦上網(wǎng)”;對于“感覺該方式風(fēng)險(xiǎn)大小”方面,只有8人認(rèn)為其風(fēng)險(xiǎn)很大或比較大;對被調(diào)查者的一般人口學(xué)特征、續(xù)藥檢查現(xiàn)狀及網(wǎng)絡(luò)續(xù)藥的可及性中可能影響糖尿病患者網(wǎng)絡(luò)續(xù)藥需求意愿的諸因素進(jìn)行單因素分析發(fā)現(xiàn),只有對“推薦的檢查間隔”清楚度、“對該院目前取藥流程滿意度”和“自己/請他人幫忙操作電腦上網(wǎng)的方便程度”3項(xiàng)在兩組人群中差別有統(tǒng)計(jì)學(xué)意義,進(jìn)一步做二分類Logistic回歸分析,最終得到“自己或請他人幫忙通過電腦上網(wǎng)操作的方便程度”及“對推薦的檢查間隔時(shí)間的清楚度”兩項(xiàng)有統(tǒng)計(jì)學(xué)意義,OR值依次等于4.642(95%CI:1.978-10.893)、4.978(95%CI:2.067-11.985)。對網(wǎng)絡(luò)續(xù)藥的部分關(guān)注意向:對于“網(wǎng)絡(luò)續(xù)藥及復(fù)查預(yù)約的實(shí)現(xiàn)形式”,被調(diào)查的糖尿病門診患者選擇打電話的最多,有48.66%的人,其次是通過電腦客戶端形式實(shí)現(xiàn),占34.90%;“希望該服務(wù)可以實(shí)現(xiàn)的功能”中,304名被調(diào)查者中有284人希望該系統(tǒng)能實(shí)現(xiàn)“續(xù)藥”功能,之后依次是“檢查預(yù)約”、“續(xù)藥及復(fù)查提醒”、“(歷史查詢)查詢以往診療記錄及檢查結(jié)果”,分別有255人、252人、251人選擇。結(jié)論當(dāng)前的糖尿病門診續(xù)藥給患者及社會都帶來諸多不便,浪費(fèi)了醫(yī)患雙方大量時(shí)間及資源,整個過程體驗(yàn)亦不盡如人意;而且在整個糖尿病用藥治療過程中,患者基本比較被動,用藥安全也存在一定隱患。然而糖尿病患者對網(wǎng)絡(luò)續(xù)藥的熱情及心理接受度普遍較高,當(dāng)下也具備一定的實(shí)施可行性;該系統(tǒng)中的功能應(yīng)該能提高糖尿病患者的自我健康意識及自我管理水平,能一定程度彌補(bǔ)當(dāng)前糖尿病患者門診續(xù)藥的不足,最后廣大患者對其相關(guān)服務(wù)費(fèi)用及個人信息安全問題比較關(guān)注。
[Abstract]:Objective: To investigate and analyze the current status of daily reexamination and reexamination of diabetic patients, to understand the desire and influencing factors of diabetic patients' demand for Internet continued drugs, to analyze the feasibility of its implementation, and to further investigate the interest of the patients on the network, and to provide reference for the prevention and treatment of diabetes. In 11~12 month of 2014, a questionnaire survey was conducted on 320 patients in the outpatient department of metabolic disease hospital of Medical University Of Tianjin. 304 effective questionnaires were collected, the current drug withdrawal was analyzed, the current situation was examined, the desire for the demand for the network continued and the feasibility of its implementation. Results: the internal homogeneity of the self-designed questionnaire was made. The partial analysis of the higher reliability analysis showed that the partial half reliability (Split-half coefficient) was 0.785, the Krone Bach alpha coefficient was 0.872, the reliability of the questionnaire was ideal, and all the items were analyzed by factor analysis in the validity test, and finally 13 public factors were obtained. The cumulative contribution rate was 71.17%. general situation: the male accounted for 50 of the respondents. .99%, women accounted for 49.01%, the median age of the population was 60.97 years, and the cultural level was mainly concentrated in two categories: "junior high school" and "high school / secondary school", accounting for 29.28%, 37.17% of the total number of respondents, 2000-2999 yuan per month per capita of family 44.74% and 3000-4999 yuan accounting for 26.65%; of which 2 diabetes patients accounted for the total number of respondents. 97.37%, the median of the course of the disease was 10 years; the median time of total consumption of a continuous drug in the hospital was 2.60 hours, the four digits was P25:2.03 hours, P75:3.58 hours, and the status of taking medicine and examination: 74.30% of the total number of the respondents were received in the hospital less than 3 weeks, while only 15.96% of the respondents were required. In half a year, 135 people, or 44.41% of the respondents, "continued drug need to be accompanied or taken", and 30.88% of the respondents said they had the phenomenon of excessive drugs; for "drug usage and consumption", 80.59% of the respondents were very clear, "medication attention" only 43.09% people are very clear, and for "recommended" The interval time of examination was very clear only 2%, and 86.20% of the daily reexaminations of diabetic patients, 85.90% of the people selected "grade three / specialist hospital". There were 174 people and 103 people, which accounted for 91.12% of the total number of respondents, "no interest", "not very interested" or "general" expected network drug service to carry out a total of 27 people, a total of 8.88%. "To the hospital's current drug extraction process satisfaction", 237 people are not satisfied, 53.95%, there are 227 people that can achieve "self / invite him". "People help to operate computer Internet"; only 8 people think that the risk of this way is very large or relatively large, and a single factor analysis of the factors of the general demographic characteristics of the respondents, the current status of the continued drug examination and the possibility of the Internet continued drug demand in the accessibility of Internet continued drugs Only the "recommended interval" clarity, "the hospital's current drug recovery process satisfaction" and "the convenience of your own / ask for help to operate the Internet" 3 items in two groups of people with statistical significance, further to do two classification of Logistic regression analysis, the final "oneself or ask for help through the computer Internet access to the Internet." The convenience of operation and the two items of "clarity for recommended interval time" were statistically significant. The OR value was equal to 4.642 (95%CI:1.978-10.893), 4.978 (95%CI:2.067-11.985). At the top of the phone, there are 48.66% of them, followed by a computer client, accounting for 34.90%. "Hope that the service can be realized", and 284 of the 304 respondents hope that the system can implement the "continued drug" function, followed by "check reservations", "continuation and review reminders", "(historical inquiry) inquiries There were 255 people, 252 people and 251 choice, respectively. Conclusion the current diabetic outpatient medicine continued to bring a lot of inconvenience to the patients and the society, waste a lot of time and resources between the doctors and patients, and the whole process experience is not satisfactory, and the patients are basically passive in the course of the treatment of diabetes. However, there are some hidden dangers in the safety of drug use. However, the enthusiasm and psychological acceptance of the diabetic patients are generally high, and the present also has a certain implementation feasibility. The function of the system should be able to improve the self health awareness and self management level of the diabetic patients, and to a certain extent make up for the current diabetes patients in the outpatient clinic. In the end, the majority of patients are concerned about their related service fees and personal information security.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R587.1
，

本文編號：2085864