CAJ | 학술논문

目的：分析基于行为转变理论（ TTM）指导的阶段性干预对2型糖尿病患者自我效能及生存质量的影响，并为该类群体实施优质医疗服务提供循证依据。方法采用整群分层随机抽样法，于2012年7月—2013年6月抽取杭州市8个行政区中的4个社区卫生服务中心，共纳入243例2型糖尿病患者。采用随机数字表法将其分为研究组（122例）和对照组（121例）。对照组实施传统社区健康指导，研究组在对照组基础上开展基于TTM理论指导的阶段性干预。分别于干预前、干预后第6个月末记录两组患者自我管理评分、应对方式评分、生存质量评分、空腹血糖（FBG）及糖化血红蛋白（HbA1c）水平。结果两组干预前自我管理各维度评分间差异无统计学意义（P>0.05），干预后研究组自我管理各维度评分均高于对照组（P<0.05）。两组干预前应对方式各维度评分间差异无统计学意义（P>0.05），干预后研究组面对维度评分均高于对照组（P<0.05），回避维度及屈服维度评分低于对照组（P<0.05）。两组干预前生存质量各维度评分间差异无统计学意义（ P>0.05），干预后研究组生存质量各维度评分均高于对照组（P<0.05）。两组干预前FBG及HbA1c水平间差异无统计学意义（P>0.05），干预后研究组FBG及HbA1c水平均低于对照组（P<0.05）。结论以TTM理论为指导的阶段性干预能提高2型糖尿病患者自我管理能力和生存质量，且能有效控制血糖，取得较为满意的临床效果。
목적：분석기우행위전변이론（ TTM）지도적계단성간예대2형당뇨병환자자아효능급생존질량적영향，병위해류군체실시우질의료복무제공순증의거。방법채용정군분층수궤추양법，우2012년7월—2013년6월추취항주시8개행정구중적4개사구위생복무중심，공납입243례2형당뇨병환자。채용수궤수자표법장기분위연구조（122례）화대조조（121례）。대조조실시전통사구건강지도，연구조재대조조기출상개전기우TTM이론지도적계단성간예。분별우간예전、간예후제6개월말기록량조환자자아관리평분、응대방식평분、생존질량평분、공복혈당（FBG）급당화혈홍단백（HbA1c）수평。결과량조간예전자아관리각유도평분간차이무통계학의의（P>0.05），간예후연구조자아관리각유도평분균고우대조조（P<0.05）。량조간예전응대방식각유도평분간차이무통계학의의（P>0.05），간예후연구조면대유도평분균고우대조조（P<0.05），회피유도급굴복유도평분저우대조조（P<0.05）。량조간예전생존질량각유도평분간차이무통계학의의（ P>0.05），간예후연구조생존질량각유도평분균고우대조조（P<0.05）。량조간예전FBG급HbA1c수평간차이무통계학의의（P>0.05），간예후연구조FBG급HbA1c수평균저우대조조（P<0.05）。결론이TTM이론위지도적계단성간예능제고2형당뇨병환자자아관리능력화생존질량，차능유효공제혈당，취득교위만의적림상효과。
Objective To evaluate the effect of intervention based on transtheoretical model of behavior( TTM)on self-efficacy and quality of life( QOL)of patients with type 2 diabetes mellitus( T2DM). Methods From July 2012 to June 2013,this study enrolled 4 community health service centers( including 243 T2DM patients)in this study,and divided them randomly into groups study(n=122),control(n=121). The control group were given traditional community health guidance, the study group given TTM based on the traditional. The scores of patients' self-management,coping modes,QOL and levels of fasting blood glucose( FBG),glycosylated hemoglobin( HbA1c )were recorded before intervention and at the end of 6 months af-ter. Results There was no significant difference in self-management ability in different dimensions between 2 groups before in-tervention(P>0. 05),higher in study group than in control group after intervention(P<0. 05). There was no difference in scores of coping mode in different dimensions between 2 groups before intervention(P>0. 05),those of coping dimension higher in study group than in control group after intervention(P<0. 05),and those of avoidance and yielding dimensions lower in study group than in control group( P <0. 05 ). There was no difference in QOL scores between 2 groups before intervention( P >0. 05),higher in study group than in control group after intervention(P<0. 05). There was no difference in levels of FBG, HbA1c between 2 groups before intervention(P >0. 05),lower in study group than in control group after intervention(P <0. 05). Conclusion TTM,which can improve T2DM patients' self-management ability and QOL and control FBG level effec-tively,achieves satisfactory clinical effects.