Practice And Exploration Of Chronic Non-Communicable Diseases Health Management Training For Primary Care Physician Based On Scientific Diet Guidance

Objective:Develop a dietary guidance ability assessment scale for primary care physicians,and to test its reliability and validity by exploratory factor analysis and confirmatory factor analysis.Understand the diet guidance ability of primary care physicians in some areas of Shanxi Province and analyze its influencing factors,so as to provide a basis for chronic non-communicable diseases nutrition education in grassroots medical organization and improve the diet guidance ability of primary care physicians.Methods:The first draft of the scale was formed by reviewing relevant literature,consulting experts and small sample pre-investigation.A total of 335 primary doctors from Linfen,Yuncheng,Taiyuan,Jinzhong,Xinzhou and Datong of Shanxi Province were investigated by multi-stage stratified sampling method from May to June 2022,and the reliability and validity of the scale were evaluated.From July to August 2022,convenience sampling method was adopted to conduct a questionnaire survey of primary care physicians in township health centers,village clinics and community health service centers(stations)in 6 counties and districts of Shanxi Province,to analyze the factors influencing the dietary guidance ability of primary care physicians.Results:Through developing the Dietary guidance scale for primary care physicians and test it’s reliability and validity,the final scale included 25 items in 3 dimensions(health concept,diet knowledge,assessment and implementation).The results of confirmatory factor analysis showed that χ2 /df=4.581,RMSE was 0.116,CFI was 0.838,IFI was0.839,and NFI was 0.810.The Cronbach’s α coefficient of the total scale was 0.952,and the Cronbach’s α coefficients of the three dimensions of health concept,diet knowledge and assessment and implementation were 0.951,0.939 and 0.910.The combined reliability(CR)values of each dimension were 0.952,0.940 and 0.913.The arithmetic square root of the average variance extraction(AVE)was larger than the correlation coefficient between the factors,and the correlation coefficient between the dimensions ranged from 0.497 to 0.639.The total score of the diet Guidance Ability Assessment Scale was 98(89,106),and the scores of each dimension were 37(32,40)for diet knowledge,36(36,41)for health concept,and 24(22,26)for assessment and implementation.There were statistically significant differences in the three dimensions of dietary guidance ability among primary care doctors with different completion status of standardized training(P < 0.05).There were statistically significant differences in the dimension of diet knowledge among different education levels,years of medical service,completion of standardized training,working style,and weekly independent learning time(P < 0.05).There were statistically significant differences in the dimension of assessment and implementation among different qualification certificates,completion of standardized training,and weekly independent learning time(P < 0.05).Conclusion:The level of nutrition knowledge in primary care doctors is affected by education background,standardized training and independent learning time.At present,the level of nutrition knowledge in primary care physicians is low,and the ability of assessment and implementation is not good.However,the health concept of nutrition in primary care doctors is acceptable,and they understand the importance of dietary guidance for patients,and pay attention to the compliance of patients and the cooperation of patients’ families when receiving patients.The lack of nutrition knowledge and short learning time are the main difficulties faced by primary care physicians at present.In the future,basic knowledge of nutrition management,knowledge of nutrition assessment and practical skills of nutrition management should be added to the diet guidance training of primary care physicians.The workshop mode was used to conduct chronic disease diet guidance training for primary general practitioners.The scores of primary general practitioners before and after the training in three dimensions of health concept,diet knowledge,evaluation and implementation were compared,and the difference was statistically significant(P <0.05).