H „ ^ Y DUPC - KY HlgM SO N A M NGAY T R U Y £ N T H 6 N G THUTSTIG CAO B A H G Y T H ^ NGUYEN (1966-»1B
Thdi Nguyen nam 2014", Scr y le Thai Nguyen, Benh vi^n Lao va Benh phoi, 236 - 2248.
. HoaDg Van Cirong, Ma Thj Hiravg, (2015).
Ky yeu cong trinh nghien cihi khoa hpc,
"Nghien cdu su biin ddi cua mot so tri so stnh hoa mdu a b?nh nhdn Iao phoi mdi irudc vd sau hai thdng diiu trj tdn cong tgi benh vien Lao vd Bfnh phdi Thdi Nguyen ndm 2014", So y te Thai Nguyen, Benh vien Lao va Benh ph6i,226-235.
. Chuong trinh chong lao Quoc gta
"Bdo cdo long kei hogi dong chuong chdng lao ndm 2014 vd piiirang huong dgng ndm 2015".
. World Health orgnization (lOil
"Treatment of tuberculosis guidelines, Fomi edition".
. Worid Health orgnization (2013), "Gbiil tuberculosis report 2013", 1-6.
DANH GIA KIEN THITC TIT CHAM SOC CUA NGlTai BENH DAI THAO DirONG TYPE 2 TAI BENH VIEN DA KHOA TJNH D I 6 N BI6N
Nguyin Vu Huyen Anh*, Nguyin Minh Tuan", Phan Thanh Nhung***, Hodng Anh Tuin"
T6M TAT
Myc tieu: Nghien cuu dugc tien hanh nhdm ddnh gid kien thtrc vd xac djnh m$t so yeu to lien quan d^n kiln thuc t\r chdm s6c ciia ngirdi b^nh d&i (hao duimg type 2 dang dieu trj ttii B^nh vi^n da khoa tinh Di$n Bien. Phutmg ph&p: Nghian Clhl m6 ti ciit ngang. Ket qua: 64,9% ngtrcri b^nh c6 kien thuc ty chftm s6c b?nh dii thao duimg type 2 is muc trung binh; 19,9% b mijc tot va 15,2% 0 mitc k6m. Difim trung binh la 25,57 ± 3,259. Ket iu^n: D6i tm^ng nghien ciiu co kiin thirc 6 muc trang binh (67,3% ± 8,58%). Ngu&i b^nh c6n thilu kiln thirc trong vt^ theo d6i. phat
•rruong Cao ddng Y ti Difn Bien,
* • Trudng Cao ddng Y ti Thdi Nguyen,
•'* Bfnh vifn Trung ucmg Thdi Nguyen Chju trfich nhi?m chinh: Nguyen Vii Huyen Anh Email: huyenanhydb@gmaixom
Ngiynhin bai: 5.9.2016 Ngiy phin bl?n khoa h<?c: ll.U.2016 Ngay duy?t bai: 29.11.2016
hi^n vfk each xir tri khi c6 bien chiiTig vi chedf ftn uong dftc bi|t \k each phan lo^i vi lgi cbvij thvrc pliam. Qua nghien cijru nh|n thay co 3 ywti lien quan den kien thuc cOa ngir6i b?nh baogk trinh d? giio dye, thirl gian bj b?nh va nguont^
c§n thfing tin ve chfim soc b^nh.
Tii- khda: Kien thirc. ty chfim s6c, dii lh»
dudng type 2.
SUMMARY
EVALUATION OF SELFCARE KNOWLEDGE AMONG TYPE 2 | DIABETES PATIENTS IN DIEN BIEN
GENERAL HOSPITAL Objectives: The research Is implemented B evaluate the knowledge and identify a number of factors affecting self care knowledge of peopit with type 2 diabetes are treating at the Dien B^
General Hospital. Methods: Cross-scclk*
descriptive study. Results: 64.9% of have the self care knowledge of type 2 di the average levels; 19.9% in good leveli 76
!^
YHOCVl&TNAMTAPJ49-THAHG12-sgDACBl£T-21>1S<kl^'^''° '" '""'^ '°^°'^' ™° a™rage score was
S
.5.57 ± 3259. Conclusion: Research population Sai tlie self care knowledge in the average levels 67.3% ± 8.58%). Patients lack of knowledge in^nonitoring, detecting, and how to manage
•'«l»mplications and special diet is the classification md selection of food. Through flie study found ' Wjiat there are 3 factors related to knowledge of Mlient include: level of education, duration of illness and accessible source of information about self care.
