摘要
目的了解社区糖尿病患者自我管理状况的影响因素。方法 2012年7—8月,在北京3个社区(街道)对240名糖尿病患者进行问卷调查。利用SAS 8.0软件对定量数据进行数据管理、统计描述、χ2检验、方差分析和通径分析等。结果患者糖尿病问题量表(PAID)得分平均为(25.0±17.8)分,中位数为21.5分;自我管理行为量表(SDSCA)得分平均为(47.0±15.4)分,中位数为48.0分;自我管理教育得分平均为(10.3±4.7)分,中位数为10.0分。不同受教育程度、家庭人均月收入者SDSCA得分差异均有统计学意义(P<0.10);不同性别、糖化血红蛋白水平者自我管理教育得分差异均有统计学意义(P<0.10)。通径分析模型显示:针对血糖控制越差的患者,社区医务人员给予的自我管理教育越多,患者自身的受教育程度高也能够提高患者的自我管理行为。虽然自我管理教育能够提高患者的自我管理行为,但是也同时给患者带来了更多的心理负担。结论受教育程度、家庭人均月收入是自我管理行为的影响因素;性别、糖化血红蛋白水平是自我管理教育的影响因素。社区医务人员提供的自我管理教育不仅在"数量"和"质量"上存在严重问题,还加大了患者的心理负担。因此,在慢性病患者的自我管理中,仅仅给予"知识"是远远不够的,还要注重"知识"的可吸收性和可操作性,要让患者真正掌握并能够恰当地运用于实际生活中,否则"冗余的知识"不但是无效的,而且还可能给患者带来负面影响。
Objective To assess the influencing factors of self - management among diabetes patients in Beijing com- munities. Methods The questionnaire survey was conducted among 240 patients with diabetes mellitus form three communities of Beijing from July to August 2012. SAS 8. 0 software was used for statistical analysis of the collected data. Results The average score of version of the Problem Areas in Diabetes （PAID） was （25.0±17. 8）, with the median of 21.5. The average score of summary of diabetes self-care activities （SDSCA） was （47.0 ± 15.4）, with the median of 48.0. The average score of self - management education was （ 10. 3 ±4. 7）, with the median of 10. 0. The difference in education background and average monthly income per capita of a family showed significant in the score of SDSCA （P 〈 0. 10） . The difference in sex and level of glycosylat- ed hemoglobin showed significant in the score of self- management education （P 〈 0. 10） . The analysis model revealed that the worse a patient＇s control of blood sugar was, the more education on self- management the community medical staff gave to the pa- tient; and a patient with higher education had a higher capability in self- management. However, the more education on self- management also brought on more metal burden to the patient. The worse a patient＇s control of blood sugar was, the lower a pa- tient＇s power in self - management was, and the younger a patient＇s age was, the heavier burden the patient had mentally. Furthermore, the lower a patient＇s power in self - management was, especially for a male patient, the worse the pa- tient＇s control of blood sugar. The average monthly income per capita of a family was also a negative factor. The higher a patient＇s monthly average income per capita was, the lower a patient＇s power in self- management was, and the worse a patient＇s control of blood sugar was, the heavier burden the patient had mentally. Conclusion The education background and average monthly in- come per capita of a family are the impacting factors for self - management power. And the sex and level of glycosylated hemoglobin are the impacting factors for self - management education. The education on self - management offered by the community medical staff not only has problems both quantitatively and qualitatively, but also enhance the patients＇ metal burden. Therefore,＂ knowl- edge＂ itself is far from enough, and the absorbability and operability of knowledge are more important for a patient to really master the knowledge and apply it practically. Otherwise,＂ redundant knowledge＂ is not only non - effective, but may bring about nega- tive effects to patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第16期1862-1864,共3页
Chinese General Practice
基金
国家自然科学基金资助项目(81150001)
关键词
糖尿病
自我管理
影响因素
Diabetes mellitus
Self - management
Influencing factors
