中青年2型糖尿病病人健康饮食行为阶段的影响因素

Influencing factors of healthy dietary behavior stage of young and middle⁃aged patients with type 2 diabetes mellitus

目的:基于结构方程模型分析中青年2型糖尿病病人(T2DM)健康饮食行为阶段的影响因素。方法:于2021年9月—2022年6月采用便利抽样法选取广西壮族自治区百色市某三级甲等医院内分泌科收治的280例中青年T2DM病人为研究对象,采用一般资料调查表、健康饮食行为阶段问卷、负面社会支持互动量表、糖尿病态度量表、糖尿病管理自我效能量表进行调查,随后采用有序逻辑回归以及结构方程模型对中青年T2DM病人健康饮食行为阶段的影响因素进行分析。结果:280例中青年T2DM病人中,处于前意向阶段46例(16.4%),意向阶段87例(31.1%),准备阶段82例(29.3%),行动阶段46例(16.4%),维持阶段19例(6.8%)。回归分析结果显示,文化程度、病程、并发症、糖尿病住院史、糖化血红蛋白、糖尿病态度、负面社会支持互动、糖尿病管理自我效能对病人健康饮食行为阶段的改变有影响(P<0.05)。结构方程模型显示,糖尿病管理自我效能对健康饮食行为的前意向阶段、意向阶段、准备阶段和行动阶段均有直接影响,糖尿病态度和负面社会支持互动可以通过糖尿病管理自我效能对健康饮食行为阶段产生间接影响。结论:中青年T2DM病人健康饮食行为阶段受多种因素影响,医务人员应针对影响因素对病人进行干预,以改善其健康饮食行为。

Objective:To analyze the influencing factors of healthy dietary behavior stage of young and middle⁃aged patients with type 2 diabetes mellitus(T2DM)based on structural equation model.Methods:A total of 280 young and middle-aged patients with T2DM were selected as subjects by convenience sampling method from September 2021 to June 2022,who were admitted to the endocrinology department of a tertiary grade A hospital in Baise,Guangxi Zhuang Autonomous Region.General information questionnaire,healthy dietary behavior stage questionnaire,Unsupportive Social Interaction Scale,The Third Version of the Diabetes Attitude Scale and Diabetes Management Self⁃Efficacy Scale were used to investigate.Then,the Logistic regression and structural equation modeling were used to analyze the influencing factors of healthy dietary behavior stage of young and middle⁃aged patients with T2DM.Results:Among 280 young and middle⁃aged patients with T2DM,46(16.4%)were in the pre⁃intention stage,87(31.1%)were in the intention stage,82(29.3%)were in the preparation stage,46(16.4%)were in the action stage,and 19(6.8%)were in the maintenance stage.Regression analysis results showed that education level,course of disease,complications,diabetes hospitalization history,glycated hemoglobin,diabetes attitude,unsupportive social interaction,and diabetes management self⁃efficacy had impaction healthy dietary behavior stage of patients(P<0.05).The structural equation modeling showed that diabetes management self⁃efficacy had direct impact on pre⁃intention stage,intention stage,preparation stage,and action stage of healthy dietary behavior.And diabetes attitude and unsupportive social interaction had indirect impact on healthy dietary behavior stage through diabetes management self⁃efficacy.Conclusions:The healthy dietary behavior stage of young and middle⁃aged patients with T2DM is influenced by multiple factors,and medical staff should intervene in patients based on these influencing factors to improve their healthy dietary behavior.