动机性访谈对糖尿病患者糖脂代谢指标、自我效能与自我管理水平的影响

Effect of Motivational Interview on Glucose and Lipid Metabolism Indicators,the Level of Self-efficacy and Self-management in Diabetic Patients

目的:探讨动机性访谈(MI)对糖尿病患者糖脂代谢指标、自我效能与自我管理水平的影响。方法:将70例2型糖尿病患者(3例因肺功能衰竭或不能坚持回访被排除研究)随机分为实验组34例和对照组33例。对照组采用常规糖尿病教育干预,实验组采用MI干预。分别记录和比较干预前、干预3个月和干预6个月两组体重指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、糖尿病患者知识量表(ADKnowl)、糖尿病患者自我效能与自我管理量表。结果:干预3、6个月,实验组FPG、2 h PBG、Hb A1c低于对照组(P<0.05),ADKnowl、自我效能与自我管理水平评分与对照组比较差异有统计学意义(P<0.05);干预6个月,实验组FPG、2 h PBG、Hb A1c变化率均高于对照组(P<0.05);干预3、6个月,实验组ADKnowl和自我效能与自我管理量表变化率均高于对照组(P<0.05)。结论:MI能更好地改善2型糖尿病患者糖代谢水平,提高患者自我管理水平。

Objective： To explore the effect of motivational interview（MI） on glucose and lipid metabolism indicators, self-efficacy and self-management level in diabetic patients. Methods：A total of 70 patients with type 2 diabetes mellitus were randomly divided into the ex- perimental group with 34 cases and the control group with 33 cases ,3 patients were excluded from the study because of pulmonary failure or failure to adhere to a interview. The control group received conventional diabetes education intervention, and the experimental group re- ceived MI intervention. Before the intervention ,3 months and 6 months after the intervention, two groups＇ body mass index（ BMI）, fasting blood glucose （ FPG ）, 2 h postprandial blood glucose （ 2 hPBG）, glycosylated hemoglobin （ HbA1 c ）, triglyceride （ TG ）, high density lipopro- tein（HDL-C） ,low density lipoprotein （LDL-C）, diabetes knowledge scale （ADKnowl）, diabetes self-efficacy and self-management scale were recorded and compared. Results ：3,6 months after the intervention,the experimental group＇s levels of FPG,2 hPBG, HbA1 c were sig- nificantly lower than those of the control group（ P 〈 0.05 ）. There was significant difference between two groups on the scores of ADKnowl and self-efficacy and self-management level. The changing rates of FPG,2 hPBG and HbA1 c in the experimental group were significantly higher than those of the control group after 6 months intervention（ P 〈 0. 05 ）. After 3 and 6 months intervention,the changing rates of AD- Knowl and self-efficacy and self-management scale in experimental group was significantly higher than those in control group （ P 〈 0.05 ）. Conclusion ： MI can improve the level of glucose metabolism and improve the self-management level of patients with type 2 diabetes mellitus.