授权理论在社区2型糖尿病老年患者教育中的应用

The application of empowerment theory in health education of elders with type 2 diabetes mellitus in community

目的探讨以授权理论为指导的糖尿病教育对社区2型糖尿病老年患者糖化血红蛋白及自我效能的作用。方法采用随机数字表法,将两个社区的86例2型糖尿病老年患者分为试验组与对照组,每组各43例。试验组采用授权理论为指导的糖尿病教育6周,对照组采用社区常规管理。教育结束后,两组均电话随访6个月,并分别在干预前、干预后6周、第3、6个月评价患者糖尿病控制自我效能,同时在干预前、干预后第3、6个月检测糖化血红蛋白。结果试验组干预后不同时间点糖尿病控制自我效能量表总分及多个维度的均分较干预前提高,且明显高于对照组,差异有统计学意义(P<0.05);与干预前相比,试验组患者干预后第3个月糖化血红蛋白显著下降,差异有统计学意义(P<0.01)。结论以授权理论为指导的糖尿病教育在提高患者糖尿病控制自我效能及血糖控制水平方面具有明显的促进作用。

Objectives To evaluate the effectiveness of the empowerment theory-based education on the level of metabolic control （HbAlc） and self-efficacy in the elders with type 2 diabetes mellitus in community. Methods The study was a randomized clinical trial（RCT）. Eighty-six elders with type 2 diabetes mellitus were randomly divided into the intervention group and the control group. The intervention group（n=43） received empowerment theory-based education consisted of 6 weekly sessions whilst the control group（n=43） received general community management. After 6 weeks of sessions all patients were followed up 6 months by phone call. The scores of self-efficacy was collected before the sessions and 6 weeks,3 months and 6 months after the end of the sessions. The HDAlc were measured before and 3 months, 6 months after. Results The mean scores of diabetes selfefficacy in most domains had increased after the intervention and significantly higher in the intervention group than those in the control group. HbAlc in the intervention group significantly decreased 3 months after the intervention（P〈0.01）. Conclusion The empowerment theory-based education can significantly improve patients＇ self-efficacy and deerease the level of HhAlc.