| Objective:In order to provide the reference actively for the development of the community health care of the diabetes in Nanchang,which take residents' demands orientation,have complete service item and whole service system.The study was carried out by means of investigating the supplies and demands of the community care of the diabetes patients in Nanchang,and analyzing the influencing factors completely.Methods:The following crowds were investigated unifiedly according to the inclusion criteria and exclusive criteria from April to October in 2011.1.Community resident with diabetes:292 diabetes patients were sampled by the method of the multistage simple random sampling from 3 community health service centers in Nanchang.They were interviewed by self-designed questionnaire(Cronbach'? value is 0.866,Content validity value is 0.929).It contained diabetes patients'general information,disease material and the demands of the community health care.2.Community nurse:154 community nurses were sampled by the methord of the stratified cluster sampling from 13 community health service centers and 17 community health service stations in Nanchang.They were interviewed by self-designed questionnaire.It contained nurses' general information and the supplies of the community health care of the diabetes.All the datum were analyzed and dealed with by SPSS 17.0.Measurement data was described by means±standard deviation,enumeration data was described by frequency and composition ratio.T test or oneway ANOVA was used to compare the difference of the level of the demands of the diabetes patients between the two or more different groups.X2 test was used to compare the difference of the general information of the nurses from 5 urban areas in Nanchang.Multiple stepwise regression analysis was used to analyze the factors which effected the demands of the community health care of the diabetes patients.Results:1.The total demands of the community health care of the diabetes patients in Nanchang reached the moderate level(scored 3.9910.19),the demand of health promotion was the highest(scored 4.08±10.30),the second one was the disease nursing(scored 4.0710.26),while the demand of prevention of complications was the lowest(scored 3.80±0.29).2.Regarding the specific items,the supplies of the periodic physical examination was the highest demand of the disease nursing of diabetes(100%),the prevention and emergency rescue of the hypoglycemia was the highest demand of prevention of complications(98.6%),and so was the supplies of the guidance of health behaviors and life style of the health promotion(96.9%).3.By the means of the multiple stepwise regression analysis,the main factors affected patients'community health care demands were the complication of diabetes,treatment methods,patients'age,the characteristics of primary caregivers and so on,but the most important factor was the complication of diabetes.Specific content as follows:(1)There were 5 factors effected the demand of the disease nursing of diabetes,they were the treatment of the diet and activities,comprehensive treatment,cerebrov-ascular disease,the complication of the diabetes,other diabetes patients in family.The biggest influence was the comprehensive treatment.(2)There were 6 factors effected the demands of the complications protection of diabetes,they were the primary caregiver was myself,the complication of the diabetes,the distance between the place and the nearly community health service agencies,living with children,taking a walk or taijiquan,age.The biggest influence was the complication of the diabetes.(3)There were 4 factors effected the demands of the health promotion,they were patients' age,the complication of the diabetes,retired,cerebrovascular disease.The biggest influence was the patients' age.(4)There were 3 factors effected the total demands of the community care of the diabetes patients,they were the complication of the diabetes or not,comprehensive treatment.The biggest influence was the comprehensive treatment.4.The overall quality of community nurses in Nanchang was low.5.There were statistical differences in community nurses' general information from 5 urban areas.The community nurses in the Donghu area have the most of the high titles and high educational level.Compared to the other areas,the community nurses in the new Honggutan area had less fixed establishment,took part in the community and clinical for a shorter time,submitted an expense account of training partly.6.The dominant supply of the community care of the diabetes was the disease nursing;health promotion needed to be improvemented;Compared to the demands of the diabetes patients,the supplies of complications protection did not reach the designated position.7.Regarding the specific items,more than 50%items still didn't be supplied,which were the building of the family sickbed,the prevention education and urgent attention of the high permeability coma,the sex life guidance of the sexual dysfunction caused by the diabetes,the founding of the club of the diabetes patients8.The main factor affected the supplies was the lack of the professional knowledge of community health care of diabetes and the limit of the level of the skills.Conclusion:The level of the demands of the community care of the diabetes patients in Nanchang were higher and the content of demands were widespread too,but the demands were still effected by various subjective and objective factors.The overall quality of community nurses in Nanchang was low so that it shoud to be improved,There were still a definite disparity between the supplies and the demands of the community care of the diabetes.The development of the community health care of the diabetes should according to the patients' dmands and analyze the the influcing factors between the supplies and the demands.It is important to extend the content,perfect the modes and enhance the service quality in 3 aspects of disease nursing,prevention of complications and health promotion. |
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