初级卫生保健机构有效管理2型糖尿病的障碍

IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Public Health in Africa Pub Date : 2025-09-10 eCollection Date: 2025-01-01 DOI:10.4102/jphia.v16i1.1420
Ntlogeleng M Mogale, Thembelihle S Ntuli, Paul K Chelule
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引用次数: 0

摘要

背景:2024年,2型糖尿病(T2DM)——一项公共卫生挑战——影响了全球5.89亿成年人。在南非,该病的患病率估计为15%,造成约340万人死亡。在患者中实现最佳血糖控制具有挑战性,导致可预防的并发症和死亡。迫切需要系统性改革和有针对性的干预措施。目的:确定卫生保健专业人员(HCPs)有效管理T2DM患者所面临的障碍。环境:一项调查是在南非豪登省茨瓦内大都会市进行的。方法:该研究于2022年5月至2022年6月期间涉及22家诊所和6个社区卫生中心的205名HCPs。对数据进行描述性分析。分类变量比较采用Fisher精确检验,p值< 0.05被认为是显著的。结果:大多数参与者是护士(84%),年龄< 50岁(65%),女性(87%),黑人(64.7%),10年以上工作经验(65%),并接受过T2DM的学术和内部培训(38.5%)。HCPs在管理T2DM患者时面临的主要障碍包括:工作量大,难以监测患者(53%)和筛查并发症(57%),提供高质量护理的时间压力(59%)和教育患者(69%),胰岛素启动知识不足(68%)和缺乏连续性护理(62%)。结论:工作量过大、人员不足、时间压力、胰岛素惰性和知识差距阻碍了个性化护理的提供、患者教育和监测。贡献:应对这些挑战将需要协作式护理模式、劳动力优化、有针对性的培训、更好的资源分配和卫生技术,并能显著改善患者的治疗效果,减轻卫生服务提供者的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Barriers to effective management of type 2 diabetes mellitus in primary healthcare facilities.

Background: In 2024, type 2 diabetes mellitus (T2DM) - a public health challenge - affected 589 million adults worldwide. In South Africa, the prevalence is estimated at 15%, contributing to approximately 3.4 million deaths. Achieving optimal glycaemic control in patients is challenging, resulting in preventable complications and deaths. Systemic reforms and targeted interventions are urgently required.

Aim: To identify barriers faced by healthcare professionals (HCPs) to effectively manage patients with T2DM.

Setting: A survey was conducted in the Tshwane Metropolitan Municipality, Gauteng province, South Africa.

Methods: The study involved 205 HCPs across 22 clinics and 6 community health centres from May 2022 to June 2022. Data were analysed descriptively. Categorical variables were compared using Fisher's exact test and a p-value of < 0.05 was considered significant.

Results: Most participants were nurses (84%), < 50 years (65%), female (87%), black people (64.7%), and > 10 years experience (65%) and had academic and in-house training on T2DM (38.5%). Key barriers faced by HCPs in managing patients with T2DM included workload making it difficult monitor patients (53%) and screen for complications (57%), time pressures to deliver quality care (59%) and educate patients (69%), inadequate insulin initiation knowledge (68%) and lack of continuity of care (62%).

Conclusion: Excessive workloads, insufficient staffing, time pressures, insulin inertia, and knowledge gaps - impede the delivery of personalised care, patient education and monitoring.

Contribution: Addressing these challenges will require collaborative care models, workforce optimisation, targeted training, better resource allocation and health technology and can significantly improve patient outcomes and alleviate burden among HCPs.

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来源期刊
Journal of Public Health in Africa
Journal of Public Health in Africa PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
自引率
0.00%
发文量
82
审稿时长
10 weeks
期刊介绍: The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.
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