探讨社区空巢老年糖尿病患者的心理特点及对策

Investigation of the Psychological Characteristics of Community Empty Nesters with Diabetes and the Countermeasures

目的探讨社区空巢老年糖尿病患者心理特点及对策。方法 2009年9月—2012年9月期间对该社区确诊的空巢老年糖尿病患者进行为期3年的医护干预,心理疏导前后对患者进行问卷调查和医学体检,评价其效果。结果 292人参与,男性131人,女性161人,在糖尿病诊断标准、服降糖药感觉良好后仍需保持良好的心态等方面,除遗传是危险因素知晓率无差别外,其余知识的知晓率在心理疏导前后差异有高度统计学意义(P<0.01);对控制体重、有氧运动,戒烟、限酒和保持心理平衡等非药物疗法的使用率均上升,除戒烟外,其余差异有统计学意义(P<0.05)。心理疏导后患者总复查率、总药物治疗率和总控制率较心理疏导前分别提高了12.81%,7.41%和23.62%,其中心理疏导前后总控制率差别有统计学意义(χ2=10.84,P<O.01)。心理疏导后空腹血糖和血压分别下降了8.07 mmol/L和5.47 mm Hg,差别有统计学意义(t值分别为13.73和1.74,均P<0.05)。结论为空巢老年糖尿病患者制定个体化健康指导方案,主要是定期心理疏导,对提高患者糖尿病知识知晓率、药物、非药物治疗依从性以及血糖控制率方面具有重要意义。

Objective To explore the psychological characteristics of community empty nesters with diabetes and the countermea-sures. Methods The empty nesters confirmed with diabetes in the community were given a 3-year medical and nursing interven-tion from September 2009 to September 2012. And they underwent the questionnaire survey and medical examination before and after psychological counseling. And the effect was evaluated. Results 292 people were enrolled in this study, including 131 males and 161 females. There were statistically significant differences in the awareness rate of rest knowledge about diagnostic criteria for diabetes, patients need to keep good state of mind even if they feel good after taking hypoglycemic drugs and so on except the awareness rate of risk factor heredity before and after psychological counseling （P〈0.01）. In the patients, the unilization ratio of non-drug treatment, such as weight control, aerobic exercise, quitting smoking, alcohol limitation and keeping psychologic equilib-rium, increased after psychological counseling, the differences in the above non-drug treatment factors except quitting smoking be-fore and after psychological counseling were statistically significant （P〈0.05）. After psychological counseling, the overall review rate, total drug treatment rate and total control rate increased by 12.81%, 7.41% and 23.62%, respectively, as compared with that before psychological counseling, and significant difference was found in the total control rate before and after psychological coun-seling（χ^2=10.84, P〈0.01）. Compared with before psychological counseling, after psychological counseling, the fasting blood glucose of the patients decreased by 8.07 mmol/L, with statistically significant difference （t=13.73, P〈0.05）, blood pressure decreased by 5.47 mmHg, with statistically significant difference （t=1.74, P〈0.05）. Conclusion For the empty nesters with diabetes, formulating individualized health guidance scheme mainly including regular psychological counseling, is of great significance in improving the awareness rate of diabetic knowledge, drug and non-drug treatment compliance and blood glucose control rate.