多学科合作健康教育模式对老年糖尿病病人心理状况的影响

Effect of multi-disciplinary team health education on the psychological status of the elderly patients with diabetes mellitus

目的探讨多学科合作(MDT)模式下健康教育对老年糖尿病病人焦虑抑郁心理状态的影响。方法采用自愿招募方式选取83例糖尿病门诊就诊的老年糖尿病病人,对其开展1年MDT模式健康教育。于教育前后对病人采用健康问卷抑郁症症状调查表(PHQ-9)、广泛性焦虑自评量表(GAD-7)、躯体症状群量表(PHQ-15)进行评估,比较教育前后病人的相关危险因素改善情况及焦虑和抑郁状况。结果 MDT模式健康教育后,病人的糖尿病知晓率、治疗率、血压达标率、血脂达标率均较教育前明显提高,病人的体质量指数(BMI)、臀围、腰围、收缩压、空腹血糖(FBG)、糖化血红蛋白均较教育前有所改善,差异有统计学意义(P<0. 05)。抑郁与病人的BMI、腰围、臀围、FBG呈正相关(r=0. 177,0. 336,0. 201,0. 213,P<0. 05),与其他相关因素无明显相关性(P>0. 05)。经PHQ-9、GAD-7、PHQ-15量表评价,MDT模式健康教育后病人抑郁程度明显减轻(P<0. 05)。结论 MDT健康教育模式在老年糖尿病病人的治疗中有积极作用,可明显改善病人的抑郁状态,提高病人的治疗依从性。

Objective To explore the effect of multi-disciplinary team( MDT) health education on the anxiety and depression state of the elderly patients with diabetes mellitus. Methods A total of 83 elderly diabetic patients in diabetes clinic were selected by voluntary recruitment,and they were given MDT health education for one year. Before and after education,all the patients were assessed by the Health Questionnaire Depression Symptom Questionnaire( PHQ-9),the General Anxiety Self-Rating Scale( GAD-7) and the Body Symptom Group Scale( PHQ-15). The related risk factors of diabetes mellitus and anxiety and depression status of patients were compared before and after education. Results After MDT health education,the diabetes awareness rate,treatment rate,target levels of blood pressure and blood lipid of the patients were significantly increased. Body mass index( BMI),waistline,hipline,systolic blood pressure, fasting blood glucose( FBG), and HbA1 c of the patients were significantly improved after education( P< 0. 05). Depression was positively correlated with BMI,waistline,hipline and FBG( r = 0. 177,0. 336,0. 201,0. 213,P< 0. 05). The degree of depressive was significantly alleviated after MDT health education( P< 0. 05). Conclusions MDT health education can improve the depression status of the elderly patients with diabetes mellitus and improve the compliance of patients.