北京市郊区中年2型糖尿病患者自我管理行为现状及影响因素分析

Self-Management Behaviors and Its Influencing Factors among Mid-Aged Adult Patients with Type 2 Diabetes in A Suburb of Beijing

目的了解北京市郊区中年2型糖尿病患者的自我管理行为现状及其影响因素。方法方便抽样法选取2015年5月至2016年6月北京市某郊区医院收治的93例中年2型糖尿病患者为研究对象,采用解释性序列设计的混合研究,首先采用糖尿病自我管理行为量表(the summary of diabetes self-care activities measure,SDSCA)对研究对象的自我管理行为及影响因素进行问卷调查;然后根据调查结果,选择14例自我管理行为较差的患者进行深入访谈。结果93例中年2型糖尿病患者自我管理行为总分为(3.56±1.33)分,其中用药管理(5.59±2.34)分、运动管理(4.22±2.92)分、饮食管理(3.84±2.13)分、足部管理(1.53±2.07)分、血糖监测(0.86±1.25)分。多元逐步回归显示,年龄、糖化血红蛋白(glycosylated hemoglobin,HbA1c)与用药管理、足部护理有关,家庭收入与血糖监测有关(均P<0.05)。深度访谈结果显示:中年2型糖尿病患者自我管理行为不佳的主要原因为缺乏糖尿病相关的知识或存在认识误区、对疾病自我管理不重视、执行困难以及经济条件制约。结论郊区中年2型糖尿病患者的自我管理行为有待提高,应进一步探讨更为有效的干预措施。

Objective To describe the self-management behaviors and explore the influencing factors on self-management among mid-aged adult patients with type 2 diabetes mellitus(T2DM)in suburb of Beijing.Methods By convenience sampling method,93 middle-aged patients with T2DM admitted to the Hospital from May 2015 to June 2016 were selected.The mixed study of interpretative sequence design was used,the self-management behavior and influencing factors of the subjects were investigated by the summary of diabetes self-care activities measure(SDSCA).Based on the results,14 patients with poor self-management behaviors were selected for in-depth interviews.Results For 93 T2DM patients,the total score of SDSCA were 3.56±1.33,including medication management(5.59±2.34),exercise management(4.22±2.92),diet management(3.84±2.13),foot management(1.53±2.07)and blood glucose monitoring(0.86±1.25).Multiple stepwise regression analysis showed that age and HbA1c were related with drug administration and foot care;family income was related with blood sugar monitoring(all P<0.05).Analysis of interviewed data showed that the main causes of the patients with poor self-management were“lack of diabetes related knowledge or misunderstanding”,“lack of the disease self-management awareness”,“difficulties in implementation”and“constraints of economic conditions”.Conclusions The self-management of the middle age patients with T2DM in suburb of Beijing needs to be improved,more effective interventions should be explored.