2型糖尿病患者自我护理行为的现状及其影响因素

Influencing Factors of Self-care Behaviors in Patients with Type 2 Diabetes

目的调查2型糖尿病患者自我护理行为现状,并依据保护动机理论,探讨患者自我护理行为的影响因素,为临床人员采取干预措施、提高糖尿病患者的自我护理水平提供参考依据。方法 2016年10月至2017年4月,便利抽样法选取在北京市某三级甲等医院内分泌科住院的254名2型糖尿病患者为调查对象,采用糖尿病自我管理活动问卷、糖尿病患者保护动机问卷和自行设计的一般资料问卷,对其进行问卷调查。结果糖尿病患者自我管理量表总均分为(3.21±1.47)分,处于中等偏下水平,其中,遵医嘱用药维度得分最高,为(4.04±2.25)分;足部自我护理维度得分最低,为(2.36±2.55)分。不同性别的糖尿病患者其血糖自我监测行为差异有统计学意义(t=2.26,P=0.024),是否有糖尿病家族史的患者,其血糖自我监测行为的差异亦有统计学意义(t=2.24,P=0.026)。而不同文化程度、吸烟状况、有无合并症的糖尿病患者在各方面自我护理行为的差异均无统计学意义(均P>0.05)。除保护动机中的反应成本维度与自我护理总均分及其各维度得分相关关系均无统计学意义(均P>0.05)外,其余各维度与自我护理总均分或自我护理各维度得分呈正向或负向相关(P<0.05或P<0.01)。结论2型糖尿病患者的自我护理水平有待进一步提高,临床护理人员者可以保护动机中7个维度作为切入点,采取针对性的干预措施,激发患者的保护动机,从而提高其自我护理水平。

Objective To investigate the self-care status of patients with type 2 diabetes,and to explore its influencing factors based on the Protection Motivation Theory （PMT）,in order to provide a reference to improve self-care behaviors in patients with type 2 diabetes.Methods A total of 254 patients from endocrinology department were investigated by the Summary of Diabetes Self-Care Activities （SDSCA）,Protection Motivation Scale of Diabetes （PMSD） and self-designed general information questionnaire. Results The total mean score of self-care of patients by type 2 diabetes was （3.21±1.47）, which was at a low level. The prescribed medication dimension scored the highest, with the score of （4.04±2.25）. There were significant difference in blood glucose self-monitoring behavior between different genders of diabetic patients（ t =2.26, P =0.024） and between patients with family history（ t =2.24, P =0.026）. There was no significant difference in self-care behavior among diabetic patients with different educational background, smoking status and complications （all P 〉0.05）. There was no significant correlation among the total mean score of self-care, the dimension of reaction cost and each dimension score （all P 〉0.05）. The other dimensions were either positively or negatively correlated with the total mean score of self-care or the scores of self-care （ P 〈0.05 or P 〈0.01）.Conclusions The self-care of patients with type 2 diabetes needs to be improved. Nursing providers may take interventions based on seven aspects of protection motivation to stimulate patients’ motivation, and to enhance their self-care behaviors.