Key words:
diabetes.
knowledge, self care, type 2
^ Baijliio dirong type 2 la m6t benh man
^ ^ R H lay liSn quan dSn chi do Sn u6ng.
Ploi song, c6 toe dp phdt trifin tk
thieu hut ve kiln thiic se gop phSn xay dimg noi dung g i ^ due thich hop cho nguoi benli, no luc phong ngira bign chimg va tao dieu kien cho cac can thiep cu thfi theo nhu c4u cua ngucri benh. Chinh vi vay ngluen cihi duoc tien hanh voi muc tieu:
1. Danh gia kien thiic tu cham soc cua nguoi benh dai thao duong type 2 dang difiu tn tai Benh vifin da khoa tinh Difin Bifin.
2. Xac dinh mot so yfiu to lifin quan dfin kifin thiic tu cham soc cua ngucri b|nh dai fliao duong type 2 dang difiu tri tji B^nh vien da khoa tinh Dien Bien.
II. BOI TUpNG vA PHiroWQ PHAP NGHISN cijru Doi tu-ong, dia dilm v i th6i gian bfio^
' nhanh o nhieu nudc trfin thfi gi4i. Theo th6ng "Bhien cihi
' ke cua To chiic Y te Thfi giii nSm 2000 c6 Ngucri bfinh da dupc chjn doan dii thSo
^^ 171 trifu ngucri mic dai thao duong tien toan '^"^i 'yP= 2 va dang difiu trj ngo»i tni t^
,j cSu v4 d\r bdo s6 luong ngucri mJc vdo ndm ^"^ " ' " ^ ^°^ ''"h B'?n Bifin tir fc2030 sfi 14 366 triju. Nhung tren thvc tfi chi <'l«2016dfin31/8/20I6.
2. Thiet ke nghien cihi: nghifin ciru mo td cdt ngang.
3. Cd* mau vd cfa^n mlu
Ci mau u6c lupng dugc tinh todn theo 7^ una sau 11 ndm Id vdo ndm 2011, s6 nguoi bfinh
liiiddi thdo du6ng dd la 366,2 triju trfin todn thfi giiW. Tji Vifit Nam dieu tra nam 2012 tji 6 I" viing mien tten cd nu4c cho thdy ty lfi DTD
Id 5,7% [1], Vi$c tdng miic dp nghifim trpng ™"8 thiic:
ciia bjnh ddi thdo dutag moi ndm co lifin
quan din sir thifiu kien thiic vd thuc hdnh tv ^' chdm s6c cOa ngu« bjnh. C6 bdy hdnh vi nr . ' ^ ^ '*' ' * ' ' ' '^^'^ '"" ^'^ ' " " g binh
„ chdm s6c thilt ylu 6 nhiing nguoi bj bjnh ddi " " ^ " " " " nhiing nguiri bjnh ddi thdo J thdo duimg bao gom sir dyng thu6c phii hpp, ' ' " ^ 8 " - 16.7% [7], v6i dp chlnh xdc mong i, chfi dj an uong Idnh mjnh, hpat dpng thi luc, ' " " ° " <i"2,5% vd miic tin edy 95%, tlnh dupc ,,(Ph6ng trdnh nguy co biin chiing, theo dai * '"^" '* " I nff™ bfinh. Lap danh sdch Ji lupng duimg trong mdu, ky nang giai quylt ^^^ nguiri benh dai thao ducmg dang difiu tri
! van de vd kf ndng d6i pho voi bjnh [4]. Tuy " 8 ° ' " " ^ **' phong khdm, Bjnh vijn da khoa
>" nhifin, nhieu nghien cuu dd chi ra r ^ g kiln *'"^ ^ ' ^ ° ^ ' ^ " ^^ '^hpn nglu nhifin hj thong
* thiic vl III chdm s6c ciia nguiri bjnh dai thdo " ^ ''hoing cdt^h mau k=2 din khi du cS mlu 'duimg c6n hju chi. Vijc xdc dinh nhihig "ghienciiu.
