社区综合干预对老年糖尿病患者血糖控制的影响

Effect of the community comprehensive intervention on glycaemic control in the elderly people with diabetes

目的:观察老年糖尿病患者经社区综合干预促进血糖控制,以及遵医行为的影响。方法:选择上海石化社区辖区数个居民小区的老年糖尿病患者,其中按照不同年龄段(60~69岁、70~79岁、80岁以上)分别招募30例患者,且患者主动配合本次研究,总计90例。所有患者均接受为期9个月的社区综合干预(加强健康教育;合理饮食,控制能量摄入;按时按量用药;运动训练,控制体重;运动训练,控制体重;心理护理;加强自我监测)。采用自制调查问卷进行问卷调查,包括疾病认知、生活行为、服药情况、监测血糖频率、生活质量评价等。结果:所有患者在按时监测血糖、良好的生活行为习惯、良好的服药依从性、正确监测血糖较干预均有明显改善(P<0.05);60~69岁组患者生活质量满意度显著高于80岁以上组的70.0%(P<0.05);60~69岁组和70~79岁组患者干预空腹血糖(FPG),餐后2 h血糖(PBG)、糖化血红蛋白较干预前均明显改善(P<0.05);80岁以上组患者干预后的PBG较干预前均明显改善(P<0.05);干预后FBG达标率显著高于干预前(P<0.05)。结论:社区综合干预可以加强患者自我管理、增强遵医行为、控制血糖。

Objective:To observe the effect of the community comprehensive intervention to promote glycaemic control of the elderly patients with diabetes after medical compliance.Methods:The elderly patients with diabetes in several residential communities under the jurisdiction of petrochemical community were selected,and 30 patients were recruited according to different age groups(60-69 years old,70-79 years old,and 80 years old above),respectively and the patients who actively cooperated with this study were a total of 90 ones.All patients received a 9-month community comprehensive intervention(strengthening health education;reasonable diet and control energy intake;medication on time and in quantity;exercise training,weight control;psychological care;strengthening self-monitoring).The self-made questionnaires were used to conduct the survey,including disease cognition,life behavior,medication use,monitoring blood glucose frequency,quality of life evaluation,etc.Results:All patients had significant improvements in blood glucose monitoring on time,good lifestyle habits,good medication compliance,and correct blood glucose monitoring compared with intervention before(P<0.05);the quality of life satisfaction of patients in the 60-69 year old group was significantly higher than that in the group over 80 years old(70.0%P<0.05);the FBG,PBG and HbAlc of patients in the 60-69 and 70-79 years old groups were significantly improved compared with those before intervention(P<0.05);the PBG in the patients over 80 years old group was significantly improved after intervention compared with that before intervention(P<0.05);the FBG compliance rate after intervention was significantly higher than that before intervention(P<0.05).Conclusion:Community comprehensive intervention can improve patients’self-management,compliance behavior,and glycaemic control.