黎衍云, 李锐, 仲伟鉴, 杨群娣, 施亮, 阮晔. 上海市部分社区2型糖尿病患者自我管理效果评价[J]. 环境与职业医学, 2015, 32(6): 501-506. DOI: 10.13213/j.cnki.jeom.2015.15141
引用本文: 黎衍云, 李锐, 仲伟鉴, 杨群娣, 施亮, 阮晔. 上海市部分社区2型糖尿病患者自我管理效果评价[J]. 环境与职业医学, 2015, 32(6): 501-506. DOI: 10.13213/j.cnki.jeom.2015.15141
LI Yanyun , LI Rui , ZHONG Wei-jian , YANG Qun-di , SHI Liang , RUAN Ye . Effect Assessment of Type 2 Diabetes Self-Management in Selected Communities in Shanghai[J]. Journal of Environmental and Occupational Medicine, 2015, 32(6): 501-506. DOI: 10.13213/j.cnki.jeom.2015.15141
Citation: LI Yanyun , LI Rui , ZHONG Wei-jian , YANG Qun-di , SHI Liang , RUAN Ye . Effect Assessment of Type 2 Diabetes Self-Management in Selected Communities in Shanghai[J]. Journal of Environmental and Occupational Medicine, 2015, 32(6): 501-506. DOI: 10.13213/j.cnki.jeom.2015.15141

上海市部分社区2型糖尿病患者自我管理效果评价

Effect Assessment of Type 2 Diabetes Self-Management in Selected Communities in Shanghai

  • 摘要: 目的 评价上海市社区2型糖尿病患者自我管理项目实施效果,为在社区推广、开展该项目提供依据。

    方法 于2014年8-9月,在上海市徐汇、闵行、松江及金山区的8个社区招募250名确诊2型糖尿病患者参加自我管理活动。对活动前后糖尿病防治知识、健康行为、健康状况和自我效能进行问卷调查,并检测空腹血糖和血压。比较自我管理活动前后的知识、行为和自我效能的变化采用两配对样本McNemar检验,比较活动前后血糖、血压的变化采用配对t检验。

    结果 所有参加自我管理的患者中男性85人(34.0%),女性165人(66.0%);平均年龄为(68.04& #177;8.91)岁;糖尿病肾病、视网膜病变、神经病变、下肢血管病变和糖尿病足5种糖尿病慢性并发症的患病率分别为1.6%、11.2%、7.2%、3.6%和1.2%,冠心病、脑卒中、高血压、高血脂和慢性阻塞性肺疾病5种慢性病的患病率分别为25.6%、12.4%、75.2%、26.0%和0.8%。活动前后患者糖尿病相关知识知晓率分别为46.7%和70.3%,差异有统计学意义(P < 0.05)。活动结束时患者平均每周有3 d以上进行自我血糖监测、平均每周有5 d以上遵循糖尿病健康饮食要求、平均每周有5 d以上进行30 min或以上的有氧运动和按时服药的比例较活动前明显升高(均P < 0.05)。活动结束时患者自我效能得分较活动前升高,差异有统计学意义(P < 0.05)。活动结束时患者空腹血糖平均水平较活动开始前下降了0.93 mmol/L;过去30 d内由于疾病和紧张、压抑等不良情绪造成的健康状况不良的天数比活动前分别下降了0.77和0.51 d(均P < 0.05)。

    结论 自我管理可以有效地提高患者对糖尿病认知水平、自我管理能力及自我效能,改善患者的血糖水平和健康状况。

     

    Abstract: Objective To evaluate the effects of self-management program among type 2 diabetes (T2D) patients in Shanghai communities, and provide evidence for promoting that intervention in communities.

    Methods A total of 250 volunteers with T2D from eight communities of Xuhui, Minhang, Songjiang, and Jinshan districts in Shanghai were invited to a T2D selfmanagement program. Diabetes knowledge awareness, healthy behaviors, health status, and self-efficacy in the participants before and after the self-management program were interviewed using structured questionnaires and compared using McNemar's test for paired data. Fasting blood glucose and blood pressure before and after the intervention were tested and compared using paired t test.

    Results Of the 250 T2D patients, 85 (34.0%) were male and 165 (66.0%) were female, with an average age of (68.04& #177;8.91) years. The prevalence rates of chronic diabetic complications such as nephropathy, retinopathy, neuropathy, vascular disorder in lower extremities, and diabetic feet among the participants were 1.6%, 11.2%, 7.2%, 3.6%, and 1.2%, respectively. The prevalence rates of such chronic diseases as coronary disease, stroke, hypertension, hyperlipoidemia, and chronic obstructive pulmonary disease were 25.6%, 12.4%, 75.2%, 26.0%, and 0.8%, respectively. After the intervention, the awareness rates of diabetes knowledge increased from 46.7% at baseline to 70.3% (P < 0.05). Higher proportions were found after the program than at baseline of self-monitoring blood glucose more than 3 days per week, following T2D diet guideline over 5 days per week, and doing aerobic exercise > 30 minutes/week and > 5 days per week, and taking medicine on time (all P < 0.05). After the intervention, the total self-efficacy score in the participants increased (P < 0.05); the average fasting blood glucose decreased by 0.93 mmol/L; the average unhealthy days caused by illness and negative emotions in the last 30 days decreased by 0.77 d and 0.51 d respectively (all P < 0.05).

    Conclusion Self-management could improve T2D patient's awareness on T2D, capability, and self-efficacy of chronic disease self-management, blood glucose, and health status.

     

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