上海市闸北区2型糖尿病患者生存质量及影响因素研究

Study on quality of life and its influencing factors of patients with type Ⅱ diabetes in Zhabei community in Shanghai

目的找出影响糖尿病患者生存质量的可能因素,为今后改善社区卫生服务,提高患者生存质量提供依据。方法从上海市闸北区的3个社区卫生服务中心的糖尿病患者管理库中用单纯随机抽样法共抽取300人。通过患者自填或调查员面对面询问的方式进行问卷调查,生存质量调查用SF-36量表。采用多因素非条件Logistic回归进行影响因素分析。结果生存质量的促进因素主要包括:良好的家庭支持与交流情况,对生存质量6个维度有促进作用,OR值在总体健康感维度的1.662到精神健康维度的2.677之间;运动对6个维度有促进作用,OR值在总体健康感维度的1.481到躯体功能维度的1.956之间。生存质量的负面因素主要包括:患的其他慢性病数量,对4个维度有负面作用,OR值在躯体角色维度的0.638到躯体疼痛维度的0.712之间;单纯使用胰岛素对社会功能(OR=0.246)和情绪角色(OR=0.306)两个维度有负面作用。结论欲使糖尿病患者获得更好的生存质量,需要采取综合干预措施,重点应包括预防和积极治疗糖尿病的并发症,增进家庭支持与疾病交流,帮助患者改善运动习惯和正确认识胰岛素等。

Objective To identify the influencing factors of quality of life （QOL） of patients with type Ⅱ diabetes, and provide evidence for increasing their QOL through improving the community health service. Methods We selected 300 patients with type Ⅱ diabetes with clear diagnosis, using simple random sampling from the management database of 3 community health centers in Zhabei District- The subjects were gathered in the center and answered the questionnaire including SF - 36 for QOL by themselves or interviewers. Muhifactor unconditional logistic regression was used to explore the influencing factors of QOL Results Major positive factors to QOL included： family support and disease communication, positive to 6 scales, OR value ranging from 1. 662 of GH scale to 2. 677 of MH scale ; exercise, positive to 6 scales, OR ranging from 1. 481 of GH scale to 1. 956 of PF scale. Major negative factors to QOL included： complications, negative to 4 scales, OR ranging from 0. 638 of RP scale to 0. 712 of BP scale; single insulin use, negative to SF （OR =0. 246） and RE （ OR = 0. 306）. Conclusion Integrated intervention would be necessary to improve the QOL of diabetes patients, including preventing and actively treating the complications of diabetes, promoting family support and disease communication and helping to establish proper exercise habit and attitude towards insulin use.