以家庭为基础的自我管理在2型糖尿病患者中的应用研究

Application of family-based self-management in patients with type 2 diabetes

目的探索以家庭为基础的自我管理在2型糖尿病患者中的应用。方法选取2016年3月至2018年3月于浙江医院接受治疗的104例患者为研究对象,按照随机数表法分为对照组和观察组,对照组采用常规健康教育,观察组采用以家庭为基础的自我管理。采用简明健康状况调查表(SF-12)对患者干预前后生活质量水平进行评价。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对干预前后患者不良心理情绪进行评价。采用全自动血糖仪检测患者干预前后空腹血糖、餐后血糖、糖化血红蛋白指标。结果干预后观察组精神心理健康评分(68.74±20.36)分、躯体功能健康评分(70.15±21.49)分明显高于对照组精神心理健康评分(46.59±16.84)分、躯体功能健康评分(47.29±17.32)分,数据对比差异有统计学意义(t=2.289、2.314,P=0.032、0.029);干预后观察组SAS为(28.64±10.33)分、SDS评分为(26.91±11.24)分明显低于对照组SAS(45.29±14.75)分、SDS评分(48.53±15.27)分,数据对比差异有统计学意义(t=2.397、2.364,P=0.021、0.025)。干预后观察组空腹血糖(6.03±1.57)mmol/L、餐后血糖(8.35±2.24)mmol/L、糖化血红蛋白(6.32±1.62)%明显低于对照组空腹血糖(8.01±2.11)mmol/L、餐后血糖(9.26±3.15)mmol/L、糖化血红蛋白(7.59±1.74)%,数据对比差异有统计学意义(t=2.269、2.213、2.179,P=0.034、0.039、0.041)。结论以家庭为基础的自我管理较常规健康教育能够提高2型糖尿病患者生活质量水平,缓解患者焦虑、抑郁等不良心理情绪,并对2型糖尿病患者血糖水平有一定改善,适合临床推广应用。

Objective To discuss the application of family-based self-management in patients with type 2 diabetes.Methods 104 patients treated in Zhejiang Hospital from March 2016 to March 2018 were enrolled in the study.They were divided into the control group and the observation group using the random number table method.Patients in the control group received routine health education,and those in the observation group received family-based self management education.The quality of life before and after the intervention was evaluated using the Concise Health Status Questionnaire(SF-12).The anxiety and self-rating scale(SAS)and the self-rating depression scale(SDS)were used to evaluate the adverse psychological emotions of patients before and after the intervention.The automatic blood glucose meter was used to detect fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin before and after the intervention.Results After the intervention,the mental health score and physical fitness score were significantly higher of patients in the observation group than that of those in control group(68.74±20.36 vs 46.59±16.84;70.15±21.49 vs 47.29±17.32;t=2.289,2.314,P=0.032,0.029),while the SAS score and SDS score were significantly lower(28.64±10.33 vs 45.29±14.75;26.91±11.24 vs 48.53±15.27;t=2.397,2.364,P=0.021,0.025).Also,after the intervention,the serum levels of fasting blood glucose,postprandial blood glucose,and glycated hemoglobin were all significantly lower in the observation group compared to that in the control group(6.03±1.57 vs 8.01±2.11 mmol/L;8.35±2.24 vs 9.26±3.15 mmol/L;6.32±1.62 vs 7.59±1.74%;t=2.269,2.213,2.179,P=0.034,0.039,0.041).Conclusions Family-based self-management can improve the quality of life,relieve the anxiety and depression and lower the blood sugar level of patients with type2 diabetes.