电话随访对2型糖尿病患者依从性及心理状况的影响

Effect of telephone follow-up on the compliance and mental status of patients with type 2 diabetes mellitus

目的探讨电话随访对2型糖尿病(type 2 diabetes mellitus,T2DM)患者依从性及对心理状况的影响。方法选取内分泌门诊及住院患者140例,随机分为对照组与电话随访组各70例,对照组患者在出院时嘱其定期复诊,电话随访组在对照组的基础上,定期电话随访。干预前后患者填写依从性问卷、抑郁自评量表(self-rating anxiety scale,SAS)及焦虑自评量表(self-rating depression scale,SDS),并比较患者出院后3个月的空腹血糖(fasting blood glucose,FBG)、餐后血糖(postprandial blood glucose PBG)、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)水平。计量资料组间比较采用两独立样本t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果干预后电话随访组患者在遵医用药、合理饮食、适量运动、血糖监测、定期复查等方面的依从性,分别为[(9.4±1.6)、(8.9±2.1)、(8.1±1.3)、(7.7±2.0)、(7.3±2.6)分]较对照组[(8.0±1.8)、(7.6±2.2)、(7.5±1.2)、(7.0±2.0)、(6.4±2.5)分]明显提高,差异均有统计学意义(均P<0.05)。干预3个月后,两组患者焦虑、抑郁得分[(44.57±5.25)、(44.63±4.57)分与(50.30±5.11)、(50.78±5.35)分]比较,差异均有统计学意义(均P<0.05);随访组干预前后焦虑、抑郁得分比较,差异均有统计学意义(均P<0.05)。干预后两组患者FBG、PBG、Hb A1c水平[(6.57±1.37)、(8.29±2.16)mmol/L、(7.01±1.12)%与(7.96±2.28)、(11.09±4.29)mmol/L、(8.54±2.31)%]比较,差异均有统计学意义(均P<0.05)。结论电话随访可提高T2DM患者依从性、改善心理焦虑、抑郁状况及血糖水平,这有利于提高患者的自我管理能力和生活质量水平。

Objective To explore the effect of telephone follow-up on type 2 diabetes millitus （T2DM）patients＇ compliance and psychological status.Methods 140 patients of T2DM were chosen from endocrine outpatient and hospitalized patients. The pa- tients were randomly divided into two groups, telephone follow-up group（n=70）and control group（n=70）.The control group was as regular reexamination,patients in follow-up group received regular telephone foUow-up based on regular reexamination. After the patients were discharged from hospital, they completed the questionnaire at the beginning and the end of the study, after three months, compare the patients of fasting blood glucose（FBG）, postprandial blood glucose（PBG）, glycosylated hemoglobin level（HbA1c）. Independent samples t test was used compared with two group, and paired samples t test was used compare with the group before and after for measurement data,P〈0.05 was considered statistically significant. Results After the intervention,compared with control group, telephone follow-up significantly improved patients＇ compliance including in medicine, reasonable diet, exercise, blood sugar monitoring, periodic review, the scores of control group were [（8.0 ± 1.8）, （7.6 ± 2.2）,（7.5 ± 1.2）,（7.0 ± 2.0）, （6.4 =t： 2.5）] and intervention group were [（9.4 ± 1.6）, （8.9 ± 2.1）, （8.1 ± 1.3）, （7.7 ± 2.0）, （7.3 ± 2.6）] （P〈0.05）. There was statistically significant difference of the patient＇s anxiety and depression scores between control group and follow-up group,the scores were （44.57 ± 5.25）, （44.63 ± 4.57）and（50.30 ± 5.11）, （50.78 ± 5.35）（P〈0.05）. After intervention, there was statistically significant difference of the patient＇s FBG,PBG,HhAlc, the scores were（6.57 ± 1.37）, （8.29 ± 2.16）, （7.01 ± 1.12）and（7.96 ± 2.28）, （11.09 ± 4.29）, （8.54 ± 2.31）（P〈0.05）. Conclusion Telephone follow-up can improve T2DM patients＇ compliance, psychological anxiety and depression and blood glucose levels, which could be beneficial to the patient＇s level of self-management ability and quality of life.