老年2型糖尿病患者的疾病描绘及影响因素研究

Disease Description of Senior Patients with Type 2 Diabetes and Its Influencing Factors

目的基于"常识模式"从疾病认知描绘与情绪描绘2方面,探讨老年2型糖尿病患者对疾病的认知及影响因素,有助于医护人员从患者的角度,提供有效的照护。方法采用便利抽样法,利用一般资料调查表和简易疾病认知问卷(Brief Illness Perception Questionnaire,Brief-IPQ),对就诊于广州市珠江医院内分泌科住院部与门诊的137例老年2型糖尿病患者进行调查。结果经单因素分析和多元回归分析结果显示,老年2型糖尿病患者工作状态、住院次数、并发症、病程和治疗方式分别从不同维度影响患者的疾病描绘。其中,对疾病辨识的描绘主要受住院次数的影响(P<0.01),疾病时间线的描绘主要受并发症数量(P<0.05)和病程影响(P<0.05),疾病结果的描绘主要受治疗方式(P<0.01)和并发症的影响(P<0.01),疾病可控性的描绘主要受病程的影响(P<0.05),自觉对糖尿病的综合理解程度主要受工作状态的影响(P<0.05)。结论从本研究疾病描绘各维度得分可以看出,老年2型糖尿病患者普遍自觉对疾病了解度高,相信自己可以控制疾病,已经具备自我管理的心理基础,同时对疾病的描绘受多方面因素影响(包括工作状态、住院次数、并发症、病程和治疗方式)。医护人员应根据患者对疾病的认知特点采取针对性的健康教育,从而有效提高患者自我管理水平。

Objective To discuss disease cognition of senior patients with type 2 diabetes and its influencing factors from the perspective of cognition description and emotion description based on the common-sense model and to provide effective nursing for patients. Methods With convenience sampling, a general information questionnaire and Brief Illness Perception Questionnaire （Brief-IPQ） were applied to survey 137 senior patients with type 2 diabetes. Results Single factor analysis and hierarchical regression analysis indicated that working or not, hospitalization frequency, complications, course of disease and treatment of the patients exerted influence on patients ’ cognition about the disease. The confirmation of symptom was influenced by hospitalization frequency（P〈0.01）, the description of disease time axis by treatment （P〈0.05）and complications（P〈0.05）, disease control by course of disease（P〈0.05） and comprehensive understanding by with working or not（P〈0.05）. Conclusion Most senior patients with type 2 diabetes do psychological preparation for self-management but their disease description is influenced by many factors. Health education based on patients’ cognition about the disease is beneficial to the improvement of patients’ self-management.