社区糖尿病患者自我管理行为与焦虑程度影响因素分析

Analysis of influencing factors of self-management behavior and anxiety degree of diabetic patients in community

目的糖尿病患者容易在生理和心理上出现一系列不同程度的情感障碍。本研究探讨社区卫生服务中心糖尿病患者自我管理能力与焦虑程度关系,以提高糖尿病患者健康教育水平。方法2019年8-11月对洋中社区卫生服务中心、瀛洲社区卫生服务中心、茶亭社区卫生服务中心、义州社区卫生服务中心和上海街道社区卫生服务中心管理的116例糖尿病患者进行问卷调查,调查问卷包括自制一般资料问卷、焦虑自评量表和糖尿病自我管理行为量表6(SDSCA-6),采用Logistic回归分析糖尿病患者自我管理能力与焦虑程度关系。结果116例社区糖尿病患者中共有80例患者存在不同程度的焦虑,焦虑自评得分为(55.25±9.45)分,SDSCA-6总得分为(18.04±6.13)分。轻度、中度和重度焦虑糖尿病患者SDSCA-6评分分别为(14.43±4.09)、(17.26±4.03)和(19.75±4.98)分,随着焦虑程度加重,患者自我管理水平升高,F=7.671,P=0.001。年龄(χ2=8.295,P=0.016)、病程(χ2=11.706,P=0.009)、文化程度(χ2=26.633,P<0.001)和体质量指数(BMI)(χ2=13.794,P=0.001)与社区糖尿病患者不同程度的焦虑情绪有关联。多因素Logistic回归分析显示,病程(OR=1.204,95%CI为1.085~1.336,P<0.001)、文化程度(OR=7.050,95%CI为2.892~17.189,P<0.001)和BMI(OR=0.824,95%CI为0.719~0.946,P=0.006)是社区糖尿病患者焦虑情绪的危险因素;健康饮食(OR=1.954,95%CI为1.295~2.949,P=0.001)、血糖监测(OR=2.067,95%CI为1.347~3.173,P=0.001)、足部护理(OR=1.484,95%CI为1.066~2.066,P=0.002)及SDSCA-6评分(OR=1.228,95%CI为1.080~1.396,P=0.002)是社区糖尿病患者焦虑程度影响因素。结论社区糖尿病患者焦虑症状普遍偏重,一定程度上影响患者自我管理行为,病程、文化程度、BMI、健康饮食、血糖监测、足部护理及自我管理总分均是社区糖尿病患者焦虑程度的影响因素。

Objective Diabetes patients are prone to a series of emotional disorders of varying degrees,both physically and psychologically.This study aimed to explore the relationship between the self-management ability of diabetic patients in community health service centers and the degree of anxiety in order to improve the level of health education for diabetic patients.Methods From August to November 2019,aquestionnaire survey of 116 patients with diabetes managed by Yangzhong Community Health Service Center,Yingzhou Community Health Service Center,Chating Community Health Service Center,Yizhou Community Health Service Center and Shanghai Sub-district Community Health Service Center were selected as the objects.The questionnaire included self-made general information questionnaire,anxiety self-rating scale and diabetes self-management behavior scale 6(SDSCA-6).Logistic regression was used to analyze the relationship between diabetic self-management ability and anxiety.Results There were a total of 80 patients with varying degrees of anxiety among 116 community diabetic patients.The anxiety self-evaluation score was 55.25±9.45,and the total score of SDSCA-6 was 18.04±6.13.The SDSCA-6 scores of mild,moderate and severe anxiety diabetic patients were 14.43±4.09,17.26±4.03 and 19.75±4.98,as the degree of anxiety increased,the patient’s self-management level increased,F=7.671,P=0.001.Age(χ2=8.295,P=0.016),course of disease(χ2=11.706,P=0.009),education level(χ2=26.633,P<0.001)and body mass index(BMI)(χ2=13.794,P=0.001)were associated with different degrees of anxiety of diabetes patients in the community.Multivariate logistic regression analysis showed that the course of disease(OR=1.204,95%CI:1.085-1.336,P<0.001),education level(OR=7.050,95%CI:2.892-17.189,P<0.001)and BMI(OR=0.824,95%CI:0.719-0.946,P=0.006)were risk factors for anxiety in diabetic patients in the community.Healthy diet(OR=1.954,95%CI:1.295-2.949,P=0.001),blood glucose monitoring(OR=2.067,95%CI:1.347-3.173,P=0.001),foot care(OR=1.484,95%CI:1.066-2.066,P=0.002)and SDSCA-6 score(OR=1.228,95%CI:1.080-1.396,P=0.002)were influencing factors of the anxiety of community diabetes patients.Conclusions The anxiety symptoms of diabetic patients in the community are generally heavier,which affects the self-management behavior of the patients to a certain extent.The course of disease,education level,BMI,healthy diet,blood glucose monitoring,foot care,and self-management total scores are all affected by the anxiety degree of the diabetic patients in the community factor.