Investigation into knowledge, attitude, and practice regarding medical nutrition therapy among patients with diabetes in China: Results from a national multicenter cross‐sectional study

• Published in: Journal of diabetes Vol. 9; no. 9; pp. 865 - 873
• Main Authors: Jing, Lu Lu, Chen, Wei, Sun, Zi Lin, Zhu, Sai Nan, Shen, Li, Li, Wen Xia, Huang, Jin, Lou, Qing Qing, Bian, Rong Wen, Guo, Xiao Hui
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.09.2017; John Wiley & Sons, Inc
• Subjects: attitude and practice; Blood Glucose - metabolism; China; Cross-Sectional Studies; Diabetes; diabetes mellitus; Diabetes Mellitus - diet therapy; Diabetes Mellitus - psychology; Dietetics - education; Dietitians; Female; Glucose monitoring; health education; Health Knowledge, Attitudes, Practice; Humans; knowledge; Male; medical nutrition therapy; Nutrition therapy; Patient Education as Topic; Surveys and Questionnaires; 健康教育; 医学营养治疗; 态度和实践; 知识; 糖尿病; China; attitude and practice; health education; 健康教育; 态度和实践; medical nutrition therapy; diabetes mellitus; 糖尿病; 知识; knowledge; 医学营养治疗
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12500

Background The aim of the present study was to investigate knowledge, attitude, and practice (KAP) associated with medical nutrition therapy (MNT) among Chinese adult patients with diabetes and prediabetes. Methods From May to August 2014, a cross‐sectional study was conducted in 40 hospitals across China. The KAP of respondents was investigated through a pretested structured questionnaire in face‐to‐face interviews. Anthropometric and biochemical data were collected, and KAP scores were recorded according to patient responses. Results In all, responses from 7017 of 7508 patients were analyzed. The mean (±SD) overall KAP score was 9.63 ± 3.46, with individual scores for the K, A, and P components being 2.69 ± 1.90, 1.77 ± 1.99, and 5.17 ± 1.99, respectively (out of possible total scores of 19, 6, 3, and 10, respectively). All scores were higher in respondents who received ≥15 min MNT education than in those with shorter sessions. Patients with higher KAP scores exhibited significantly better glycemic control, with a higher proportion achieving target HbA1c, fasting plasma glucose, and 2‐h postprandial blood glucose levels (P < 0.05). “Health publicity in hospitals” and “expert outpatient services” were the most favorable means of acquiring MNT information. The two predominant concerns associated with MNT were “the feasibility” and “the authenticity and professionalism of the information”. Conclusions Patients with diabetes and prediabetes achieved moderate scores for KAP towards MNT. Glycemic control was positively correlated with the KAP score. Thus, MNT education should be improved, with a particular focus on feasibility and authenticity and professionalism, in China. 摘要 背景本研究的目的是调查中国成人糖尿病及糖尿病前期患者对医学营养治疗的知识(知)、态度(信)、行为(行)相关现况。 方法2014年5月至8月,在全国40家医院开展了此项横断面调查。该研究采用预先测试后的结构化问卷对糖尿病患者进行面对面的知信行调查。研究同时收集了人体测量指标和生化检查的相关数据,并根据问卷调查结果对患者的知信行进行评分。 结果一共有7508名糖尿病患者参与调查,其中7017名患者的数据纳入分析。调查结果显示,糖尿病及糖尿病前期人群的知信行总分为9.63 ± 3.46(最高分19分),知、信、行的得分分别为2.69 ± 1.90、1.77 ± 1.99和5.17 ± 1.99(最高分分别为6、3和10分)。其中曾接受超过15分钟的医学营养治疗教育的患者的知信行总分及知、信、行的得分均高于接受较短时长教育的患者。知信行总分较高的患者具有更好的血糖控制,其糖化血红蛋白、空腹血糖、餐后2小时血糖的控制达标率更高,差异具有显著性意义(P < 0.05)。调查结果还显示,“医院内相关资讯”以及“门诊的专家讲解”是患者获取医学营养治疗信息的最受欢迎途径。患者对于获取的糖尿病医学营养治疗知识的两个主要担忧是“可行性”以及“信息的真实性和专业性”。 结论对于医学营养治疗,中国糖尿病及糖尿病前期患者仅具有中等程度的知信行水平。血糖控制与知信行评分呈正相关。因此,中国糖尿病患者的医学营养治疗教育需要进一步改善,尤其需要注意提高教育的可行性、真实性和专业性。 Effects of duration of face‐to‐face medical nutrition therapy (MNT) education on knowledge, attitude, and practice (KAP) scores. Scores were adjusted for the sex, age, occupation, education level, type of diabetes, body mass index, disease course, and the type of treatment received (drug, lifestyle, or insulin therapy). (), <15 min MNT education; (), ≥15 min MNT education. Data are the mean ± SD. *P < 0.001 compared with the group receiving <15 min MNT education. Highlights Patients with diabetes and prediabetes in China attained moderate scores in knowledge, attitude, and practice (KAP) towards medical nutrition therapy (MNT). Education regarding MNT in China should be improved, meaning that more focus should be placed not only on authenticity and professionalism, but also on feasibility. The KAP scores were positively correlated with patients’ glycemic control and can be enhanced through MNT education for specified periods of time.