文化程度、遵医行为与糖尿病患者血糖水平的关系

Association of educational level and behavior of medical compliance with the level of blood glucose in diabetic patients

目的:调查并评价糖尿病患者文化程度与遵医行为间的关系,进而分析了解患者这种遵医行为对血糖控制的影响。方法:选择2001-01/2003-12商丘市第一人民医院内分泌科2型糖尿病患者168例。对调查项目均知情同意并符合其他纳入标准的糖尿病患者144例。男86例,年龄(61±12)岁;女58例,年龄(60±13)岁。文化程度:大学(大专、本科及以上)23例、高中(高中或中专)64例、初中(初中及以下)57例。作者参照王冬梅等的遵医行为调查问卷进行设计。问卷内容:以是否完全遵从医嘱、部分遵从医嘱、不遵从医嘱为三大因子。具体内容涉及戒除烟酒、定期复查、药物治疗、运动疗法、饮食控制等,同时询问患者性别、文化程度、病程等。问卷于患者入院后3d内完成,采取面对面询问方式并做详尽记录。用血糖仪测定患者空腹及餐后2h血糖。计数、计量资料差异测定采用χ2检验和t检验。结果:2型糖尿病患者144例均完成问卷调查,并进入结果分析。①遵医行为:大学和高中文化程度糖尿病患者对戒除烟酒、日常监测、药物治疗、饮食控制完全遵从医嘱百分率明显高于初中文化程度者(大学:78%,91%,91%,65%;高中:59%,88%,89%,55%;初中:37%,44%,47%,38%,χ2=18.256～24.613,P<0.05)。②血糖水平:大学及高中文化程度的糖尿病患者空腹血糖和餐后2h血糖均明显低于初中文化程度者[大学:(7.78±2.34),(11.01±4.73)mmol/L;高中(7.76±2.54),(10.86±4.89)mmol/L;初中:(8.95±3.75),(12.86±5.42)mmol/L,t=2.14～2.26,P<0.05]。结论:文化程度较高糖尿病患者对医嘱遵从率较高,血糖水平也较低。

AIM：To investigate and assess the association between the educational level and behavior of medical compliance in patients with diabetes mellitus, so as to analyze effect of the behavior of medical compliance on the control of blood glucose. METHODS： A total of 168 type 2 diabetic patients were selected from the Department of Endocrinology, Shangqiu First People＇s Hospital from January 2001 to December 2003,and 144 of them,who were in accordance with other inclusive criteria, participated in the study voluntarily, including 86 males aged （61 ± 12）years and 58 females aged （60 ± 13）years.The educational level was university （university and above） in 23 cases, senior high middle school in 64 cases, and middle school （or below） in 57 cases. The patients were investigated with the self-designed medical compliance of diabetic patients inventory in reference to that of Wang DM et al.The questionnaire consisted of 3 factors of complete medical compliance, part medical compliance and medical incompliance, it also included withdrawal of smoking and drinking, regular reexamination,drug therapy,exercise therapy and dietary control, besides, the gender, educational background and disease course were also inquired.The inventory was finished within 3 days after admission by means of faee-to-face visit and recorded detailedly. The fasting and 2-hour postprandial blood glucose was detected with the blood glucose meter. The differences of the enumeration data and measurement data were detected with the chi-square test and t test. RESULTS：AII the 144 type 2 diabetic patients finished the inventory investigation, and were involved in the analysis of results. ① Behavior of medical compliance： The pereentages of the complete medical compliance of smoking and drinking withdrawal, daily monitoring, drug therapy and dietary control were obviously higher in the diabetic patients with the educational background of university and senior high middle school than in the those of middle school （university： 78%, 91%, 91%, 65%; senior high middle school： 59%, 88%, 89%, 55%; middle school： 37%, 44%, 47%, 38%,X^2=18.256-24.613,P 〈 0.05）. ②Blood glucose levels： The fasting blood glucose and 2-hour postprandial blood glucose were obviously lower in the diabetic patients with the educational background of university and senior high middle school than in the those of middle school [university： （7.78±2.34）, （11.01±4.73） mmol/L; senior high middle school： （7.76±2.54）, （10.86_±4.89） mmol/L; middle school： （8.95±3.75）, （12.86±5.42） mmol/L, t=2.14-2.26, P 〈 0.05]. CONCLUSION：The diabetic patients with higher educational levels have higher rate of medical compliance and lower blood glucose level.