| Objective of the Research:Diabetes mellitus is a group of metabolic diseases characterized by chronic high blood glucose levels, that result from defects in insulin secretion, or action, or both. It causes body severe metabolic disorders, including glucose, proteins, lipids as well as water-electrolyte, and often leads to acid-base disorders when severely. Long-term abnormal blood glucose levels can cause multi-system damage and lead to chronic complications, including tissues of eyes, kidneys, nerves, heart, and blood vessels. The complication rate of DM is up to 65.1%, which is the main reason for disability and death in patients with diabetes. The current treatment for diabetes concentrates on improvements of lifestyle modifications, rational dietary and appropriate medications, as well as prevention and management for relevant complications of diabetes. The positive prevention and treatment for DM complications can significantly reduce mortality and avoid the serious consequences of the disease, so the important part of control and treatment for DM is that all medical staff and patients themselves have deep understanding about DM and its relevant complications. Along with the population aging, DM has become the third largest diseases followed by the malignant tumors and cardiovascular diseases, and its incidence is increasing year by year. According to the latest statistics from the International Diabetes Federation 2007, currently there are about 246 million DM patients worldwide, more than 300 million by 2025, and nearly 40 million in China, remaining the NO.2 in the world. According to the literature, nearly half of patients with diabetes must accept surgery due to other diseases, and the incidence of complications, infections and mortality increased significantly after operations. There are complex interactions and effects between surgical disease on diabetes and diabetes itself on surgery. Surgical operations for such patients become more difficult because of hyperglycemia and metabolic multi-disorders from DM, and a sudden increase in blood glucose may occur after operations. There are some factors causing diabetic hyperglycemia in perioperative period, such as surgical stress, pains, infection, hormones, catecholamines, etc, which lead to insulin resistance and inadequate insulin secretion through cytokines pathways. Improper handling can easily lead to ketoacidosis or hypertonic syndrome. DM itself can also affect postoperative wound healing, lead to postoperative infections, and seriously affect the postoperative rehabilitation and quality of life. On the other hand, the surgical diseases and surgery themselves play a great difficult role in control of blood glucose levels, and the stress of anesthesia and operations can worsen the disease and have a great impact on its progress. Thus there are critically important among surgical medical staff knowledge about DM in perioperative period, the impact of DM for effects of surgery itself, and for postoperative recovery. Surgery medical staff is engaged in the surgical treatment of diseases and managements relevant to operations. As the process of the specialization of medical work, surgical clinical specialties work to further refinement and further differences in the medical division. Such medical activities engaged by surgical medical staff are more and more specialized, and the research of surgical treatments is furthering gradually. Medical diseases usually associate with diseases of surgery or resulted from operations, and their influence on the aspects of perioperative treatments are not the surgical research emphasis. The most closely related to and interactive with medical disorders are DM in a variety of complications for surgical patients. Studies have shown that more than 10% of elderly surgical patients have DM. However, the basic knowledge of surgical medical staff about DM is originated mostly from the stage of the medical course study during their basic medical education, so that the knowledge is mainly from the classroom education and learning stage. The classroom education mainly introduces medical knowledge and treatments for DM, however, such aspect of knowledge about perioperative observations and treatments for DM patients accepted surgical operations is rarely addressed. After entering the surgical clinical work, surgical medical staff focuses on the research of surgical techniques, preventions and treatments for operative complications,and updated methods for operations, so re-learning for DM knowledge usually works very little. Surgery medical staff undertakes the task of the perioperative nursing and treatments for such patients, The status of their knowledge about DM directly affects effects of perioperative treatments. Currently, the understanding of DM knowledge has been reported from groups of grass-roots medical workers, general practitioners, non-specialists, nurses, etc, however, such knowledge of surgical medical staff about DM haven't been seen in relevant researches. This study aims to understand the status of surgical medical staff knowledge about DM, providing a basis of knowledge training for the surgical medical staff.Methods of the Research:A self-designed questionnaire was conducted on the basis of referring to domestic and foreign literature and consulting with nursing experts in Guangdong Province, including:(1) The first part was the basic knowledge questionnaire for DM, mainly referred to the diabetes knowledge assessment and tests designing, which is from "China's Diabetes Care and Education Guide" written by Chinese Medical Association, diabetes care and diabetes education group. This part of the questionnaire included 6 dimensions of 21 items, including 3 basic knowledge items, 4 dietary knowledge items,4 sports knowledge items,4 monitoring knowledge items, 3 medication knowledge items, and 3 complications knowledge items. (2) The second part of the questionnaire was the perioperative knowledge with 10 items, mainly about the impact of the operation on DM and the perioperative blood glucose control. At first the questionnaire survey was conducted through pre-investigation in small sample, the re-survey was performed