以自我效能干预为基础的健康教育对精神分裂症合并糖尿病患者的效果

目的探讨自我效能干预对康复期精神分裂症伴糖尿病患者的健康教育效果。方法将60例患者按住院先后顺序单号为观察组（30例），双号为对照组（30例）。在药物治疗的基础上，观察组参与自我效能干预10周；对照组不作特殊安排，接受一般说教式健康教育模式和常规护理方法，每人发放一份健康教育手册，内附精神分裂症与糖尿病健康知识、糖尿病监测记录单。应用自制健康知识问卷表、社会功能缺陷筛选量表（SDSS），评定患者对糖尿病的认知程度、患者社会功能改善状况，采用全自动生化分析仪测定患者空腹血糖（FPG）、餐后2h血糖（2hPG）控制状况。结果10周后观察组患病原因、服药依从性、服药注意事项、并发症的管理、自我检测常识、饮食计算和综合管理能力水平高于对照组，差异有统计学意义（t值分别为2．810，3．843，3．617，2．841，2．741，4．281，3．867；P均〈0．05）；SDSS各因子分（社会性退缩、病房内活动、个人生活自理、对外界的兴趣和责任性和计划性）显著低于对照组，差异有统计学意义（t值分别为3．640，2．802，2．953，3．241，2．915；P均〈0．05）；FPG和2hPG明显低于对照组[（5．1±1．4）mmol／L比（9．5±2．4）mmol／L，（8．9±1．3）mmol／L比（11．4±2．4）mmol／L]，差异有统计学意义（t值分别为3．74，3．57；P均〈0．01）。结论以自我效能干预为基础的健康教育，能改善精神分裂症伴糖尿病患者的症状及糖代谢，有效改善患者社会功能，提高患者生存质量。

Objective To investigate the health education effect of self-efficacy intervention on schizophrenia patients with diabetes mellitus.Methods Sixty patients were divided according to their hospitalized order,with odd number for the experimental group (n =30) and even number for the control group (n =30).The experimental group received self-efficacy intervention for 10 weeks in addition to drug treatment,while the control group received general preaching health education pattern and conventional nursing method,and each patient was provided with a health education handbook including knowledge about schizophrenia and diabetes,and diabetes monitoring record sheet.Self-designed health knowledge questionnaire and social function flaw screening meter (SDSS) was used to evaluate patients ' cognition about diabetes and social function improvement.Automatic biochemistry analyzer was also used to monitor the control condition of patients' fasting blood-glucose (FPG) and 2-hour postprandial blood-glucose (2 hPG).Results Ten weeks later,patients' knowledge about the cause of disease,drug compliance,notice in drug-taking,complication management,self examination,diet calculation and comprehensive management ability was higher in the experimental group than that in the control group,and the difference was statistically significant (t =2.810,3.843,3.617,2.841,2.741,4.281,3.867,respectively; P ＜ 0.05).Factors in SDSS including social withdrawal,ward activity,personal care,interests in outer world,responsibility and tradition of planning were all lower in the experimental group than those in the control group,and the differences were statistically significant (t =3.640,2.802,2.953,3.241,2.915,respectively ;P ＜ 0.05).The FPG and 2 hPG were also lower in the experimental group than those in the control group,and the differences were statistically significant (t =3.74,3.57,respectively ; P ＜ 0.01).Conclusions Health education based on self-efficacy intervention can improve the symptoms and saccharometabolism of schizophrenia patients with diabetes,thus to further improve patients' social function and quality of life.