483例糖尿病患者自我管理现状及影响因素分析

The current status and influential factors of self-management in 483 cases of diabetic patients

目的了解糖尿病患者自我管理的现状并探讨其影响因素,为临床开展糖尿病健康教育及提高患者的自我管理水平提供理论依据。方法采取便利抽样方法,抽取2011年3月至2013年4月重庆市一所三甲医院和两所社区医院住院及门诊治疗的483例糖尿病患者用自制糖尿病自我管理问卷调查量表进行调查。结果发放问卷500份,收回有效问卷483份,有效回收率为96.6%。483例被调查糖尿病患者中,78.7%的患者是通过医务人员了解糖尿病知识;治疗方案遵循方面:执行力最好的是药物方案59%;糖尿病知识平均得分为(41.747±10.23),得分指标为51.5%;有82.2%的患者对自我的糖化血红蛋白值不了解,44.5%患者对餐后2h的血糖不了解;糖尿病患者的自我护理行为平均得分为(3.59±1.249),得分指标为51.29%,不同的自我管理水平得分指标有所不同;文化程度、离退休人员、饮食控制、血糖监测、糖尿病知识掌握是接受健康教育的保护因素。结论患者对糖尿病知识掌握普遍较差,患者的自我管理现状不容乐观,应加大对糖尿病患者针对性教育,努力提高糖尿病患者的自我管理能力。

Objective To Know the present situation of diabetes′ self-management ,explore its influencing factors and provide theoretical evidences for conducting diabetic health education and improving patients′ level of self-management .Methods Using random sampling method ,we took 483 cases of diabetic patients concluded inpatient and outpatient from a first class hospital and two community hospitals who meet the inclusion criteria from March 2011 to April 2013 in Chongqing city .All patient were investi-gated with diabetes self-management questionnaire scale .Results 500 questionnaires ,received 483 valid questionnaires ,and the ef-fective rate of recovery is 96 .6% .Among 483 cases of diabetic patients in the investigation ,78 .7% of patients understood diabetes knowledge from medical staffs .In the aspect of following the treatment plan ：drug plan had the best executive power with 59% ;the average score of diabetes knowledge was （41 .747 ± 10 .23） ,score index was 51 .5% ;82 .2% of patients did ,not understand their value of glycated hemoglobin ,44 .5% of patients did not understand the two-hour postprandial blood glucose ;The average score of diabetes′self-care behaviors was（3 .59 ± 1 .249） ,score index was 51 .29% ,different score index accompany with different self-man-agement levels .Educational level ,retirees ,diet control ,blood glucose monitoring ,the understanding of diabetes knowledge were pro-tective factors for receiving health education .Conclusion Patients grasp diabetic knowledge are poorly in average ,the present situa-tion of patients′self-management is not optimistic ,it is better to increase the health education of diabetes′ self-management ,and make great efforts to improve diabetes′self-management skills .