Study on the status of cognitive behaviour for delayed diagnosis and treatment in diabetes patients in rural areas

doi:10.3761/j.ssn.0254-1769.2021.01.015

Abstract

Abstract:

Objective To describe the status of cognitive behaviour in diabetes patients with delayed diagnosis and treatment in rural areas,and to analyze the influencing factors. Methods From June 2018 to December 2019,a convenience sampling method was used to select 832 cases of diabetes patients with delayed diagnosis and treatment in rural areas of Daqing city in Heilongjiang province and Tangshan city in Hebei province. By general data questionnaire and the scale for cognitive behaviour with delayed diagnosis and treatment of diabetes patients in rural areas,we investigated and analyzed its influence factors. Results The total score of cognitive behavioral for delayed diagnosis and treatment of diabetes patients in rural areas was（47.98±11.27）,with the highest score in disease control dimension and the lowest score in symptom alert dimension. The results of linear regression analysis showed that age,gender and per capita monthly family income were independent factors influencing the level of cognitive behaviour for delayed diagnosis and treatment of diabetes patients in rural areas. Conclusion The level of cognitive behaviour of diabetes patients with delayed diagnosis and treatment in rural areas was lower.Medical personnel should pay more attention to the diabetes patients with delayed diagnosis and treatment in rural areas,and help them to improve the diagnosis and treatment rate and control blood glucose level through health education,warning education,dynamic tracking and other interventions.

Key words: Cognitive behaviour, Diabetes in Rural Areas, Analysis of Influencing Factors, Nursing Care, Delayed Diagnosis and Treatment, Cognitive behaviour, Diabetes in Rural Areas, Analysis of Influencing Factors, Nursing Care

摘要：

目的调查农村糖尿病诊治延误患者认知行为的现状,并分析其影响因素。方法采取便利抽样方法,2018年6月—2019年12月,选取黑龙江省大庆市和河北省唐山市农村糖尿病诊治延误患者832例为调查对象,采用一般情况调查问卷、农村糖尿病诊治延误认知行为量表对其进行调查,并分析农村糖尿病诊治延误患者认知行为的影响因素。结果农村糖尿病诊治延误患者的认知行为得分较低,为（47.98±11.27）分,其中疾病控制维度得分最高,症状警觉维度得分最低。线性回归分析结果显示,年龄、性别及家庭人均月收入是影响农村糖尿病诊治延误患者认知行为的独立因素。结论农村糖尿病诊治延误患者的认知行为处于较低水平。医护人员应该多关注农村糖尿病诊治延误患者,通过健康宣教、警示教育和动态跟踪等干预措施,协助其提高诊治率,控制其血糖水平。

关键词: 诊治延误, 认知行为, 农村糖尿病, 影响因素分析, 护理

JIA Honghong,HUO Guixia,WANG Haili,LIU Yang,LUO Xiaoxi,YANG Shuang. Study on the status of cognitive behaviour for delayed diagnosis and treatment in diabetes patients in rural areas[J]. Chinese Journal of Nursing, 2021, 56(1): 91-96.

贾红红,霍桂霞,王海丽,刘杨,罗小茜,杨爽. 农村糖尿病诊治延误患者认知行为的调查研究[J]. 中华护理杂志, 2021, 56(1): 91-96.

