Background Hypoglycaemia is a potentially serious condition, characterised by lower-than-normal blood glucose levels, common in people with diabetes (PWD). It can be prevented and self-managed if expert support (e.g., education on lifestyle and treatment) is provided. Our aim was to conduct a process evaluation to investigate how ambulance staff and PWD perceived the ‘Hypos can strike twice’ booklet-based ambulance clinician intervention. Methods We used an explanatory sequential design with a self-administered questionnaire study followed by interviews of PWD and ambulance staff. We followed the Medical Research Council framework for process evaluations of complex interventions to guide data collection and analysis. Following descriptive analysis and exploratory factor analysis, multiple regression models were fitted to identify demographic predictors of overall and subscale scores. Results 113 ambulance staff members and 46 PWD completed the survey. We conducted interviews with four ambulance staff members and five PWD who had been attended by an ambulance for a hypoglycaemic event. Overall, there were positive attitudes to the intervention from both ambulance staff and PWD. Although the intervention was not always implemented, most staff members and PWD found the booklet informative, easy to read and to use/explain. PWD who completed the survey reported that receiving the booklet reminded and/or encouraged them to test their blood glucose more often, adjust their diet, and have a chat/check up with their diabetes consultant. Interviewed PWD felt that the booklet intervention would be more valuable to less experienced patients or those who cannot manage their diabetes well. Participants felt that the intervention could be beneficial but were uncertain about whether it can prevent a second hypoglycaemic event and/or reduce the number of repeat ambulance attendances. Conclusions The ‘Hypos may strike twice’ intervention was found to be feasible, acceptable to PWD and staff, prompting reported behaviour change and help-seeking from primary care.

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04 糖尿病患者和救护人员对基于小册子的糖尿病低血糖干预的看法，“hypos 可能发生两次”：混合方法过程评估

背景 低血糖症是一种潜在的严重疾病，其特征是血糖水平低于正常水平，常见于糖尿病患者 (PWD)。如果提供专家支持（例如生活方式和治疗教育），则可以预防和自我管理。我们的目的是进行过程评估，以调查救护车工作人员和 PWD 如何看待“Hypos 可以罢工两次”基于救护车临床医生干预的小册子。方法 我们使用解释性顺序设计和自我管理的问卷调查，然后采访残疾人和救护车工作人员。我们遵循医学研究委员会对复杂干预措施进行过程评估的框架，以指导数据收集和分析。经过描述性分析和探索性因素分析，拟合多元回归模型以识别总体和子量表得分的人口统计预测因子。结果 113 名救护人员和 46 名残疾人完成了调查。我们采访了四名救护车工作人员和五名因低血糖事件而由救护车参加的残疾人。总体而言，救护人员和残疾人士对干预持积极态度。尽管干预措施并不总是得到实施，但大多数工作人员和残障人士发现这本小册子内容丰富、易于阅读和使用/解释。完成调查的残障人士报告说，收到这本小册子会提醒和/或鼓励他们更频繁地测试血糖，调整饮食，并与他们的糖尿病顾问聊天/检查。受访残障人士认为，小册子干预对经验不足的患者或不能很好地控制糖尿病的患者更有价值。参与者认为干预可能是有益的，但不确定它是否可以防止第二次低血糖事件和/或减少重复救护车就诊的次数。结论“Hypos 可能会罢工两次”干预被认为是可行的，PWD 和工作人员可以接受，促使报告的行为改变和向初级保健寻求帮助。