上海市基层全科医师中西医结合防治糖尿病实施意愿影响因素OA

Objective To investigate the willingness of general practitioners(GPs)in Shanghai primary healthcare institutions to implement integrated Chinese and Western medicine(ITCWM)for the prevention and treatment of diabetes,compare the differences in willingness among GPs with different characteristics,and explore the influencing factors.Methods In January 2024,using convenience sampling based on the required sample size and the distribution of community health service centers(CHSCs),GPs from 32 CHSCs across 7 districts in Shanghai were selected for the survey.The survey included basic personal information,willingness to implement,and related influencing factors.Binary Logistic regression analysis was used to analyze the factors influencing the implementation willingness.Results A total of 360 valid questionnaires were collected.Among the 360 GPs,38.9％(140/360)reported low willingness to implement ITCWM for diabetes,while 61.1％(220/360)reported high willingness.Univariate analysis showed that department,education level,additional financial incentives,establishment of an on-site herbal pharmacy,staffing and equipment allocation,fee charging and reimbursement rates,sense of professional value,awareness of diagnostic and treatment methods,and knowledge of ITCWM were associated with GPs' willingness(P＜0.05).In the subgroup with a postgraduate degree or above,the proportion of Chinese medicine GPs with high willingness(88.9％)was significantly higher than that of Western medicine GPs(11.1％,P＜0.001).Stratified analysis showed that for both Chinese medicine and Western medicine GPs,the proportion of high willingness increased significantly when physicians had received cross-disciplinary training(Western medicine learning Chinese medicine or vice versa)and had higher knowledge of ITCWM methods(P＜0.01).Logistic regression analysis indicated that being a Chinese medicine practitioner(OR=2.974),having an on-site herbal pharmacy(OR=2.061),high sense of professional value(OR=6.147),high knowledge of diagnostic and treatment methods(OR=1.796),and high perceived efficacy(OR=2.346)were independent influencing factors for GPs' willingness to implement(P＜0.05).Conclusions The proportion of GPs in Shanghai primary healthcare institutions with high willingness to implement ITCWM for diabetes prevention and treatment is 61.1％.Factors such as the department type,the establishment of an on-site herbal pharmacy,perception of the value of ITCWM,awareness of ITCWM methods,and perceived efficacy significantly influence GPs'.