印度尼西亚2型糖尿病患者自我管理预测因素研究

Predictors of diabetes self-management among type 2 diabetics in Indonesia:Application theory of the health promotion model

目的确定印度尼西亚玛琅地区2型糖尿病患者自我管理的预测因素。方法采用横断面研究。采用多阶段抽样法选取印度尼西亚玛琅地区5所初级健康中心127例2型糖尿病患者。采用一般糖尿病知识问卷(the General Diabetes Knowledge Questionnaire)、治疗效果信念问卷(the Beliefs of Treatment Effectiveness Questionnaire)、糖尿病困扰量表(the Diabetes Distress Scale)、糖尿病自我效能量表(the Self-Efficacy for Diabetes Scale)、简明慢性病资源调查表(the Brief Chronic lIness Resources Survey).环境问卷(the Situa-tional Questionnaire)、自我护理行为报告(the Summary of Diabetes Self-Care Activities)进行数据收集。问卷的选取是基于健康促进模型。采用多元逐步回归方法进行数据分析。结果糖尿病知识问卷得分为(13.75±3.59)分、治疗效果信念问卷得分为(34.9±4.89)分糖尿病困扰量表得分为(3.03±0.86)分、糖尿病自我效能量表得分为(3.60±0.53)分,简明慢性病资源调查得分为(27.79±5.56)分、环境问卷得分为(3.27±0.58)分、自我护理行为报告得分为(3.81±1.08)分。玛琅地区2型糖尿病患者自我管理预测因素为治疗、自我效能感、环境影响,可解释糖尿病自我管理水平总变异的20.8%。结论通过加强2型糖尿病患者自我效能感,可提高其自我管理水平,从而实现自我管理行为,如健康饮食、规律锻炼、主动监测血糖服药和足部护理,并为促进良好.环境影响提供支持。

Objective:This study aimed to identify factors predicting diabetes self-management among adults with type 2 diabetes mellitus in Malang City,East Java,Indonesia.Methods:A cross-sectional design was used in this study.Participants were selected from five primary health centers in Malang City,East Java,Indonesia using the multistage sampling method.A total of 127 adults with type 2 diabetes mellitus were recruited.Data were collected by questionnaires which were the general diabetes knowledge,the Beliefs of Treatment Effectiveness,the Diabetes Distress Scale,the Self-efficacy for Diabetes Scale,the brief Chronic Illness Resources Survey,the Situational Questionnaire and the Summary of Diabetes Self-care Activities.A self-administered questionnaire was used to collect the data.Multiple linear regression with stepwise method was used toanalyze the data.Results:The scores of seven questionnaires(i.e,diabetes knowledge,perceived benefit of diabetes self-management,diabetes distress,perceived self-efficacy,social support,situational influence,and diabetes self-management)were 13.75±3.59,34.9±4.89,3.03±0.86,3.60±0.53,27.79±5.56,3.27±0.58,3.81±1.08,respectively.The significant predictors of diabetes self-management were treatment,perceived self-efficacy,and situational influences.These variables explained 20.8%(adjusted R^(2)=0.208)of the variance in diabetes self-management among adults with type 2 diabetes mellitus in Malang City.Conclusion:Diabetes self-management among adults with type 2 diabetes mellitus could be improved by enhancing their perceived self-efficacy to achieve their self-management behavior,such as having a healthy diet,exercising regularly,actively monitoring blood glucose level,taking medication and foot care,and providing support to promote good situational influence.