The Hong Kong Special Administrative Region IGR & DM Patient's Health Education Survey Research

ObjectivesThe patients at Hong Kong Special Administrative Region(HKSAR) 22's DM Centres were studied through the questionnaire to understand their knowledge of impaired glucose regulation(IGR),diabetes(DM).The objective is to empower the patient with self management techniques,prevent disease advancement and complications and reduce expenses to the HKSAR health sector.MethodsThe final draft of the Questionnaire was confirmed after study of foreign and Chinese medical papers and in consultation with a psychologist,statistician and 3 nursing specialists.The questionnaire's three sections are as follows:A) Patient Profile:gender,age,nationality,ethnicity,Educational level,Job description,Bill settlement categorization,Disease period,diagnosis,related medical complications.B) Health education needs:disease awareness,dietary awareness,exercise regime,health educative,self- management,complication,Medication,and understanding of hospital discharge instructions.The patients were graded on their needs on a level of 1-5.(1 is highly need and 5 is no such need accordingly)C) Method of acquiring IGR and DM patients' management information:The questionnaire has fourteen items in multiple choice format.The questionnaires were collected by the investigators immediately after the interviews.Eight surveyors were hired to conduct the survey. The questionnaires content and requirement were explained to IGR and DM patients and filled.The statistical data of the review on the condition and research outcomes and investigation of the health education of IGR and diabetes patient was analyzed by SPSS13.0 software.The software's statistical methods include reliability of homogeneity,construct-related validity analysis,frequency and descriptive statistics, ordinal logistic regression,binary logistic regression,Wilcoxon nonparametric test of 2 related samples,Friedman nonparametric test of K related samples.Results:The reliability of homogeneity(Cronbach's alpha is 0.977,x~2=107.366,P=0.000) and construct-related validity health education demands of IGR and diabetes patients is very accurate.Health education needs of disease awareness,dietary awareness, exercise regime,health educative,self-management,complications,Medication,and understanding of hospital discharge instructions is very accurate as well.In the general health education needs aspects,patients would like to understand the clinical findings, diagnosis,regulation,prevention of diabetes,diagnosis regulation of IGR,and clinical classification of diabetes(P=0.002);In order to dietary health education needs,the patient would like to know more about energy calculation,after that is food therapy,food selection,distribution of nutrition elements and eating frequencies, methods of food exchanging,caloric calculation,conception of GI(P=0.000).For exercise regime health education needs,patients would like to focus on sport therapy and content of sportive prescription(P=0.779);In Order to self-management health education needs,patients are more care on the frequencies of plasma glucose,urine glucose,inspective aim and method of HbAlc(P=0.905);In Order to medical education needs,patients would focus on prevention and therapy of low plasma glucose,side effect and method of oral medicines to decrease plasma glucose,using method and key points of INT,kind of oral medicines decreasing plasma glucose (P=0.161)The health education which provided by nurses or by doctors,there is no difference(P=0.083).Knowledge's of complications,there is not difference (P=0.564).The IGR and diabetes health education in the all items and complications compare(P=0.000),the worker of physical strength(P＜0.015),medical expenditure (P＜0.003) relater,the low complications,brainworker,free medical groups they need more education;except general health education "know the harm of diabetes" and pharmacy health education need "know the kinds of diabetes oral drug",other education need compare with gender(P＜0.05),female patients their needs is very sharp.In the general education needs "Understanding harmful effects of diabetes,the clinical symptoms of diabetes and the process of IGR diagnosis".In the dietary health education "Understanding the dietary schedules,Plasma Glucose Information,food Selection Method.In the excerise regime,"Understanding fitness & health education by doctor & self".In the Self management needs,"Understanding Plasma Glucose, HbAIc detection methods",in the need of medication education "Understanding the kinds of diabetes oral drug and use method".In the need of complications health education "Understanding the diabetes's complications in nursing care" all relate to age(P＜0.05).Elderly the need is more.In the general education need "Understanding the meaning of diabetes,the harmful of diabetes,the harmful effects of diabetes, diabetes prevention,the clinical symptoms of diabetes,the dietary schedules,Plasma Glucose Information,food Selection Method.In the excerise regime,"Understanding fitness & health education by doctor & self,the plasma glucose,HbAIc detection method".In the need of medication education,"Understanding the kinds of diabetes oral drug and use method and the side effect",the INT use method and the critical points,prevention of low plasma glucose".In the need of complications health education,"Understanding the diabetes's complications in nursing care" and "process of discharge" all related to education level(P＜0.05).Higher education level, the patients would like to have more health education.Others regression equation of health education demand are P＞0.05.The patients preferred health education method is to visit the in the need of medication education nursing center for clinical consultation.The next option is brochures and books from hospitals.The patients through newspaper,journal,phone consultation,lecture in hospital,medical and nursing home serve,internet,poster,the mobile phone short message service(SMS), video,CD-ROM is very low(X~2=1530.033,P=0.000).The brochures and books posted from hospital and medical expenditure(P=0.002,R~2=1.041),and the number of complications(P=0.015,R.2=-0.849),expenditure by oneself,low complication the patients need request more high.The patients have health education in the diabetes nursing center for clinics consultation of diabetes nurse compare with the number of complications(P=0.003,R~2=1.442),the worker of physical strength(P=0.024,R~2= -2.024) related,brainworker,high complication need more.Other health education method are P＞0.05.ConclusionsThe questionnaire's content has been designed to fit Hong Kong IGR and DM patient's health education evaluation in the HKSAR.It can be used to evaluate the needs of health education to different IGR and diabetes patients.The Statistic data shows that patients pay more attention on their own conditions and treatment methods, nursing care plan,etc.They look for the diabetes knowledge after their diagnoses. Patients don't have enough knowledge of the prevention.From the Diabetes educator's view,there is a shortage of diabetes nurses.From DM patient's view,Hong Kong DM patients are increasing.That means patients diabetes knowledge is not enough in the society.Government should provide more education even from the school.Although,IGR and DM's patient have diet control,however,the understanding of the DM knowledge is not enough.Hong Kong diabetes nurses should increase the education to the patients.The diabetes nursing center for clinics consultation of diabetes nurses is the most popular way to the patients to get information of diabetes knowledge.So the diabetes nurses are the most important role for health education.Patients like to go to diabetes nursing center for clinical consultation compare with the number of complication,both the blue collar workers and white collars workers need DM center more.These definitely increase the DM nurses work load.And we should also ensure the knowledge of the DM nurses is professional enough.There are so many different types of brochures and books are available at hospitals,but the contents are different.That means Hong Kong DM nurse use evidence-based nursing(EBN) Aim at the problems of nursing research education and limits of problem-based learning to create one manual for DM patient. Female patients they request more on health education and harmful of in the need of medication education.They are very responsible to their families.The nurse specialists should provide health education base on the different patients' needs such as;gender,age,nationality,ethnicity,educational level,job description,bill settlement categorization,disease period,diagnosis,related medical complications.The most important point is that we should educate the patient with self management techniques,prevent disease advancement and complications in order reduce expenses to the HKSAR health sector.