英国国家糖尿病眼病筛查计划中从事医疗保健工作的专业人员对为年轻成年人提供糖尿病视网膜病变筛查的感知障碍和促进因素：横断面调查。
Perceived barriers and enablers to the provision of diabetic retinopathy screening for young adults: a cross-sectional survey of healthcare professionals working in the UK National Diabetic Eye Screening Programme.
机构信息
School of Health Sciences, City, University of London, London, UK.
Centre for Behaviour Change, University College London, London, UK.
出版信息
BMJ Open Diabetes Res Care. 2021 Nov;9(2). doi: 10.1136/bmjdrc-2021-002436.
INTRODUCTION
Diabetic retinopathy screening (DRS) attendance in young adults is consistently below recommended levels. The aim of this study was to conduct a survey of screening providers in the UK Diabetic Eye Screening Programme (DESP) to identify perceived barriers and enablers to DRS attendance in young adults and elicit views on the effectiveness of strategies to improve screening uptake in this population.
RESEARCH DESIGN AND METHODS
Members of the British Association of Retinal Screening (n=580) were invited to complete an anonymous online survey in July 2020 assessing agreement with 37 belief statements, informed by the Theoretical Domains Framework (TDF) of behavior change, describing potential barrier/enablers to delivering DRS for young adults and further survey items exploring effectiveness of strategies to improve uptake of DRS.
RESULTS
In total, 140 (24%) responses were received mostly from screener/graders (67.1%). There was a high level of agreement that the DESP had a role in improving attendance in young adults (96.4%) and that more could be done to improve attendance (90.0%). The most commonly reported barriers related to TDF domains and including lack of integration of DRS with other processes of diabetes care, which limited the ability to discuss diabetes self-management. Other barriers included access to screening services and difficulties with scheduling appointments. Less than half (46.4%) of respondents reported having a dedicated strategy to improve screening uptake in young adults. Strategies perceived to be effective included: screening within the community; prompts/reminders and integrating eye screening with other diabetes services.
CONCLUSIONS
Screening providers were concerned about screening uptake in young adults, although many programs lacked a dedicated strategy to improve attendance. Problems associated with a lack of integration between DRS with other diabetes care processes were identified as a major barrier to providing holistic care to young adults and supporting diabetes self-management.
简介
糖尿病视网膜病变筛查（DRS）在年轻人中的参与率持续低于推荐水平。本研究旨在对英国糖尿病眼病筛查计划（DESP）中的筛查提供者进行调查，以确定他们对年轻人 DRS 参与率的看法，并探讨提高该人群筛查参与度的策略的有效性。
研究设计和方法
英国视网膜筛查协会（British Association of Retinal Screening）的成员（n=580）受邀于 2020 年 7 月完成一项匿名在线调查，评估他们对 37 项信念陈述的同意程度，这些陈述是基于行为改变的理论领域框架（TDF）提出的，描述了为年轻人提供 DRS 的潜在障碍/促进因素，以及进一步调查项目，以探讨提高 DRS 参与度的策略的有效性。
结果
共收到 140 份（24%）回复，主要来自筛查员/分级员（67.1%）。大多数受访者认为 DESP 在提高年轻人的参与率方面发挥了作用（96.4%），并且可以做更多的工作来提高参与率（90.0%）。报告最多的障碍与 TDF 领域有关，包括 DRS 与其他糖尿病护理过程缺乏整合，这限制了讨论糖尿病自我管理的能力。其他障碍包括获得筛查服务和安排预约的困难。不到一半（46.4%）的受访者报告有专门的策略来提高年轻人的筛查参与率。被认为有效的策略包括：在社区内进行筛查；提供提示/提醒，并将眼部筛查与其他糖尿病服务相结合。
结论
筛查提供者对年轻人的筛查参与率表示关注，尽管许多项目缺乏提高参与率的专门策略。与 DRS 与其他糖尿病护理过程缺乏整合相关的问题被确定为为年轻人提供整体护理和支持糖尿病自我管理的主要障碍。
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