社区2型糖尿病患者的社会心理行为特点

Characteristics of the social psychological behavior in patients with type 2 diabetes mellitus in community

目的:分析社区2型糖尿病患者的社会心理行为特点,为制定健康教育方案提供资料。方法:于2004-06/12对属于社区服务中心辖区内并愿意接受有关糖尿病健康教育观察和在社区门诊治疗的116例2型糖尿病患者和62例对照人群进行自我评估,内容包括一般资料、简易应对方式问卷的积极和消极应对方式、社会支持评定量表的主、客观支持和支持利用度、世界卫生组织生活质量测定量表简表的生理、心理、社会和环境领域4个方面的生活质量指标、抑郁自评量表的抑郁情绪、艾森克个性问卷的内外向、情绪的稳定性、精神质和心理掩饰。结果:①共发放问卷200份,回收有效问卷178份,糖尿病组116份,对照组62份。②糖尿病组体质量指数高于对照组眼(25.61±1.93)kg/m2,(24.00±2.00)kg/m2,t=5.24,P<0.01演。对糖尿病的了解:糖尿病组:很了解42例(36.2%)、了解63例(54.3%)、不甚了解11例(9.5%)。对照组:很了解6例(9.7%)、了解52例(83.9%)、不甚了解4例(6.5%),两组差异有显著性(χ2=16.45,P<0.01)。运动规律两组分布差异无显著性(P>0.05)。③糖尿病组艾森克个性问卷中心理掩饰分、抑郁自评量表评分、消极应对方式评分高于对照组(50.74±4.27,48.71±4.65;38.78±4.94,29.06±7.90;9.90±1.53,9.32±1.73,t=2.933熏8.805,2.420,P<0.05～0.01);社会支持评定量表的客观支持分、支持利用分、世界卫生组织生活质量测定量表简表的心理领域分、社会领域分、自我满意分均低于对照组(8.10±1.78,9.00±1.79;6.60±0.77,7.47±0.78;10.84±2.56,12.71±3.20;28.72±2.75,32.18±5.18;72.80±8.20,77.39±7.98,t=3.183熏7.106,4.233,5.833,3.587,P<0.01)。④回归分析显示社会支持对糖尿病患者的生活质量和抑郁情绪影响突出(P<0.05～0.01)。结论:糖尿病患者具有不稳定的情绪、较差的社会支持利用度、不成熟的个性特点和消极的应对方式等社会心理行为特点。

AIM： To analyze the characteristics of psychosocial behavior in patents with type 2 diabetes in community in order to build the program of health education. METHODS： Totally 116 patients with type 2 diabetes in community serve center, who would like to accept educations about diabetes knowledge, follow-up and 62 controls were evaluated from June to December 2004. The evaluation included general materials, positive and negative copying styles of simplified coping style questionnaire, subjective and objective support and support utilization of social support rating schedule, physical, psychic, social and environmental fields of WHOQOL-BREF, depressed emotion of Self-Rating Depression Scale （SDS）, extraversion/introversion; neuroticism/stability and psychoticism of Eyscnck Personality Questionnaire （EPQ）. RESULTS： ① A total of 200 questionnaires were sent out and 178 informants completed surveys, including 116 in study group and 62 in control group. ② Body mass index （BMI） of patients with type Ⅱ diabotes of study group was significantly higher than that in control group [（25.61±1.93） kg/m^2, （24.00±2.00） kg/m^2, t=5.24, P 〈 0.01]. There were mastery of diabetes knowledge in 42 cases （36.2%）, knowing diabotes knowledge in 63 cases （54.3%）, incomprehension diabetes knowledge in 11 cases （9.5%） in patients with type Ⅱ diabetes, and mastery of diabotes knowledge in 6 cases （9.7%）, knowing diabetes knowledge in 52 cases （83.9%）, incomprehension diabetes knowledge in 4 cases （6.5%） in control group. The difference were significant between study group and control group （χ^2=16.45, P 〈 0.01）. The difference of regular exercise was not significant （P 〉 0.05）. ③ The L-EPQ scales, total SDS scales, negative coping style scales of patients with type Ⅱ diabetes in the study group were higher than those in the control group significantly （50.74±4.27, 48.71±4.65; 38.78±4.94, 29.06±7.90; 9.90±1.53, 9.32±1.73, t = 2.933, 8.805, 2.420, P 〈 0.05-0.01）. The objective social support scales, utilizing social support scales, psychic and social field and satisfaction self of WHOQOL-BREF scales of patients with type Ⅱ diabetes were lower than those in control group （8.10±1.78, 9.00±1.79; 6.60±0.77, 7.47±0.78; 10.84±2.56, 12.71±3.20; 28.72±2.75, 32.18±5.18; 72.80±8.20, 77.39±7.98, t = 3.183, 7.106, 4.233, 5.833, 3.587, P 〈 0.01）. ④ Regression analysis showed that the effect of social support on quality of life and depression emotion of patients with type Ⅱ diabetes significantly （P 〈 0.05-0.01）. CONCLUSION： Patients with diabetes are characterized by emotion instability, social support insufficiency, immature personality and negative coping style.