抑郁对糖尿病患者自我管理能力的影响

Study of depression on self-management of patients with diabetes mellitus

目的:探讨抑郁对糖尿病患者自我管理能力的影响。方法:175例门诊糖尿病患者根据9条目患者健康问卷(patient health questionnaire-9,PHQ-9)评定结果,分为糖尿病伴抑郁组(PHQ-9≥12分,n=63)、糖尿病不伴抑郁组(PHQ-9<12分,n=112),采用自制调查表采集患者一般资料,同时进行糖尿病患者自我管理知识、态度、行为评价量表行为分量表(diabetes self-management behavior assessment sub-scale,DSBAS)的评定。结果:①糖尿病伴抑郁组患者DSBAS总分(t=-6.784,P<0.01)及运动评分(t=-5.000,P<0.01)、遵嘱服药评分(t=-2.161,P<0.05)、足部护理评分(t=-2.994,P<0.01)、血糖血压监测评分(t=-2.621,P<0.01)、并发症检查评分(t=-3.376,P<0.01)评分,均低于不伴抑郁组;糖尿病伴抑郁组自我管理依从性不良的比例,显著高于不伴抑郁组(χ~2=11.156,P<0.01);②Logistic回归分析显示,抑郁可正向预测自我管理依从性不良(β=1.582,P<0.01),而住院次数可逆向预测自我管理依从性不良(β=-0.763,P<0.01)。结论:抑郁可能是导致糖尿病患者自我管理依从性不良的一个危险因素。

Objective:To explore the effects of depressed mood on self-management of patients with diabetes mellitus.Methods:A total of 175 cases diabetes outpatients investigated with patient health questionnaire-9(PHQ-9)were divided into diabetes with depression group(PHQ-9≥12 scores,n=63),diabetes without depression group(PHQ-9<12 scores,n=112).All the subjects were studied by self-administered questionnaire,diabetes self-management behavior assessment sub-scale(DSBAS).Results:Diabetes patients with depression had significantly lower total scores of DSBAS(t=-6.784,P<0.01),scores of exercise(t=-5.000,P<0.01),scores of medication adherence(t=-2.161,P<0.05),scores of foot care(t=-2.994,P<0.01),scores of self-monitoring of blood glucose and pressure(t=-2.621,P<0.01),and scores of examination of complication(t=-3.376,P<0.01)than those in diabetes patients without depression.Diabetes patients with depression had more ratio of poor adherence(χ~2=11.156,P<0.01).Logistic regression showed that the depressed mood(β=1.582,P<0.01),less admission times(β=-0.763,P<0.01)indicated poor self-management adherence in diabetes patients.Conclusion:Depression may have harmful roles on self-management in patients with diabetes mellitus.