HNKH y OUgC - K t NI&W 50 NAM NGAY TRUVeN T H 6 N G TRITC^NG CAO B A N G Y T H J U N G U Y 6 N ( I M
4. Phmmg phap thn thap so lieu Phong vSn bMg bg cau hoi tu dien phat cho nguoi b€nh DTB vao thai di6m tnroc khi ngiroi benh dugc kham va di§u tri t£ii phong kham ngoai tru. Bo cau hoi gom 21 cau hoi diing sai dugc xay dung dua tren bg cong cu do luong kifin thijrc tu cham s6c bfinh dai thdo dirong type 2 tai Nigeria cua tac gia Maxwell 0 Adibe va 17 cau hoi chgn dap an dung nhat dirge xSy dyng dira tren Test trac nghiem kifin thur b?nh dai thao dircmg (DKT) cua tmng tam dao t^o va nghifin cuu khoa hgc ve dai thao duong - Tru6ng d^ hpc Michigan [61-
Kifin thirc tu chdm s6c bjnh ddi dudng type 2 dupc lupng h6a bdng c d ^ diem: mdi cau trd Icri diing dupc 1 difim, ck trd Icri sai hodc khong bifit dupc 0 di IDL TSn difim la 38 diem dupc chia lam 3 muc ^ kifin thiic tot (>75% tong dilm), tmng lil^
(60-74% tfing difim) vd kfim (<59% tai;
dilm) [8].
5. Phvong phap phdn tich so li^u Sli dyng phdn mfim thong kfi SPSS 2Z0 dfi phan tich voi cdc thudt toan thing ke tti tk tdn sudt, ty lfi, gid ui ming binh, dj 1^
chuan, phdn tich tuong quan Pearson va Chi square.
lll.K^QUANGHieNCOrU
Bang I. Kiin thu-c lir cham sic idl thio iuing type 2 ciia nguii benh (n=171) T6t T m n g binh
SL
%
Bilm trung blobChe dp dn 20,5 35,1 3,78 ±0,938
(63% ±15,6%)
Sii dyng fliu6c 56,7 3,66 ± 0,983
(73,2% ±19.7%)
Ho^t dpng thfi chat 84 49,1 39,8 11,1
(79, 2,38 ± 0,679
,3% ±22,
M
T\r theo dSi duimg
^mdu 56,1 4,42 ±1,332
1%±
_(61 19%) Ph6ngv4 xir tri biin
chiing 12,3 86 50,3
i 6 3 7,66 ±1,736
,8% ±14,4%)'
Theo d5i chdm s6c 106 62,0 52 7,6 3,81 ±0,92
(76,2% ±18,4%)
Kien thiic cbung 64,9 26 15,2 25,57 ±3,259
(67,3% ±8,58%).
Nhfn xil: 64,9% dfii tupng nghifin ciiu c6 dpng thfi chdt va theo d6i chdm sfic, c6 ldi kien thiic tv chdm sic bfinh dai thdo duimg thiic 6 miic trung binh v l che d j dn, sli dW typej! 4 muc hung binh; 19,9% o miic tit vd thuic, tir theo d6i duimg mdu, phbng vi li 15,2% cr muc kfim. Dilm tnmg binh Id 25,57 tri bien chiing. Ddc bijt nguiri bjnh cim Hii
± WS9; thip nhJt 18 dilm vd cao nhdt la 33 hyt kiln thiic d chi d j dn, tv theo d6i dui*
difim. Nguiri bjnh da CO kiln thirc tit vl boat mdu, phbng va xii tri biin chiing.
s
Y H e x V l ^ NAM TAP 449 - T H A H G 12 - SO OAC BlgT - 2016D i e n i T o n g
Bleu do 1. Tmmg quan giira tu6i va miic d j kien thirc ciia nguiri benh BTD type 2 (n=171)
Nhfn xil: Khong c6 mli tuong quan giila tuii va miic dp kiln thilc tu chdm s6c ciia nguiri bjnh ddi thdo duimg type 2 trong mau nghien ciiru.
