健康教育对糖尿病患者依从性及生命质量影响的研究

Influence of health education on the treatment compliance and quality of life of diabetics

目的探讨健康教育对糖尿病患者治疗依从性及生命质量的影响，为提高糖尿病教育水平提供理论依据。方法选择2008年10月至2009年3月参加中国医科大学附属第一医院糖尿病健康教育讲座的糖尿病患者90例作为干预组；2008年9至10月在该院住院且从未参加过糖尿病健康教育的糖尿病患者205例作为对照组，通过一般状况问卷、糖尿病依从性问卷和sF-36健康调查量表，采用设立对照组比较和自身前后配对比较方法，分析糖尿病教育对患者治疗依从性和患者生命质量的影响。结果干预组治疗依从性随着参加健康教育次数的增多而提高（P〈0．05）；对照组患者治疗依从性在人院和刚出院的短期内有一定提高，但随后逐渐下降。长时间中断糖尿病教育易导致患者依从性下降。干预组干预后24周依从性总分（42．44±4．10）分高于对照组（35．60±3．90）分，也高于干预组干预前（34．56±4．34）分（P均〈0．01），且5个维度得分差异有统计学意义（P〈0．05或0．01）。干预组干预后的8个维度中，活力、社会功能、情感职能和精神健康4个维度的评分均高于自身干预前，且除情感职能外的其他3项差异有统计学意义（P〈0．05）。长期参加教育的患者，其心理健康指数有一定提高。结论长期的健康教育不仅对患者的治疗依从性起到积极作用，坚持参加健康教育更能够提高糖尿病患者心理健康质量。

Objective To observe the influence of diabetes educationon the treatment compliance and quality of life （QOL） of diabetics and to find out the influencing factors of diabetics＇ QOL. Methods This study applied the questionnaire of compliance and the SF-36 to make an investigation on diabetics. Ninety diabetics who participated in the course of diabetes education during the period from October 2008 to March 2009, and 205 diabetics who were seen in the first affiliated hospital of China Medical Universitybut never participated in the course of diabetes education during the period from September to October of 2008. By comparing the data with control group and using self-paired comparison, the influence of diabetes education on the treatment compliance and the QOL of diabetics was studied. The factors influencing the QOL of each dimension were analyzed by means of single or multiple regressions. Results The treatment compliance of patients was improved with the number of times that these patients participated diabetes education was increased （P〈O.05）. The treatment compliance of the patients in hospital who had not participated in diabetes education was improved temporarily. However, 2 weeks after these patients were discharged the treatment compliance of these patients had began to decline. The treatment compliance would be declined if patients discontinued participating education for a long time. After 24 weeks intevention, the total score of compliance of intervention group （42.44±4.10） was higher than control group （35.60±3.90）, and also higher than the intervention group before intervention （34.56 ± 4.34）（all P〈0.01）. The scores of 5dimensions were significantly different （P〈0.05 or 0.01）. Of 8 dimensions of intervention group, the scores of vitality, social functioning, role-emotional and mental health were all increased after intervention, with significant differences except for role-emotional （P〈0.05）. The mental health index of patients with long-term health education was increased to a certain degree. Conclusion Long-term health education plays an active role in treatment. Insisting on taking part in health education regularly can improve the quantity of mental health.