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目的本研究旨在探讨影响全科医生对患者进行2型糖尿病筛查的因素,描述全科医生对这些因素的诠释以及他们与患者就筛查结果进行的沟通。方法本研究采用半结构式的基于病历诱导回顾的访谈方法。研究对象为来自密歇根大学医学院及医院系统的20位全科医生。访谈内容为,对通过立意抽样抽取的134例符合美国糖尿病协会标准需要进行2型糖尿病筛查的非糖尿病患者,全科医生是、否对其进行筛查的原因。访谈内容被录音,然后转写成文字,并进行定性分析。结果共有63例患者没有进行2型糖尿病筛查。没有给这些患者做筛查的原因是:49%的全科医生认为根据患者以前所做筛查的结果判断其不需要做;48%的全科医生解释为患者只是来做咨询而不是做健康维护检查。共有71例患者进行了2型糖尿病筛查。给这些患者做筛查的原因是:49%的全科医生认为根据患者以前所做筛查的异常结果判断其需要做;42%的全科医生根据患者的体质量判断其需要做,38%的全科医生根据患者的年龄判断其需要做。全科医生对患者的筛查结果诠释的正确率是89%,实事求是地将筛查结果告诉给患者的比例为95%。对查出有糖尿病前期的24例患者,58%的全科医生给出的预防糖尿病的建议是减肥、增加活动量。结论患者以前的2型糖尿病筛查结果,患者约全科医生要做的事项类型,患者体质量及年龄是影响全科医生对其是、否进行2型糖尿病筛查的因素。一般来说,全科医生能够正确地理解患者的筛查结果并实事求是地将其转达给患者;其对糖尿病前期患者给出的预防糖尿病的建议具有循证意义。
Objectives The purpose of this study was to explore the factors that influence GP screening of patients with type 2 diabetes and to describe the general practitioners’ interpretation of these factors and their interaction with patients on screening results. METHODS: This study used a semi-structured interview based on medical record-based recall. The study population consisted of 20 general practitioners from the University of Michigan Medical School and Hospital System. The interview was conducted on 134 non-diabetic patients who were screened for type 2 diabetes who met the American Diabetes Association criteria by conception sampling and whether general practitioners were screening for it. Interviews were recorded, then translated into text, and qualitative analysis. A total of 63 patients did not have type 2 diabetes screening. The reason for not screening these patients is that 49% of GPs consider that they do not need to be done based on the results of previous screenings, and 48% of GPs interpret that patients are counseling rather than healthier Maintenance inspection. A total of 71 patients underwent type 2 diabetes screening. The reason for screening these patients is that 49% of GPs think they need to be diagnosed based on the abnormal results of previous screening performed by their patients, 42% of GPs decide what to do based on the patient’s weight, 38% The GP determines what needs to be done based on the patient’s age. The correct rate of general practitioner interpretation of the patient’s screening results was 89%, and the percentage of truthful screening reports to the patients was 95%. Of the 24 patients found to have pre-diabetes, 58% of GPs recommended diabetes prevention to lose weight and increase activity. Conclusion The results of previous screening of type 2 diabetes patients, the type of patients to be treated by the general practitioner, and body mass and age of the patients are the factors influencing general practitioners’ ability to do type 2 diabetes screening. In general, GPs are able to correctly understand the patient’s screening results and truthfully convey it to the patient; its advice to prevent diabetes in pre-diabetic patients is evidence-based.