Bing 2. Mil Uen quan giua mfl si igc linh cd nhan vii liiin Ihuc l{f cham sic cua
Ylu to
Gi«i Nam
Nil Ddn tpc
Kinh Thdi H'Mong
Khac Trinh d j hpc van
Tilu hpc THCS THPT Trung cip, CD,
DH
Mau nghien cihi
(n=171) SL(%) 86 (50.3) 85 (49.7) 124 (72.5) 37(21.6)
6(3.5) 4(2.3) 34(19.9) 30(17.5) 58 (33.9) 49 (28.7)
Miic d j kien thirc Tot
(n = 34) SU%) 18(10.5)
16 (9.4) 26 (15.2) 6(3.5) 1 (0.6) 1 (0.6)
0 4(2.3) 15(8.8) IS (8.8)
Trung binh ( n = l l l )
SL(%) 53 (31.0) 58 (33.9) 82 (48.0) 26(15.2) 1 (0.6) 2(1.2)
21 (12,3) 22 (12.9) 35 (20.5) 33 (19.3)
Kfim (n = 26)
SL(%) 14 (8.2) 12 (7.0) 16(9.4) 5 (2.9) 4(2.3) 1 (0.6)
13(7.6) 4(2.3) 8 (4.7) 1 (0.6)
P (testx^)
>0,05
>0,05
<0,05
HNKH Y D U C K : - K V N I E M SO NAM NGAY T R U Y S N T H O N G TRlfJrNG CAO D A H G Y T H A I NGUVeH (11
Nguon thong tin Can bp y te TT dai chung
TT due tilp Ban be, nguiri than
74 (43.3) 44 (25.7) 18(10.5) 11 (6.4)
31(18.1) 3(1.8)
0 0
42 (24.6) 36(21.1) 15(8.8) 7(4.1)
Nhfn xet. Khong nhan thay co sir lifin quan giila gioi, ddn tjc vdri miic do kiln thde cb nguiri benh. Co su tuong quan thuan giila trinh dp gido due, nguon thong tin truyin th6ng*|
muc dp kien thiic tu chdm soc cua nguiri bjnh ddi thao ducmg type 2. *
DIvmTong
Bieu do 2. Tirong quan giira giiia thiri gian bi bjnh vd miic dp kiln thirc ciia ngirliri bjnh BTB type 2 (n=171)
Nhfn xel: Cfi sy tuong quan thudn giUa thiri gian bj bjnh vd miic dp kiln thiic cua lii tupng nghien cilu. S l ndm bj bjnh cdng nhilu thi miic dj kiln thirc cdng cao (r - 0.382) IV. BAN LU«N
1. Mirc d j kien thiic ve tir chdm s6c bjnh ddi thdo dvdng type 2
Qua nghien ciiu nhjn thdy mirc dp kien thiic ty chdm soc cua dli tupng nghifin ciiu a mure trung binh vfiri 64.9% nguiri bjnh. Dilm sl hung binh cua kiln thirc ty chdm soc Id 25.57 ± 3.259. Sy thilu hyt kiln thiic ty chdm s6c bjnh dai thio duimg type 2 * dli tupng nghien cihi co lifin quan din che d j dn.
cdch phdt hijn vd xil tri cdc biin chftng 0 bijt Id bien chiing cdp tinh. Tj Ij nguiri bfnS cfi kiln thiic t i t v l ty chdm s6c trong nghien ciiu ndy chi dfit 19,9% cr thip hon nghien dn cua Odili khi sii dyng test kiln thiic ddi thto duimg 6 Nigeria vd thay mftc d j kiln thfte i i tot 6 mftc 39,5% ± 16,7%, trong dfi nguf bjnh cfi thilu hyt kiln thfte v l chi dj *' uing vd ty theo dai duimg huyit [7]. Diil nay Id do trong qudn thi nghifin cftu cua 00!