Figures/Tables 3

References 23

[1]	嵇加佳, 刘林, 楼青青, 等. 2型糖尿病患者自我管理行为及血糖控制现状的研究[J]. 中华护理杂志, 2014,49(5):617-620.
	Ji JJ, Liu L, Lou QQ, et al. Self-management behaviors and glycemic control in patients with type 2 diabetes mellitus[J]. Chin J Nurs, 2014,49(5):617-620.
[2]	陈冬梅, 邢凤梅, 张小丽, 等. 农村Ⅱ型糖尿病患者知识掌握情况与自我管理行为的关系[J]. 现代预防医学, 2015,42(15):2764-2766.
	Chen DM, Xing FM, Zhang XL, et al. Correlation between knowledge and self-management behavior of patients with type 2 diabetes[J]. Mod Prev Med, 2015,42(15):2764-2766.
	Chen DM, Xing FM, Zhang XL, et al. Correlation between knowledge and self-management behavior of patients with type 2 diabetes[J]. Mod Prev Med, 2015,42(15):2764-2766.
[3]	Nakao T, Shimizu Y, Nunoi K, et al. A mixed methods study to examine the difficulties experienced and coping behaviours used by people with type 2 diabetes of working age in Japan[J]. Int Diabetes Nurs, 2017,14(2/3):60-65.
	Nakao T, Shimizu Y, Nunoi K, et al. A mixed methods study to examine the difficulties experienced and coping behaviours used by people with type 2 diabetes of working age in Japan[J]. Int Diabetes Nurs, 2017,14(2/3):60-65.
[4]	Wändell PE, Carlsson AC, Gåfvels C, et al. Measuring possible effect on health-related quality of life by tactile massage or relaxation in patients with type 2 diabetes[J]. Complementary Ther Med, 2012,20(1/2):8-15. DOI URL
	Wändell PE, Carlsson AC, Gåfvels C, et al. Measuring possible effect on health-related quality of life by tactile massage or relaxation in patients with type 2 diabetes[J]. Complementary Ther Med, 2012,20(1/2):8-15. DOI URL
[5]	Ängerud KH, Brulin C, Näslund U, et al. Patients with diabetes are not more likely to have atypical symptoms when seeking care of a first myocardial infarction. An analysis of 4028 pa-tients in the Northern Sweden MONICA study[J]. Diabet Med, 2012,29(7):e82-e87. DOI URL PMID
	Ängerud KH, Brulin C, Näslund U, et al. Patients with diabetes are not more likely to have atypical symptoms when seeking care of a first myocardial infarction. An analysis of 4028 pa-tients in the Northern Sweden MONICA study[J]. Diabet Med, 2012,29(7):e82-e87. DOI URL PMID
[6]	薛丽丽. 2型糖尿病社区干预效果研究[D]. 福州:福建医科大学, 2017.
	薛丽丽. 2型糖尿病社区干预效果研究[D]. 福州:福建医科大学, 2017.
	Xue LL. Study on the effect of community intervention for type 2 diabetes mellitus[D]. Fuzhou: Fujian Medical University, 2017.
	Xue LL. Study on the effect of community intervention for type 2 diabetes mellitus[D]. Fuzhou: Fujian Medical University, 2017.
[7]	杨莉丽, 张文喜, 刘森林. 600例农村老年糖尿病患者慢性并发症筛查分析[J]. 上海医药, 2015,36(16):53-54.
	杨莉丽, 张文喜, 刘森林. 600例农村老年糖尿病患者慢性并发症筛查分析[J]. 上海医药, 2015,36(16):53-54.
	Yang LL, Zhang WX, Liu SL. Analysis of the screening results of the chronic complications in 600 cases of the rural elderly diabetic patients[J]. Shanghai Med Pharm J, 2015,36(16):53-54.
	Yang LL, Zhang WX, Liu SL. Analysis of the screening results of the chronic complications in 600 cases of the rural elderly diabetic patients[J]. Shanghai Med Pharm J, 2015,36(16):53-54.
[8]	Kato A, Fujimaki Y, Fujimori S, et al. Psychological and beha-vioural patterns of stigma among patients with type 2 dia-betes:a cross-sectional study[J]. BMJ Open, 2017,7(3):e013425. DOI URL PMID
	Kato A, Fujimaki Y, Fujimori S, et al. Psychological and beha-vioural patterns of stigma among patients with type 2 dia-betes:a cross-sectional study[J]. BMJ Open, 2017,7(3):e013425. DOI URL PMID
