深圳市宝安区2型糖尿病患者自我管理模式效果评价

Evaluating the Effects of Self-management Mode on Type 2 Diabetes Patients in Baoan District of Shenzhen

目的评价2型糖尿病患者自我管理模式干预效果。方法将319例社区2型糖尿病患者随机分为自我管理模式组(干预组)和社区常规管理组(对照组),对照组按照常规的管理模式对糖尿病患者进行健康教育、发放健康教育宣传资料、随后定期进行电话随访和面对面随访;干预组在对照组的基础上,强调患者自我管理的重要性,传授自我管理知识,定期开展活动,并有针对性地进行干预。采用改良密西根糖尿病知识测试问卷(DKT)、参考Deborah的糖尿病自我管理量表(DCP)进行效果评价。干预1年后,比较干预组(161例)和对照组(158例)患者血糖控制率、糖尿病知识水平和自我管理得分等方面的变化情况。结果干预组血糖控制率从28.71%升高为59.63%,对照组从22.78%升高为29.75%,干预组优于对照组(χ2=28.787,P<0.001);干预组糖尿病知识水平得分、饮食依从性及用药依从性得分高于对照组(P<0.05),运动依从性和检查依从性与对照组比较无明显差异(P>0.05)。结论自我管理模式在血糖控制、糖尿病知识水平提高和饮食依从性及用药依从性提高方面明显优于常规的糖尿病管理模式。

OBJECTIVE To evaluate the intervention effects of the self-management model on type 2 diabetes patients. METHODS 319 patients with Type 2 diabetes were randomly divided into intervention group and control group. Patients of control group were given health education about diabetes, provided health education information, regular telephone and face-to-face interview. Patients of self- management group were emphasized the importance of self-management, taught knowledge of self-management on the basis of the conventional management mode. To evaluat the effectiveness by improved Michigan diabetes knowledge test questionnaire and Deborah diabetes se!f-management scale. One year later, the differences between the two groups in aspects such as blood glucose control and diabetes knowledge and self-management score were compared. RESULTS After intervention, the intervention group was obviously superior to the control group in the rate of blood glucose control, the rate rose from 28.71% to 59.63% in the intervention group, while it rose from 22.78% to 29.75% （P〈0.05） in control group. The grades of the intervention group were higher than that of control group in diabetes knowledge, diet compliance and medication adherence（P〈0.05）. Exercise adherence and check compliance with the control group was not significantly different in the intervention group（P〉0.05）. CONCLUSION The self-management model could significantly improve the level of blood glucose control, diabetes knowledge, diet compliance and medication adherence.