S S
YHOC VieTNAMTAP449-THAHS12.SO BAC BieT-2015 l.(| j ™ 56% nguoi benh da ttrdi qua gido due siic
111 '*°= •"* "^hdm soc benh ddi thao duimg, giao III idyc sftc khoe vfi chdm soc bfinh dai thdo J. duimg dupc cung cip cho tit cd ngucri bfinh i^gjUgay tft 1 ^ ddu tifin dupc chdn dodn bfinh.
ihi,; Al-Adsani da danh gid muc dp kiln thilc ty chdm soc cua ngucri bjnh dai thdo duimg .„.„vd cdc yeu to lien quan trong 5114 ngucri bjnh Kuwait vdi bjnh tifiu duimg type 2 va ttal thdy dilm ttung binh 58,9%, sy thilu hut kiln fliuc CO trong cdc cdu hoi lien quan din che i)j 8n udng [3]. Kit qui ndy cung tuong ty ket qud nghifin curu tai Dijn Bifin trong nghifin cftu nay. Hifin nay, 6 Vi jt Nam chua cd nghifin cftu ndo ddnh gia kiln thuc ty chdm^^Scua ngucri bjnh dii thao duimg type T X p c cfing bo nfin kit qud trong nghien cuu ndy chua so sdnh dupc v6i mftc dp kiln thfte 6 khu vyc khde.
2. Mpt s l ylu lo lifin quan din kiln Ihirc t|f chdm sdc ciia ngirM bjnh BTB type 2
Qua nghifin cftru cho thay khfing co sy Idiic bijt vfi muc dp kiln thfte a cdc nhom tuoi khde nhau vd giUa hai gioi. Dilm kiln Ihuc trung binh cua gifiri nam Id 25.56 ± 3.357 vd cua gifiri nft Id 25.57 ± 3.179. Nhu ' =11 "*''' ''^' '*"* "^'''*° ' ^ "*>' ^^'^ ^"i ^^' 1™
'' cua Nguyin Vdn Lanh khi nghifin cftu it fii'^f^ Khmer tinh Hju Giang [2]. Sy khde
w ' ' ' ' ' "*'' "^ ^ ^ '* ''" P'>°ng tV^ % quin.
• w ' " ™ "'^'" ^^ ' * ™ * * " ''=nh ciia Id khde
"'nhau.
i l ^ ' ^ ' " " " " S qnan thuin giila ttinh dp giio
* I've vi mftc dp kiln thuc cua ddi tupng t*'nghifin cftu. Trinh d j giio dye cdng cao thi
* mftc d j kiln thuc cing ting. Difiu ndy phii '<*hpp vdi thyc tl, nhiing ngufiri ninh dp giio
!*i dye cao hon cfi co hji tilp cjn vi tim hieu
dupc lufin thuc tti nhilu ngudn. Hp co mpt co hpi lorn hon thu thip kiln thuc tir cic phuong tifin ttuyin thong dai chung, sdch vi intemet.
Ngoii ra, hp co it rdo cdn ttong giao tilp vcri cdc dich vu chdm soc sue khoe, vi co thi nam bat thong tin tit hon. Nhiing nguiri khong bilt chii se gap kho khan ttong vific dpc vi ty tun hilu cdc thong tin v i huong ddn CO lien quan din kiln thurc ty cham soc.
Hp chi CO thfi tilp thu kiln thiic bdng cdch nghe truyfin thong giio due sue khoe.
Thcri gian bj bfinh cOng da dupc tun thiy lien quan ding kfi voi mftc dp kiln thuc ty chdm soc. Kfit qui niy'ttiong tu nghifin cftu cfta Odili, thiri gian nhdn thfte bfinh li ylu to duy nhit cfi lifin quan dang kl v6i mftc dp kien thfte [7]. Nhihig nguiri da co bjnh trong mpt thori gian c<S thfi gjp phdi li do thiic diy hp Um kilm giftp dS, tdng thfim kiln thfte trong qua trinh ndy. Thiri gian b( bjnh cdng lau, s6 lin ngucri benh dupc m vdn gido dye sftc khfie cang nhilu, kl ndng tim kilm thong tin tdng Ifin, nguiri bjnh cfi thi n^o dfii thdng ' tin voi nhiing ngucri cung bi bjnh thfing qua cdc bufii sinh hoat ciu lac bp dii thdo duimg hodc tu vin sftc khoe. Do dfi, tang cuimg tjp huin giio dye cho nguiri bjnh cfi thi giftp ngdn chdn sy phdt ttiln cua bjnh ddi thdo duimg biin chftng. Gido dye ttong bjnh ddi thdo duimg vd chim soc bjnh Id mjt qud ttinh lifin tyc IJp di lip Iji thuimg xuyfin v i lifin tuc mori cfi thi dem liii hifiu qui cao nhdt.