[9]	Jia HH, Liu L, Huo GX, et al. A qualitative study of the cognitive behavioral intention of patients with diabetes in rural China who have experienced delayed diagnosis and treatment[J]. BMC Public Heal, 2020,20:478.
	Jia HH, Liu L, Huo GX, et al. A qualitative study of the cognitive behavioral intention of patients with diabetes in rural China who have experienced delayed diagnosis and treatment[J]. BMC Public Heal, 2020,20:478.
[10]	Johnston DW, Johnston M, Kinmonth A, et al. Motivation is not enough:prediction of risk behavior[J]. Health Psychol, 2004,23:533-538. DOI URL PMID
	Johnston DW, Johnston M, Kinmonth A, et al. Motivation is not enough:prediction of risk behavior[J]. Health Psychol, 2004,23:533-538. DOI URL PMID
[11]	徐慧文, 王世伟, 陈璇, 等. 自我效能在空巢老年2型糖尿病病人社会支持与糖尿病相关心理痛苦间的中介效应[J]. 护理研究, 2019,33(16):2736-2740.
	徐慧文, 王世伟, 陈璇, 等. 自我效能在空巢老年2型糖尿病病人社会支持与糖尿病相关心理痛苦间的中介效应[J]. 护理研究, 2019,33(16):2736-2740.
	Xu HW, Wang SW, Chen X, et al. Mediating effect analysis of self efficacy in the relationship with social support and diabetes related distress in empty nest elderly patients with type 2 diabetes[J]. Chin Nurs Res, 2019,33(16):2736-2740.
	Xu HW, Wang SW, Chen X, et al. Mediating effect analysis of self efficacy in the relationship with social support and diabetes related distress in empty nest elderly patients with type 2 diabetes[J]. Chin Nurs Res, 2019,33(16):2736-2740.
[12]	武益民, 邵媛媛. 糖尿病及其防治[J]. 中国农村卫生, 2014,5(2):352-353.
	武益民, 邵媛媛. 糖尿病及其防治[J]. 中国农村卫生, 2014,5(2):352-353.
	Wu YM, Shao YY. Diabetes mellitus and its prevention[J]. Chin Rur Heal, 2014,5(2):352-353.
	Wu YM, Shao YY. Diabetes mellitus and its prevention[J]. Chin Rur Heal, 2014,5(2):352-353.
[13]	赵静, 赵秋利, 侯赛宁, 等. 2型糖尿病患者饮食行为影响因素的质性研究[J]. 护理学杂志, 2018,33(5):35-38.
	赵静, 赵秋利, 侯赛宁, 等. 2型糖尿病患者饮食行为影响因素的质性研究[J]. 护理学杂志, 2018,33(5):35-38.
	Zhao J, Zhao QL, Hou SN, et al. A qualitative study on factors influencing eating behaviors of persons with type 2 diabetes[J]. J Nurs Sci, 2018,33(5):35-38.
	Zhao J, Zhao QL, Hou SN, et al. A qualitative study on factors influencing eating behaviors of persons with type 2 diabetes[J]. J Nurs Sci, 2018,33(5):35-38.
[14]	周春雷, 裴楠, 孙健. 强化健康教育在糖尿病住院患者中的应用效果[J]. 中国实用医药, 2018,13(3):176-177.
	周春雷, 裴楠, 孙健. 强化健康教育在糖尿病住院患者中的应用效果[J]. 中国实用医药, 2018,13(3):176-177.
	Zhou CL, Pei N, Sun J. The application effect of strengthening health education in diabetes inpatients[J]. Chin Pract Med, 2018,12(3):176-177.
	Zhou CL, Pei N, Sun J. The application effect of strengthening health education in diabetes inpatients[J]. Chin Pract Med, 2018,12(3):176-177.
[15]	中华医学会内分泌学分会. 中国2型糖尿病合并肥胖综合管理专家共识[J]. 中华内分泌代谢杂志, 2016,32(8):623-627.
	中华医学会内分泌学分会. 中国2型糖尿病合并肥胖综合管理专家共识[J]. 中华内分泌代谢杂志, 2016,32(8):623-627.
	Chinese Society of Endocrinology. Expert consensus on integrated management of type 2 diabetes mellitus with obesity in China[J]. Chin J Endoc Meta, 2016,32(8):623-627.
	Chinese Society of Endocrinology. Expert consensus on integrated management of type 2 diabetes mellitus with obesity in China[J]. Chin J Endoc Meta, 2016,32(8):623-627.
[16]	Chiu CJ, Yu YC, Du YF, et al. Comparing a social and communication app,telephone intervention,and usual care for diabetes self-management:3-arm quasiexperimental evaluation study[J]. Jmir Mhealth Uhealth, 2020,8(6):e14024. DOI URL PMID