after 2 weeks with high similar outcomes, and then the formal investigation was conducted as amended by experts. With the method of convenience sampling, trained full-time nurses were sent to make anonymous survey of registered doctors and nurses worked in orthopaedics, urinary surgery, general surgery, neurosurgery, and thoracic and cardiovascular surgery from October to December 2009, and the questionnaires were released uniformly and recovered at the same day.535 questionnaires were returned from the total of 600, whose items missing values being more than 20% were removed, and finally 513 valid questionnaires were received. Data were processed and analyzed by SPSS13.0, and measurement data were expressed in the form of percentage and mean±standard deviation. Two sample t-test was used to compare measurement data, while multiple samples were analyzed by analysis of variance. The difference was statistically significant when P<0.05.Results:1,The status of surgical medical staff knowledge about DM was relatively low. The status of knowledge about DM from surgical medical staff surveyed from grade A class 3 hospitals was relatively low.The total score was 72.24. 2,The mastery degree of knowledge about DM from Surgical medical staff in the basic area was better than in the perioperative period. The score was 76.97 in basic knowledge questionnaire for surgical medical staff, while 62.30 in perioperative period knowledge questionnaire, with P<0.01 indicating the difference was statistically significant and demonstrating the mastery degree of knowledge about DM in the basic area was better than in the perioperative period. Among the items with the high rate of correct answers, there were 8 items belonged to basic knowledge questionnaire, while among the items with the low rate of correct answers in the Table 2, there were 5 items belonged to perioperative period knowledge questionnaire and 4 belonged to basic knowledge questionnaire.3,There were no significant difference about the status of knowledge about DM among surgical medical staff with different ages. When compared the status of the basic and perioperative period knowledge about DM among medical staff with different ages, the rate of correct answers in basic area was no significant difference among groups (P> 0.05), while the rate in perioperative period area was also no significant difference among groups (P> 0.05), indicating the increase of knowledge about DM from surgical medical staff wasn't along with the increase of working life. Although medical staff whose work experience less than 3 years was the minimum, the score was 77.26 in based knowledge and 64.14 in perioperative period knowledge, which was the highest rate among all groups. On the contrary, medical staff whose work experience more than 20 years was the maximum, the score was 76.19 in based knowledge and 54.62 in perioperative period knowledge, which was the lowest rate among all groups, which indicated that surgical medical staff did not attach importance to the study of DM knowledge, so that the longer working life, the more knowledge of aging and obsolete, and also showed that surgical medical staff in the clinical practice did not pay full attention to the accumulation of knowledge, generating the distance from the clinical diagnosis and treatment progress.4,The status of knowledge about DM was different between doctors and nurses. The score of correct answers were statistically significant differences between doctors and nurses (P<0.01) among some areas, such as general questionnaire, perioperative knowledge questionnaire, basic knowledge, and sports knowledge. There were also statistically significant differences between them (P<0.05) in the area of-basic knowledge questionnaire, monitoring knowledge, and knowledge of complications, which indicated that the knowledge of doctors mostly better than nurses. However, there were no statistically significant differences between them in the area of dietary knowledge (P> 0.05), which demonstrated the score was no significant differences. The score was 76.41 for doctors about drug knowledge, which was 83.94 for nurses, with t=-3.455, P<0.05, and differences being statistically significant. The score of knowledge about drugs for nurses was higher than doctors. The drug knowledge from questionnaires focused on details of insulin storage conditions, injection methods, and the custody of drugs in clinical work, which were mainly implemented by nurses, while the attention was relatively low for doctors. The statistical results showed that the correct rate of drug knowledge for nurses was higher than doctors.Conclusions:The surgical medical staff knowledge about DM is relatively low, and the knowledge training should be strengthened to protect the perioperative period safety for patients with diabetes. Surgical medical staff must recognize that more and more patients with DM are existing among the surgical patients, and this proportion will increase. The perioperative risk is increasing for patients because of DM, which is prone to complications. Surgical medical staff must grasp well knowledge about DM, which helps the patients survive the perioperative period. The initiative and sense of urgency to learn DM knowledge should be increased and a variety of knowledge training should be performed for surgical medical staff, especially in the form of continuing education. Hospital leaders should pay great attention to provide all kinds of learning opportunities, create a good learning environment, and organize a variety of knowledge training and continuing education for surgical medical staff. The contents of the training should focus on perioperative and relevant monitoring knowledge. Because perioperative treatments for DM directly affect the prognosis, the training of perioperative knowledge should be strengthened. The monitoring knowledge in basic DM knowledge is at the low correct rate, so the training must also strengthen the relevant monitoring knowledge. Because of low correct rate seen from surgical medical staff with high qualification, more attention must be paid to them among training personnel.
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