摘要
背景糖尿病视网膜病变(DR)可造成视力下降、视野缺损、玻璃体积血甚至失明,但目前关于DR患者就诊延迟的研究报道较少。目的分析DR患者就诊延迟情况及就诊时间的影响因素。方法选择天津市眼科医院2018年1—5月收治的DR患者作为研究对象,采用无记名问卷调查法进行现场调查,分析其就诊时间及就诊延迟情况(就诊时间>5年定义为就诊延迟);DR患者就诊延迟的影响因素分析采用多元有序Logistic回归分析(逐步法)。结果共发放调查问卷127份,回收有效问卷120份,有效问卷回收率为94.5%。最终纳入的120例DR患者中就诊时间<1年者9例,1~2年者11例,3~5年者17例,>5年者83例,就诊延迟率为69.1%(83/120)。不同文化程度、月收入、居住地、糖尿病病程、视力、糖尿病性黄斑水肿(DME)分级、血糖监测情况及有无高血压的DR患者就诊时间比较,差异有统计学意义(P<0.05)。多元有序Logistic回归分析结果显示,居住地〔OR=3.395,95%CI(1.362,7.053)〕、视力〔OR=1.526,95%CI(1.086,2.775)〕、高血压发生情况〔OR=1.307,95%CI(1.002,5.376)〕、DME分级〔OR=5.537,95%CI(1.897,9.534)〕、血糖监测情况〔OR=2.582,95%CI(1.271,6.882)〕是DR患者就诊时间的影响因素(P<0.05)。结论DR患者就诊延迟率较高,而居住地、视力、高血压发生情况、DME分级、血糖监测情况是DR患者就诊时间的影响因素。
Background Diabetic retinopathy(DR)may cause vision loss,visual field defects,vitreous hemorrhage,and even blindness.However,there are few reports about delayed healthcare-seeking in patients with DR.Objective To analyze the influencing factors of delayed healthcare-seeking and visiting time in DR patients.Methods DR patients were recruited from Tianjin Eye Hospital from January to May 2018,to attend an anonymous questionnaire survey for understanding their healthcare-seeking status,and delay in healthcare-seeking(taking visiting time over 5 years as delayed healthcare-seeking).Influencing factors of delayed healthcare-seeking were explored using multinomial ordinal Logistic regression analysis with the stepwise method.Results The survey achieved a response rate of 94.5%(120/127).Among the 120 respondents,the visiting time was less than 1 year in 9 cases,1 to 2 years in 11 cases,3 to 5 years in 17 cases,and over 5 years in 83 cases;the prevalence of delayed healthcare-seeking was 69.1%(83/120).The visiting time differed significantly by educational level,monthly income,place of residence,course of diabetes,vision,classification of diabetic macular edema,status of blood glucose monitoring,and prevalence of hypertension(P<0.05).Multinomial ordinal Logistic regression analysis with the stepwise method showed that,place of residence〔OR=3.395,95%CI(1.362,7.053)〕,vision〔OR=1.526,95%CI(1.086,2.775)〕,prevalence of hypertension〔OR=1.307,95%CI(1.002,5.376)〕,classification of diabetic macular edema〔OR=5.537,95%CI(1.897,9.534)〕and status of blood glucose monitoring〔OR=2.582,95%CI(1.271,6.882)〕were associated with the visiting time(P<0.05).Conclusion The prevalence of delayed healthcare-seeking is high in patients with DR,which may be influenced by place of residence,vision,prevalence of hypertension,classification of diabetic macular edema and status of blood glucose monitoring.
作者
褚海琳
任永霞
CHU Hailin;REN Yongxia(Tianjin Eye Hospital,Tianjin 300022,China)
出处
《中国全科医学》
CAS
北大核心
2022年第12期1470-1474,共5页
Chinese General Practice