	Chiu CJ, Yu YC, Du YF, et al. Comparing a social and communication app,telephone intervention,and usual care for diabetes self-management:3-arm quasiexperimental evaluation study[J]. Jmir Mhealth Uhealth, 2020,8(6):e14024. DOI URL PMID
[17]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018,10(1):4-67.
	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018,10(1):4-67.
	Chinese Diabetes Association. Guidelines for the prevention and treatment of type 2 diabetes in China(2017 edition)[J]. Chin J Diabet Mell, 2018,10(1):4-67.
	Chinese Diabetes Association. Guidelines for the prevention and treatment of type 2 diabetes in China(2017 edition)[J]. Chin J Diabet Mell, 2018,10(1):4-67.
[18]	Alarslan P, Unal Kocabas G, Demir I, et al. Increased urocortin 3 levels are associated with the risk of having type 2 diabetes mellitus[J]. J Diabetes, 2020,12(6):474-482. DOI URL PMID
	Alarslan P, Unal Kocabas G, Demir I, et al. Increased urocortin 3 levels are associated with the risk of having type 2 diabetes mellitus[J]. J Diabetes, 2020,12(6):474-482. DOI URL PMID
[19]	Chomi E, Mujinja PG, Enemark U, et al. Health care seeking behaviour and utilisation in a multiple health insurance system:does insurance affiliation matter?[J]. Int J Equity Heal, 2014,13(1):25.
	Chomi E, Mujinja PG, Enemark U, et al. Health care seeking behaviour and utilisation in a multiple health insurance system:does insurance affiliation matter?[J]. Int J Equity Heal, 2014,13(1):25.
[20]	张苍, 曾咏梅, 刘可. 糖尿病足患者就诊延迟现状及其影响因素分析[J]. 中华护理杂志, 2016,51(5):567-572.
	张苍, 曾咏梅, 刘可. 糖尿病足患者就诊延迟现状及其影响因素分析[J]. 中华护理杂志, 2016,51(5):567-572.
	Zhang C, Zeng YM, Liu K. Analysis of pre-hospital delay and its influencing factors in patients with diabetic foot[J]. Chin J Nurs, 2016,51(5):567-572.
	Zhang C, Zeng YM, Liu K. Analysis of pre-hospital delay and its influencing factors in patients with diabetic foot[J]. Chin J Nurs, 2016,51(5):567-572.
[21]	贾文文, 戴付敏, Julie Elliot, 等. 老年糖尿病患者合并衰弱的相关研究进展[J]. 中华护理杂志, 2017,52(6):697-701.
	贾文文, 戴付敏, Julie Elliot, 等. 老年糖尿病患者合并衰弱的相关研究进展[J]. 中华护理杂志, 2017,52(6):697-701.
	Jia WW, Dai FM, Elliot J, et al. Research progress on frailty and elderly people with diabetes[J]. Chin J Nurs, 2017,52(6):697-701.
	Jia WW, Dai FM, Elliot J, et al. Research progress on frailty and elderly people with diabetes[J]. Chin J Nurs, 2017,52(6):697-701.
[22]	毛建芬, 王永高, 冯萍, 等. 某农村地区老年糖尿病患者的就医行为[J]. 解放军护理杂志, 2012,29(14):22-24,51.
	毛建芬, 王永高, 冯萍, 等. 某农村地区老年糖尿病患者的就医行为[J]. 解放军护理杂志, 2012,29(14):22-24,51.
	Mao JF, Wang YG, Feng P, et al. A survey of health-seeking behaviors in elderly patients with diabets in certain rural area[J]. Nurs J Chin PLA, 2012,29(14):22-24,51.
	Mao JF, Wang YG, Feng P, et al. A survey of health-seeking behaviors in elderly patients with diabets in certain rural area[J]. Nurs J Chin PLA, 2012,29(14):22-24,51.
[23]	赵雪, 黄金, 杨玲凤, 等. 2型糖尿病患者授权能力与医疗支持的相关性研究[J]. 中华护理杂志, 2018,53(3):299-304.
	赵雪, 黄金, 杨玲凤, 等. 2型糖尿病患者授权能力与医疗支持的相关性研究[J]. 中华护理杂志, 2018,53(3):299-304.
	Zhao X, Huang J, Yang LF, et al. Correlation between empowerment and medical support in patients with type 2 diabetes mellitus[J]. Chin J Nurs, 2018,53(3):299-304.
	Zhao X, Huang J, Yang LF, et al. Correlation between empowerment and medical support in patients with type 2 diabetes mellitus[J]. Chin J Nurs, 2018,53(3):299-304.