中青年2型糖尿病患者自我管理行为的影响因素研究

Self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus

目的了解中青年2型糖尿病(T2DM)患者自我管理行为并分析其影响因素,为T2DM患者健康管理提供参考。方法于2021年1—8月采用方便抽样法抽取在浙江大学医学院附属杭州市第一人民医院内分泌科就诊的18~<60岁T2DM患者为调查对象,收集性别、年龄和文化程度等基本资料;采用糖尿病患者自我管理行为量表评估自我管理水平;采用社会支持评定量表评估社会支持水平;采用医学应对问卷评估疾病应对方式;采用多重线性回归模型分析中青年T2DM患者自我管理行为的影响因素。结果调查342例,男性185例,占54.07%;女性157例,占45.93%。年龄为(43.76±3.82)岁。自我管理行为得分为(94.22±18.74)分,得分率为72.48%;其中良好63例,占18.42%;中等208例,占60.82%;差71例,占20.76%。多重线性回归分析结果显示,性别(女,β’=0.213)、文化程度(高中/中专:β’=0.187;大专及以上:β’=0.411)、家庭人均月收入(≥5 000元,β’=0.390)、病程(>5年,β’=0.340)、接受过糖尿病健康教育(β’=0.524)、应对方式(回避:β’=0.195;面对:β’=0.367)和社会支持水平(一般:β’=0.206;高:β’=0.383)是中青年T2DM患者自我管理行为的影响因素。结论中青年T2DM患者自我管理处于中等水平,与性别、文化程度、经济收入、病程、糖尿病健康教育、应对方式和社会支持水平有关。

ObjectiveTo investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus( T2 DM), so as to provide the basis for the care management of T2 DM.Methods T2 DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People’s Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities( SDSCA) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale( SSRS), while the coping modes were assessed using the Medical Coping Modes Questionnaire( MCMQ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2 DM using multivariable linear regression analysis.ResultsThe 342 respondents included 185 men( 54.07%) and 157 women(45.93%), and had a mean age of( 43.76±3.82) years. The total score of self-care activities was( 94.22±18.74), and the overall scoring rate was 72.48%, including 63 cases with high scores( 18.42%), 208 cases with moderate scores( 60.82%) and 71 cases with low scores( 20.76%). Multivariable linear regression analysis identified gender( women, β’=0.213), educational level( high school/technical secondary school, β’=0.187;diploma and above, β’=0.411), household monthly income per capita(5 000 Yuan and higher, β’=0.390), course of disease( >5 years, β’=0.340), history of receiving health education targeting diabetes( β’=0.411), coping mode( avoidance, β’=0.195;confronce, β’=0.367) and social support level( general, β’=0.206;high, β’=0.383) as factors affecting self-care activities among young and middle-aged patients with T2 DM.Conclusions T2 DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.