Study On Individual Control Effect Of Diabetics By Optimizing The Structure Of General Practitioners’ Knowledge

Object:To improve general practitioner integrated management of diabetes and the effect of glycemic control on diabete patients through design and implementation of the educational program of diabetes prevention knowledge optimization and the management program of individual skills guide.Methods:(1) The method of three sections and eight steps gradually deepening was used to optimize knowledge which was the primary "Reading self-learning" type, the intermediate "experts teach and interaction" type and the advanced "Special topic study deeply and lecture" type. And design a corresponding test program of comprehensive diabetes prevention and control knowledge of the general practitioner. By using Krona Bach alpha coefficient analysis, the knowledge appraisal scale internal reliability is0.83.(2) Design and formulate a set of diabetic patients individual monitoring management program. According to the monitoring management requires, the knowledge optimization educated community general practitioners used individual prevention and management to the diabetes research objects.(3) Using face-to-face survey by questionnaire to learn glycemic control of community diabetes and cognition of knowledge and behavior of diet and exercise therapy.Results:(1) The test scores of the experimental group general practitioners accepting the diabetes comprehensive prevention knowledge and skill education program were: before the implementation of the primary "Reading self-learning" education programs, the average score of25general practitioners was63.46. After the implementation, the average score was81.63. The difference was statistically significant p<0.05by t-test. Before the implementation of the intermediate "experts teach and interaction" education programs, the average score of52general practitioners was57.04, the after average score is73.42. The difference was statistically significant p<0.05by t-test. The total average test scores (200divided to units)of experimental group after the advanced "Special topic study deeply and lecture" type compared with the seven control groups, the average score was about26points to80points higher. The difference was statistically significant p<0.01by t-test.(2) To investigate diet and exercise therapy of the87community diabetic patients:accounted for only27.7%of patients’blood glucose controlled less than7.0mmol/L.95%of patients didn’t know the reasonable proportion of the three major nutrients.100%of patients didn’t know-food glycemic index.92%of patients didn’t know the effect of high-fiber foods on blood sugar control.69%of patients participated in the exercise, but95%of them didn’t know the positive effect of aerobic exercise on blood glucose control.49.4%of patients thank the knowledge of diabetes diet and exercise therapy was got through doctors.(3) The50diabetic patients were implemented the individual comprehensive prevention guidance and monitoring of blood glucose for6months by the general team backbone doctors who accepted the knowledge optimize education, their average blood glucose levels were decreased from8.5mmol/L to7.33mmol/L. The difference was statistically significant p<0.05by t-test. The knowledge of diabetes comprehensive treatment, the blood glucose monitoring behavior and the proportion of establishing a healthy lifestyle behavior in experimental group were higher than in control group. The difference was statistically significant p<0.05by t-test.Conclusions:Diabetic patients know the diet and exercise therapy less. The mastery of the knowledge of comprehensive prevention and control of diabetes by general practitioner can play a positive effect on the proper guidance on the patient. The research shows that the general practitioner’s knowledge and skills are improved after the cascade training and guidance of diabetes prevention knowledge and skill knowledge optimization. It plays an important role on the implementation of individual monitoring and management of diabetic patients. The research is only a pilot study. The Pengpu community health service center will study deeply of the health management of diabetes based on the information system on the basis. It is a cutting-edge research. And it will offer practices and be theoretical basis of carrying out the individual monitoring of diabetes management in our community health service centers.