老年2型糖尿病患者医学应对方式及影响因素研究

Medical Coping in Elderly T2DM Patients and Its Influencing Factors

背景目前老年2型糖尿病的治疗已成为临床关注的重点问题。患者心态对于疾病的发展至关重要,医学应对能很好地体现患者的心理状态,若熟知患者医学应对方式并找出影响因素,则可有目的地针对患者进行心理指导,以达到有效治疗目的。目的了解老年2型糖尿病患者的医学应对方式现状,分析其影响因素。方法采用便利抽样法,选取2012年11月—2014年4月于锦州市、承德市各1所三级甲等医院内分泌科治疗的228例老年2型糖尿病患者,采用中文版医学应对问卷(MCMQ)进行调查。结果老年2型糖尿病患者的医学应对方式评分分别为:面对维度(18.3±3.3)分,回避维度(14.3±4.0)分,屈服维度(11.8±3.4)分;应对方式各维度评分在不同文化程度、地域、居住方式的老年2型糖尿病患者间差异均有统计学意义(P<0.05)。多元线性逐步回归分析显示:文化程度、病程、医疗负担方式、性别、居住方式进入面对维度影响因素的回归方程(P<0.05);文化程度、病程、地域、医疗负担方式进入回避维度影响因素的回归方程(P<0.05);仅文化程度进入屈服维度影响因素的回归方程(P<0.05)。结论老年2型糖尿病患者医学应对方式中面对维度、回避维度、屈服维度的影响因素不尽相同,应加强对老年2型糖尿病患者的健康教育,对患者有区别地进行心理疏导,促进身心健康,提升老年2型糖尿病的治疗效果。

Background In recent years,T2DM treatment has become the focus of clinical attention. Patients＇ mental state is essential for the development of the disease. The medical coping can reflect patients＇ psychological state well. If we know patients＇ medical coping and find out its influencing factors,we can give patients purposive psychological guidance to gain effective treatments. Objective To investigate the medical coping in elderly T2DM patients and analyze its influencing factors. Methods This study chose,by convenience sampling method,228 elderly T2DM patients who visited 2 hospitals in Jinzhou,Chengde from November 2012 to April 2014. This study used Medical Coping Modes Questionnaire（ Chinese Version）to perform the investigation. Results The T2DM patients＇ medical coping scores were： confrontation dimension（ 18. 3 ± 3. 3）,avoidance dimension（ 14. 3 ± 4. 0）, yielding dimension（ 11. 8 ± 3. 4）. There was significant difference in coping mode dimensions between elderly T2DM patients with different educational levels and living patterns, from different regions（ P〈0. 05）. By multiple linear regression equations,educational level,duration of disease,medical burden,gender,living pattern came into the regression equation of the influencing factors of confrontation dimension（ P〈0. 05）,educational level,duration of disease,region,medical burden into the regression equation of avoidance dimension（ P〈0. 05）, educational level into the regression equation of yielding dimension（ P〈0. 05）. Conclusion Influencing factors of medical coping mode of elderly patients with type 2 diabetes in the facing, avoidance, and yielding dimension are not the same, health education and psychological counseling can improve the therapeutic effects for elderly T2DM patients.