CHOICE管理模式对1型糖尿病青少年患者依从性的管理及效果评价

Effects of CHOICE management mode on adherence of adolescents with type 1 diabetes mellitus

目的探讨CHOICE管理模式对1型糖尿病（T1DM）青少年患者依从性的影响。方法采取便利取样法选择门诊就诊的T1DM青少年患者49例，用随机数字法分为试验组（26例）和对照组（23例）。试验组接受为期1年的CHOICE管理模式，对照组实施传统的教育管理方法。分别评价2组在干预前、干预1、3、6和12个月后的自我管理行为和糖化血红蛋白（HbAlc）水平。结果对照组干预12个月后病情控制、对疾病态度及糖尿病知识的理解自评得分分别为（2．71±0．43）、（3．89±0．60）、（3．05±0．71）分，与试验组的（2．49±0．33）、（4．20±0．40）、（3．51±0．70）分比较差异有统计学意义（t=-2．101、2．129、2．289，均P〈0．05）；试验组干预1个月和3个月后饮食依从性得分（2．85±0．67）、（2．79±0．66）分，高于对照组的（2．39±0．70）、（2．38±0．67）分，差异有统计学意义（t=2．170、2．338，均P〈0．05）。试验组干预3个月后HbAlc为（8．29±0．76）％，低于对照组的（8．85±1．14）％，差异有统计学意义（t=2．041，P〈0．05））。在其他时间段各指标比较差异无统计学意义（t=-1．556～-0．527，均P〉0．05）。结论CHOICE管理模式在T1DM青少年患者的健康教育应用中有一定的优势，对患者的自我管理行为干预效果较好。

Objective To evaluate the effects of CHOICE management mode on adherence of adolescents with type 1 diabetes mellitus （T1DM）. Methods A total of 49 adolescents with T1DM wereelected using convenience sampling method, and divided into the experimental group （26 cases） and the control group （23 cases） by random number table. The experimental group received the CHOICE management for 1 year, while the control group received traditional education management. The patients＇ self-management behaviors and HbAlc were evaluated before the intervention and 1, 3, 6 and 12 months after the intervention. Results The scores of Control Problems, Attitude Toward Diabetes and Understanding Management Knowledge after 12- months intervention were （2.71±0.43）, （3.89±0.60）, （3.05 ±0.71 ） points in the experimental group, （2.49±0.33）, （4.20±0.40）, （3.51±0.70） points in the control group, there were significant differences （t=-2.101, 2.129, 2.289, P 〈 0.05）. The scores of Diet Adherence after 1 month and 3 months intervention were （2.85±0.0.67）, （2.79±0.66） points in the experimental group, （2.39 ±0.70）, （2.38±0.67）points in the control group, there were significant differences （t=2.170, 2.338, P 〈 0.05）. HbAlc was （8.29± 0.76）% in the experimental group, （8.85-＋ 1.14）% in the control group, there was significant difference （t=-2.041, P〈0.05）. There were no significant differences at the others times between two groups （t=-1.556- 0.527, P〉0.05）. Conclusions CHOICE management mode can effectively improve the self-management behavior of adolescents with T1DM.