Establishment Of Home Adverse Event Warning System For Elderly Patients With Type 2 Diabetes

Objective:To construct a home adverse event evaluation system for elderly patients with type 2 diabetes using the Delphi method,and to conduct a current situation investigation and influencing factor analysis of the research objects based on this system,and finally construct a home adverse event early warning system for elderly patients with type 2 diabetes.Further strengthen the home self-management ability of elderly patients with type 2 diabetes,and provide evaluation indicators and management tools for community medical workers.Methods:In May 2022,the initial questionnaire for the home adverse event evaluation system for elderly patients with type 2 diabetes was designed and the home adverse event evaluation system for elderly patients with type 2 diabetes was formed through topic group discussions,expert consultations,and other methods.From June to September 2022,a survey was conducted in three community hospitals in Taiyuan City,Shanxi Province.The research objects were elderly patients with type 2 diabetes under community hospital contract management.The survey content included basic information of elderly patients with type 2 diabetes and a current situation investigation based on the home adverse event evaluation system for elderly patients with type 2 diabetes.The survey results were statistically sorted and analyzed for influencing factors.Results:After The results of the expert consultation method showed that 15 valid questionnaires were collected in each round,and the recovery rate of the first round questionnaire was 88.24%,and the recovery rate of the second round questionnaire was 100%.The familiarity of the experts in the two rounds was 0.920 and 0.960,and the judgment basis was 0.946 and 0.933,respectively,that is,the authority degree was 0.933 and 0.947,respectively.The variation coefficients of each index in the first round were 0.05-0.34,and the variation coefficients of each index in the second round were 0.05-0.12.The Kendall harmony coefficients of the two rounds were both greater than 0.3.After two rounds of index deletion,addition,and modification,5 primary indicators and 27 secondary indicators were finally formed.Based on this evaluation system,a current situation investigation was conducted,which included 241 research objects.Among them,76 cases had home adverse events.The results of the multiple factor Logistic regression model showed that whether other diseases were present(OR=13.732,95%confidence interval of OR;4.927-38.274,P<0.05),self-rated health(OR=5.560,95%confidence interval of OR;1.529-20.215,P<0.05),social support level(OR=5.181,95%confidence interval of OR;1.932-13.897,P<0.05),diabetes self-management level(OR=5.108,95%confidence interval of OR;2.212-11.797,P<0.05),and life self-care ability(OR=5.991,95%confidence interval of OR;1.139-31.526,P<0.05)were influencing factors for home adverse events in elderly patients with type 2 diabetes.Therefore,a preliminary home adverse event early warning system for elderly patients with type 2 diabetes was constructed.Conclusion:The home adverse event evaluation system for elderly patients with type 2 diabetes constructed in this study can provide learning and self-management directions for patients themselves and caregivers to identify home adverse events.The home adverse event early warning system for elderly patients with type 2 diabetes constructed can provide reference for community hospital medical workers to screen high-risk groups,in order to reduce the occurrence of home adverse events in elderly patients with type 2 diabetes.