Diabetes Care Provision in UK Primary Care Practices 英文参考文献.docVIP

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Diabetes Care Provision in UK Primary Care Practices 英文参考文献.doc

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Diabetes Care Provision in UK Primary Care Practices 英文参考文献

DiabetesCareProvisioninUKPrimaryCarePractices GillianHawthorne1*,SusanHrisos2,ElaineStamp2,MarkoElovainio3,JillJ.Francis4, JeremyM.Grimshaw5,MargaretHunter2,MarieJohnston6,JustinPresseau2,NickSteen2, MartinP.Eccles2 1TheNewcastleuponTyneHospitalsNHSFoundationTrust,NewcastleuponTyne,UnitedKingdom,2InstituteofHealthandSociety,NewcastleUniversity,Newcastle uponTyne,UnitedKingdom,3HealthServicesResearchUnit,NationalInstituteforHealthandWelfare,Helsinki,Finland,4HealthServicesResearchUnit,Universityof Aberdeen,Foresterhill,Aberdeen,UnitedKingdom,5CentreforPractice-ChangingResearch,OttawaHospitalResearchInstitute,TheOttawaHospital,Ottawa,Ontario, Canada,6CollegeofLifeSciencesandMedicine,UniversityofAberdeen,Foresterhill,Aberdeen,UnitedKingdom Abstract Background:AlthoughmostpeoplewithType2diabetesreceivetheirdiabetescareinprimarycare,onlyalimitedamount is known about the quality of diabetes care in this setting. We investigated the provision and receipt of diabetes care deliveredinUKprimarycare. Methods:Postalsurveyswithallhealthcareprofessionalsandarandomsampleof100patientswithType2diabetesfrom 99UKprimarycarepractices. Results: 326/361 (90.3%) doctors, 163/186 (87.6%) nurses and 3591 patients (41.8%) returned a questionnaire. Clinicians reportedgivingadviceaboutlifestylebehaviours(e.g.88%wouldroutinelyadviseaboutcalorierestriction;99.6%about increasingexercise)moreoftenthanpatientsreportedhavingreceivedit(43%and42%)andcorrelationsbetweenclinician andpatientreportwerelow.Patients’reportedlevelsofconfidenceaboutmanagingtheirdiabetesweremoderatelyhigh;a median (range) of 21% (3% to 39%) of patients reporting being not confident about various areas of diabetes self- management. Conclusions:Primarycarepracticeshaveorganisationalstructuresinplaceandare,asjudgedbyroutinequalityindicators, delivering high quality care. There remain evidence-practice gaps in the care provided and in the self confidence that patientshaveforkeyaspectsofselfmanagementandfurtherresearchisneededtoa