农村地区2型糖尿病患者自我效能感调查及其影响因素研究

Score and Factors Associated with Self-efficacy of Patients with Type 2 Diabetics in Countryside

目的调查农村地区2型糖尿病患者自我效能感情况,并探讨其影响因素。方法采用整群随机抽样法,从唐山市农村10个县中抽取2个县———丰南县和玉田县,在2个县中各整群抽取1个镇——黄各庄镇和林南仓镇,对镇里的2型糖尿病患者进行调查。采用统一的一般资料调查表、自我效能感调查量表、社会支持评定量表和糖尿病知识问卷进行调查,并用SPSS 16.0统计软件进行数据分析。结果本次共调查456例2型糖尿病患者,其中男170例,女286例;平均年龄(61.5±8.7)岁。患者的自我效能感得分为(4.0±0.9)分,52.4%(239/456)的患者自我效能感水平低。不同年龄、文化程度、职业、体力活动、血糖监测情况、病程、合并症及有无配偶、是否独居、是否接受健康教育、是否住过院、是否用胰岛素的患者,其自我效能感得分比较差异均有统计学意义(P<0.05)。多元逐步回归分析结果显示,影响农村2型糖尿病患者自我效能感水平的因素为社会支持、糖尿病知识、血糖监测、合并症、健康教育、体力活动(t值分别为12.075、6.528、4.695、-5.029、4.337和2.755,P均<0.01)。结论农村2型糖尿病患者总的自我效能感水平较低。影响自我效能感的因素是多方面的,应该对2型糖尿病患者进行有针对性的干预,加强知识宣教、社会支持、健康教育等,以提高患者的自我效能感及生活质量。

Objective To investigate self - efficacy of patients with type 2 diabetics in countryside, and to explore the factors associated with self - efficacy. Methods Random cluster sampling was used, there are 10 counties in Tangshan city, Fengnan county and Yutian county were chosen, then Huanggezhuang town and Linnancang town of the above two counties were chosen, survey of all patients with type 2 diabetics from the above two towns was conducted. Data were collected by standard questionnaires which including self - made general data questionnaire （ SMGDQ）, self - efficacy scale, social science research solutions （SSRS） and knowledge about diabetes questionnaires, statistical analyses were performed using the statistical package for social science （SPSS） for Windows （ Version 16.0）. Results A total of 456 patients with type 2 diabetics were surveyed, with 170 men and 286 women, the mean age was （61.5 ±8.7） years. The average score of self- efficacy was （4. 0 ±0. 9）, the self - efficacy level of 52. 4% （239/456） cases was low. Univariate analyses indicated that score of self - efficacy vary by age, education level, vocation, physical activity level, health education level, blood glucose monitoring condition, course of the disease, complication, marital status, history of hospitalization and insulin use, the differences were statistically significant （P 〈 0. 05）. The results of multiple stepwise regressions showed that social support, knowledge about diabetes, blood glucose monitor, complications, health education level and physical activity level were associated with self - efficacy of patients with type 2 diabetics in countryside （t= 12.075, 6.528, 4.695, -5.029, 4.337, 2.755; P all 〈0.01）. Conclusion The self- efficacy level of type 2 diabetic patients is low in countryside. Various factors were associated with the self - efficacy. Targeted in- terventions for patients with type 2 diabetics, including education and propaganda, social support, health education and so on should be developed, which may help to improve self - efficacy level and life quality of patients with diabetics.