中青年2型糖尿病患者规律运动行为的阶段分布及其影响因素

Regular exercise behavior stage and its influencing factors in young and middle-aged patients with type 2 diabetes

目的中青年人群已为糖尿病患病率增长最快的群体,且规律运动的依从性较差,临床亟需制定有效的干预措施以促进其行为的改变。文中基于态度-社会影响-自我效能模型,探讨中青年2型糖尿病患者规律运动行为的阶段分布及其影响因素。方法采用便利抽样的方法选取南京市2所三甲医院内分泌科的430例中青年2型糖尿病患者,以一般情况调查问卷、规律运动行为阶段问卷、糖尿病运动行为态度、社会影响量表及糖尿病自我效能量表进行横断面调查。结果中青年2型糖尿病患者规律运动行为各阶段的分布比例为意图前期14.9%、意图期25.8%、准备期15.8%、行动期12.3%、维持期31.2%。Logistics回归分析结果示,在职(OR=1.77)、接受健康教育(OR=0.49)、Hb A1c水平(OR=0.78)、态度(OR=5.32)、主观规范(OR=2.43)、社会支持(OR=1.87)和自我效能(OR=1.28)是影响患者规律运动行为阶段的主要因素(P<0.05)。结论大多数中青年2型糖尿病患者规律运动行为处于行动前阶段,有待进一步提高;规律运动行为阶段受多个因素的影响。临床医务人员应基于可干预因素,针对患者不同行为阶段的特征制定个性化的干预措施。

Objective Young and middle-aged people have become the fastest growing group of diabetes,but the compliance of regular exercise is poor.It is urgent to formulate effective intervention strategies or measures to promote the change of their behavior.The article is objectively based on the attitude-social influence-self efficacy model,to investigate the stages distribution and influencing factors of regular exercise behavior in young and middle-aged patients with type 2 diabetes.Methods A convenience sampling was used to select 430 young and middle-aged type 2 diabetic patients from the department of endocrinology in two Nanjing 3A grade hospitals.A cross-sectional survey was conducted with a general questionnaire,a regular exercise behavioral stage questionnaire,a diabetes behavioral attitude and social impact scale,and a diabetes self-efficacy scale.Results The proportion of regular exercise behavior in young and middle-aged patients with type 2 diabetes is as follows.There were 14.9%patients at the precontemplation,25.8%at the contemplation,15.8%at the preparation,12.3%at the action,31.2%at the maintenance.Logistic regression analysis showed that on-the-job(OR=1.77),accepting health education(OR=0.49),HbA1c level(OR=0.78),attitude(OR=5.32),subjective norm(OR=2.43),social support(OR=1.87)and self-efficacy(OR=1.28)are main factors to affect the stages of physical activity(P<0.05).Conclusion Most of the young and middle-aged patients with type 2 diabetes are in the pre-action stages of regular exercise behavior,which needs to be improved,and many factors can affect the stages of regular exercise behavior.Clinical medical staff should provide individualized interventions for these patients with reference to the characteristics of different behavioral stages of patients.