Nhftng dli hrpng da timg dupc tu v i i tft cdc nhin vien y tfi co mftc dp kiln thfte cao hon dfii tupng chua dupc ttr vin. Ty Ij cic doi nrpng nhan duprc thong tin vl chdm soc bjnh dii thio duimg tuong ddi cao 86.6 %, tiong cic ngudn cung cip thong tin thi nguin
nHkH V DUOC - KY Nien 50 NAM NGAY TKUYfeN T H 6 N G TRtrCWG CAO S A N G Y TtiAl NGUYfiN <1966-201ll J
th6ng tin tii can bg y tfi chifim ty Ifi cao nhat 63.7%, tifip theo do la 21.6% nhan duoc tir cac phuong tien truyfin thong: sach bao, tap chi, dai phat thanh, truyfin hmh, intemet va cfic phuong tifin thdng tin dai chung khac.
Kfit qua cung cho thSy ring cac chuong trinh giao due sik khoe co thfi la mgt yfiu t6 quan trgng trong vific nang cao kien thuc dai thao duong. Difiu nay phu hgp voi Boule da. bao cdo rang vi?c tham gia vao cac chuong trinh gjdo d^c, cd ngucri tu vSn dinh duSng va t\r gifim sat ducmg trong mfiu tat ca dfiu lifin quan dfing ke v6i kifin thiic vfi b?nh DTD cao hon [5].
V. K i t LUJSLN
Ngudi b?nh c6 kifin thiic d mirc trung binh. Dilm trung binh la 25.57 ± 3.259; ihkp nhat 18 difim va cao nhat la 33 difim. 64.9%
ngirdi b^nh cd kien thiic tu ch^m soc b$nh dfii thfio dudng type 2 d miic tnmg binh;
19.9% d miic t6t vfi 15.2% d miic kfim.
C6 3 yiu td lifin quan dfin kifin thiic tu chfim sdc cCia ngudi b^nh bao gdm: trinh dg gifio dye, thdi gian bi b?nh va tiep can thdng tin vh chftm sdc b§nh.
TAIUIUTHAMKHAO
I. Bfnh vifn Nyi tiet Trung ircrng (2013). Bdo cdo Hgi nghf ldng kit hogt dpng cua Dv dn phong chong ddi thdo dudng quoc gia ndm 2012 vd triin khai ke hogch ndm 2013.
2. Nguyen VSn L&nh (2014). Thvc trgng bU ddi thdo duong. tien ddi thdo dudng dii0l Khmer tinh Hgu Giang vd ddnh gid hifu^
mot sd biin phdp can thifp, Lu^in an tien i\
hgc, Vien v? sinh dich te Tmng irong.
3. Al-Adsaoi A.M.S, Moussa M.AA, A m t n L.I et al (2009). The level and deterniinanBcl diabetes knowledge in Kuwaiti adults wid type 2 diabetes. Diabetes metabolism, 3S(ft 121-8.
4. American Association of Diabetes Edicatei|
(2009). Guidelines for the Practice ^g Diabetes Self-Management Education m Training.
5. Boule N.G, Kenny G.P, Haddad E et ri (2003). Meta-analysis of the effwt at structured exercise training DO cardiorespiratory fitness in Type 2 diabetes mellitus. Z)i"a6e/o/og/a; 46(8), 1071-1081. - 6. Maxwell O.A, Cletus N.A, Chinwe V.II
(2011). The Construct Validity of n Instrument for Measuring Type 2 Di^iSei Self-Care Knowledge in Nigeria. rro/W Journal of Pharmaceutical Research, 10(S), 619-629.
7. Odili V, Isiboge P (2011). Patienti' Knowledge of Diabetes Mellitus in a Nigerian City. Journal of Pharmaceutical Research.
10(5), 637-642.
8. Wikby K, Mufunda E, Bj6rn A ct al (2012).
Level and determinants of diabetes knowfj^
in patients with diabetes in Zimbabwe i cross-sectional study. The Pan Africa Medical Joumal. 13:78.
