摘要
目的 调查糖尿病足(DF)患者经济毒性(FT)水平,分析其影响因素,为降低患者FT程度及制订有效干预措施提供科学依据。方法 选取在上海市4所医院就诊的202例DF患者作为研究对象,采用经济毒性综合评分量表(COST-PROM)、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、糖尿病患者生存质量特异性量表(DSQL)对患者进行调查。结果 不同医保类型、个人收入、居住地、治疗DF的自付费用、Wagner分级DF患者COST-PROM得分比较,差异均有统计学意义(P<0.05)。斯皮尔曼相关分析结果显示,COST-PROM得分与糖尿病患者DSQL、PHQ-9、GAD-7评分成负相关(P<0.05)。多元线性回归分析结果显示,年龄、治疗DF的自付费用、居住地、Wagner分级、GAD评分是DF患者FT的独立影响因素(P<0.05)。COST-PROM评分≤22分的DF患者有36例,COST-PROM评分>22分的DF患者有166例。2组DF患者在放弃计划消费、医疗花费寻求别人帮助、放弃目前治疗方案方面的差异均有统计学意义(P<0.05)。结论 近1/5的DF患者存在高FT。医护人员可重点关注年轻、农村地区以及足部分级程度较高的DF患者,指导其采取有效应对措施;同时借助社会力量与政府支持,从管理层面给予帮助,从而减少FT带来的不良影响。
Objective To investigate the level of financial toxicity(FT)in patients with diabetic foot(DF)and analyze its influ-encing factors,thereby providing a scientific basis for reducing FT and formulating effective interventions.Methods A total of 202 DF patients treated at four hospitals in Shanghai were surveyed using the Comprehensive Score for Financial Toxicity Pa-tient-Reported Outcome Measure(COST-PROM),the Patient Health Questionnaire(PHQ-9),the 7-item Generalized Anxie-ty Disorder Scale(GAD-7),and the Diabetes-Specific Quality of Life Scale(DSQL).Results COST-PROM scores differed significantly across groups stratified by type of medical insurance,personal income,place of residence,out-of-pocket DF treat-ment costs,and Wagner grade among DF patients(all P<0.05).Spearman correlation and multivariate linear regression ana-lyses revealed that COST-PROM scores were negatively correlated with DSQL,PHQ-9,and GAD-7 scores(P<0.05).Re-sults showed that age,out-of-pocket expenses for treating DF,place of residence,Wagner grade,and GAD score were inde-pendent influencing factors in patients with DF(P<0.05).Among patients,36 had COST-PROM score≤22 and 166 had COST-PROM score>22;the two groups also differed significantly in"forgoing planned expenditures,""seeking others'help for medical expenses,"and"forgoing current treatment plans"(P<0.05).Conclusion Nearly one-fifth of DF patients experi-ence high financial toxicity.Healthcare professionals should pay special attention to younger patients,those from rural areas,and patients with advanced DF,guiding them in effective coping strategies.Additionally,leveraging social and governmental support at the administrative level is essential to mitigate the adverse impacts of financial toxicity.
作者
曹晨昱
韩晓妹
赵志芳
陈玉芳
刑唯杰
虞博威
顾芬
Cao Chenyu;Han Xiaomei;Zhao Zhifang;Chen Yufang;Xing Weijie;Yu Bowei;Gu Fen(Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200023,China;School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Endocrinology and Metabolism,Wusong Central Hospital,Shanghai 200940,China;Wound Care Unit,Huangpu District Central Hospital,Shanghai 200001,China;Department of Vascular Medicine,Shanghai University of TCM-Integrated Hospital,Shanghai 200082,China;School of Nursing,Fudan University,Shanghai 200032,China;Nursing Department,Huadong Hospital,Fudan University,Shanghai 200040,China)
出处
《保健医学研究与实践》
2025年第2期54-61,共8页
Health Medicine Research and Practice
基金
国家自然科学基金资助项目(82120108008)。
关键词
糖尿病足
经济毒性
影响因素
公共卫生
Diabetic foot
Financial toxicity
Influencing factors
Public health
