妊娠期糖尿病孕妇对待疾病的态度与饮食障碍的关系

Attitude to disease among pregnant women with gestational diabetes mellitus and the relationship with eating disorder

目的了解妊娠期糖尿病(GDM)孕妇对待疾病的态度及其影响因素,并探讨态度与饮食依从障碍的关系。方法选取2017年3-6月在首都医科大学附属北京妇产医院营养门诊经过健康教育并给予过个体化饮食处方后复诊的GDM孕妇200例进行问卷调查,包括一般资料量表、糖尿病综合量表(ATT-19)和个人糖尿病问卷中的饮食障碍子量表。结果 200例GDM孕妇的平均态度得分为(63.64±9.37)分,其中态度消极孕妇154例,占77.0%(态度得分≤70分)。单因素分析显示,态度积极组和态度消极组的教育水平与家庭月收入差异有统计学意义(P<0.05)。校正混杂因素后,多因素Logistic回归分析结果显示,较低家庭月收入是GDM孕妇态度消极的独立危险因素。态度消极孕妇"在家人或朋友引诱我,或不太支持我的情况下"、"需要在外就餐"、"在没有取得良好疗效的情况下"、"忙于家务、工作或其他事务"而不能依从饮食处方的比例明显高于态度积极的孕妇(P<0.05)。结论大部分GDM孕妇对待疾病态度消极,特别是较低收入人群。健康教育者应给予GDM孕妇更多的关怀和鼓励,帮助其形成积极稳定的糖尿病态度,从而减少患者的饮食障碍。

Objective To survey the attitude to disease among pregnant women with gestational diabetes mellitus（ GDM） and the relationship with eating disorder. Methods From March to June in 2017,200 pregnant women with GDM were given health education and individualized diet management in Nutrition Clinic of Beijing Obstetrics and Gynecology Hospital,then subsequent visit was peformed,a questionnaire survey was carried out,the questionnaires included general information questionnaire,modified version of diabetes integration scale（ ATT-19）,and eating disorder subscale of personal diabetes questionnaire. Results The mean attitude score was（ 63. 64±9. 37）,the pregnant women with negative attitude（ score≤70） accounted for 77. 0%（ 154 women）. Univariate analysis showed that there were statistically significantly differences in educational level and monthly family income between positive attitude group and negative attitude group（ P〈0. 05）. After adjusting the confounding factors,multivariate logistic regression analysis showed that low monthly family income was independent risk factor of negative attitude among GDM pregnant women. Under circumstance of ＂ family or friends tempt you or they are not very supportive of your efforts to eat right＂, ＂ eating away from home＂, ＂ feeling discouraged due to lack of results＂, ＂ being busy with family,work,or other responsibilities＂,the proportions of pregnant women with negative attitude who couldn＇t comply with diet management were statistically significantly higher than those of pregnant women with positive attitude（ P〈0. 05）. Conclusion Most pregnant women have a negative attitude towards disease,especially those who have lower income. Health educators should give GDM pregnant women more care and encouragement in order to help them create and maintain a positive attitude which may reduce eating disorder.