2型糖尿病病人胰岛素注射意愿与糖化血红蛋白、胰岛素注射技能相关性分析

Analysis on correlation among insulin injection willingness and glycated hemoglobin,insulin injection skills for type 2 diabetes patients

[目的]探讨2型糖尿病病人胰岛素注射意愿与糖化血红蛋白(HbA1c)、胰岛素注射技能相关性,为开展胰岛素注射技能教育提供理论依据。[方法]采用方便抽样法选取200例2型糖尿病病人,进行规范化胰岛素注射技能教育,测量病人住院及出院3个月后的HbA1c,采用胰岛素注射技能评价表对病人出院时及出院后3个月的胰岛素注射技能进行评分。[结果]以四分位法将200例2型糖尿病病人按出院3个月后继续注射胰岛素意愿分为4组,Q4组(9.0分及以上)的病人占40.0%;出院时及出院3个月后的HbA1c差值比较,Q2组、Q4组与Q1组比较差异有统计学意义(P<0.05),Q3组与Q1组比较差异有统计学意义(P<0.01);出院时及出院3个月后的胰岛素注射技能得分差值比较,4组组间比较差异均有统计学意义(P<0.01);Spearman相关分析结果显示:2型糖尿病病人出院时胰岛素注射技能得分与继续使用胰岛素注射意愿呈负相关(r=-0.595,P<0.01),病人出院3个月后胰岛素注射技能得分与继续使用胰岛素注射意愿呈正相关(r=0.233,P<0.01),病人出院时及出院3个月后的胰岛素注射技能得分差值与继续使用胰岛素注射意愿呈正相关(r=0.846,P<0.01);多元线性逐步回归分析显示:病人出院时及出院3个月后的胰岛素注射技能得分差值是影响2型糖尿病病人继续使用胰岛素注射意愿的一个独立因素。[结论]病人出院3个月后继续使用胰岛素注射意愿并不高,糖尿病专科护士在为病人制定并实施技能教育时可以充分考虑到相关影响因素,从而制定更为有效的教育手段,以提高2型糖尿病病人胰岛素治疗的意愿。

Objective：To study the correlation among insulin injection willingness and glycated hemoglobin ,insu‐lin injection skills of type 2 diabetes patients ,so as to provide a theoretical basis for the development of insulin injection skills education .Methods：A total of 200 cases of patients with type 2 diabetes were selected by using convenient sampling method .After standardized insulin injection skills education for them ,the HbA1 c of pa‐tients during hospitalization and after 3 months after discharge were measured .The insulin injection skills of the patients were scored when discharged and after 3 months after discharged by using insulin injection skills evalu‐ation form .Results：A total of 200 cases of patients with type 2 diabetes were divided into 4 groups according to the insulin injections willingness of patients after 3 months after discharge by using four percentile methods . The patients in group（9 points and above） accounted for 40% of them ;there was statistically significant differ‐ence in HbA1c difference value when discharging and after 3 months after discharging among Q2 group ,Q4 group and Q1 group（P〈0 .05） ,and the difference was statistically significant between Q3 group and Q1 group （P〈0 .01）;there were statistically significant differences in insulin injection skills score of patients when dis‐charging and after 3 months after discharge among 4 groups（P〈0 .01）;Spearman correlation analysis showed ：insulin injection skills score of type 2 diabetes patients when discharging was negatively correlated with willing‐ness to continue insulin injection（r= -0 .595 ,P〈0 .01） ,the patients’ insulin injection skills score was positive‐ly correlated with willingness to continue insulin injection after 3 months after discharging（r=0 .233 ,P〈0 .01） ,the patients＇insulin injection skills score was positively correlated with the willingness to continue insulin injection when discharging and after 3 months after discharge（r=0 .846 ,P〈0 .01）;multiple linear stepwise regression a‐nalysis showed that the patients＇insulin injection skills score when discharging and after 3 months after dis‐charged was an independent factor of affecting type 2 diabetes mellitus patients＇willingness to continue insulin injections .Conclusion：The willingness of patients for continuing to use insulin injections is not high after dis‐charge for 3 months ,and diabetes specialist nurses can give full consideration to the related influencing factors in the formulation and implementation of skills education for patients ,so as to establish a more effective means of education ,to improve the willingness of type 2 diabetic patients on insulin therapy .