以自我效能理论为基础的糖尿病高危人群干预效果分析

Intervention effect of diabetic high risk population based on self-efficacy theory in Shanghai

目的研究自我效能改变对社区糖尿病高危人群疾病控制和行为转变的影响。方法选取上海市某社区葡萄糖调节受损(IGR)者140人,按2∶1比例随机分为干预组(n=95)和对照组(n=45)。干预组由经过培训的社区医生实施为期6个月的以提高自我效能为目标的干预计划;对照组不实施任何干预措施。干预前后对研究对象进行问卷调查、体格检查以及血糖、血脂水平检测。结果干预前,干预组和对照组的自我效能总分为(27.52±6.45)和(27.16±7.63)分,组间比较差异无统计学意义(P>0.05);6个月后,干预组的自我效能总分为(30.34±4.38)分,显著高于对照组的(27.53±7.64)分,差异有统计学意义(P<0.05)。血糖检测结果显示:干预6个月后,干预组的空腹血糖(FPG)和餐后2 h血糖(PG2H)浓度均较基线值显著下降,且干预组的FPG浓度也显著低于对照组,差异均有统计学意义(P<0.05)。干预组中糖耐量异常(IGT)者的PG2H浓度显著低于对照组,差异有统计学意义(P<0.05)。干预组在干预前后的运动频率无明显变化;但干预后运动时间≥30 min者的比例(70.5%)较干预前(57.9%)明显增加,差异有统计学意义(P<0.05)。6个月后,干预组在糖尿病相关知识和态度上的得分显著高于对照组,差异有统计学意义(P<0.05)。结论自我效能水平的改变对糖尿病高危人群血糖指标的控制及运动行为的改变有一定效果。

Objective To study the effect of self-efficacy on the control of disease situation and behavior change in diabetic high risk population. Methods A sample of 145 impaired glucose regulation （IGR） patients was taken from a community in Shanghai and randomly assigned to intervention group or control group. The patients in the intervention group received intervention based on self-efficacy theory for 6 months under the community doctors＇ guidance. All patients received questionnaire survey, physical examination, and blood glucose and lipid test before and after intervention. Results The baseline scores of self-efficacy were 27.52 ~ 6.45 and 27.16 ~ 7.63 in intervention group and control group, respectively. After intervention, the score of self-efficacy in intervention group （30.34 ~ 4.38） was significantly higher than that in control group （27.53 ~ 7.64）（P 〈 0.05）. Fasting plasma glucose（FPG） and postprandial 2 hours glucose （PG2H） decreased in the intervention group after intervention compared with baseline. There was significant difference of FPG level between the two groups （P 〈 0. 05）after intervention. PG2H was decreased in intervention group compared to control group among IGT patients （P 〈 0.05）. Exercise frequency had no obvious change before and after intervention in the intervention group, but the proportion of the exercise time more than 30 min was increased after intervention （70.5%） compared to before intervention （57.9%） （P 〈 O. 05）. Six months later, patients in intervention group had higher scores of diabetic knowledge and status than those of control group （P 〈 0.05）. Conclusion Changes in the level of self-efficacy has certain effect on control of glucose level and exercise behavior in diabetic high risk population.