江苏省社区管理2型糖尿病患者生存质量和抑郁状况分析

Analysis of life quality,depressive status among patients with type 2 diabetes mellitus in the community disease management of Jiangsu Province

目的探讨江苏省社区管理2型糖尿病(T2DM)患者的生存质量、抑郁状况及其影响因素,为采取有针对性的糖尿病健康管理措施,提高患者生存质量提供依据。方法于2018年11月至2019年4月,在江苏省南京市、镇江市和盐城市的社区卫生服务中心(乡镇卫生院)招募建档并纳入基本公共卫生服务管理的1 370例T2DM患者为研究对象,采用面对面问卷调查的方式,收集患者的人口学信息和疾病相关信息,分别采用健康相关生命质量量表(SF-12)和患者健康问卷抑郁量表(PHQ-9)评估患者的生存质量和抑郁状况。使用SAS 9.4软件进行t检验、方差分析及多元线性回归分析。结果本研究中370例(27.0%)T2DM患者有抑郁症状,SF-12量表中生理总评分(PCS)和心理总评分(MCS)分别为(44.72±8.27)和(50.95±9.31)分。多元线性回归分析结果显示,影响T2DM患者PCS的因素依次为抑郁状况、年龄、并发症、患其他慢性病数量、性别及地区(β值分别为-0.370、-0.145、-0.145、-0.100、0.077和-0.063,P<0.01),影响T2DM患者MCS的因素依次为抑郁状况、并发症、性别和文化程度(β值分别为-0.463、-0.061、-0.057和0.053,P<0.05)。结论抑郁状况是影响T2DM患者生存质量的主要因素,应加强对T2DM患者抑郁情绪的管理,并对有并发症、女性、高年龄组、同时患有多种慢性病和文化程度较低的患者给予更多关注,以改善和提高T2DM患者的生存质量。

Objective To explore the life quality,depressive status and influencing factors among patients with type 2 diabetes mellitus(T2 DM) in Jiangsu Province,and to provide the basis for targeted diabetes health management measures and improving the life quality of patients.Methods From November 2018 to April 2019,1 370 T2 DM patients included in the Management of Basic Public Health Services were selected from community health service centers(township health centers) in cities of Nanjing,Zhenjiang and Yancheng in Jiangsu Province as the subjects.The investigation was performed by face-to-face questionnaires for collecting the demographic and disease-related information,the Health-related Quality of Life Scale(SF-12) and Patient Health Questionnaire(PHQ-9) were used to evaluate the life quality and depressive status of patients.The t test,analysis of rariance and multi-linear regression(MLR) method were used to analyze the data.The used software was SAS 9.4.Results In present study,370 cases(27.0%) of T2 DM patients had the depressive status,the total physiological score(PCS) and total psychological score(MCS) on the SF-12 scale were 44.72 ±8.27 and 50.95 ±9.31,respectively.MLR showed that the influencing factors of PCS in T2 DM patients were depressive status,age,complications,the number of other chronic diseases,gender and region (β values were-0.370,-0.145,-0.145,-0.100,0.077 and-0.063,respectively,P<0.01);the influencing factors of MCS in T2 DM patients were depressive status,complications,gender and education level (β values were-0.463,-0.061,-0.057 and 0.053,respectively,P<0.05).Conclusion Depressive status is the main factor that influences the life quality of T2 DM patients,the depression management of T2 DM patients should be strengthened,and more attention should be paid to the patients with complications,females,high age group,different chronic diseases and low education level to improve the life quality of T2 DM patients.