中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2014年
8期
710-714
,共5页
姜莹莹%董文兰%毛凡%张春华%丁贤彬%潘晓群%张永青%黄砚萍%董建群
薑瑩瑩%董文蘭%毛凡%張春華%丁賢彬%潘曉群%張永青%黃硯萍%董建群
강형형%동문란%모범%장춘화%정현빈%반효군%장영청%황연평%동건군
自我效验%糖尿病%健康教育%患者自我管理%自我血糖监测
自我效驗%糖尿病%健康教育%患者自我管理%自我血糖鑑測
자아효험%당뇨병%건강교육%환자자아관리%자아혈당감측
Self efficacy%Diabetes mellitus%Health education%Patient self management%Self monitoring of blood glucose
目的 调查参与社区糖尿病患者自我管理小组活动的糖尿病患者的自我血糖监测及自我效能水平,并分析其影响因素.方法 于2012年9-10月选择曾开展过慢性病患者自我管理工作、具备一定工作基础的北京市、上海市、重庆市、江苏省、广东省、浙江省的街道和乡镇为研究现场.以街道(社区)为单位,通过从街道(社区)健康档案中筛选、电话通知、张贴招募海报、发送招募邀请函等多种形式,共调查成年糖尿病患者1 401例,以调查问卷形式进行调查,收集其一般情况、患病情况、糖尿病知识的知晓情况、自测血糖及自我效能信息.采用多元线性回归方法,分析自我效能影响因素与自我效能得分之间关系.结果 1 401例糖尿病患者中,男性占37.0% (519/1 401),女性占63.0% (882/1 401),城市患者占48.0% (672/1 401),农村患者占52.0% (729/1 401),年龄为(64.9±8.9)岁.糖尿病患者自我血糖监测分析结果显示,79.9%(1 120/1 401)的患者进行过自我血糖监测,自测1~3次/月比例最高,为33.3% (446/1 401).其中,农村患者、小学文化程度患者、新型农村合作医疗覆盖患者从未进行过自我血糖监测的比例较高,分别为21.9%(160/729)、24.2%(160/662)、26.3%(125/475).糖尿病患者自我效能得分分析结果显示,自我效能总分为(69.24±16.30)分(百分制);其中,血糖监测和足部护理的得分最低,分别为(64.09 ±20.08)、(63.63±21.40)分,遵医嘱服药或注射胰岛素得分最高,为(76.10 ±22.00)分.自我效能影响因素与自我效能得分多元线性回归分析结果显示,患者居住地与自我效能得分呈负相关(β'=-0.076),患者文化程度、糖尿病知识知晓程度与自我效能得分呈正相关(β'值分别为0.114、0.193),均有统计学意义(t值分别为-2.46、3.71、7.18,P值均<0.05).结论 我国6省份社区糖尿病患者自我管理仍处于较低水平,经济和文化程度较低的患者自我管理水平更低.患者血糖监测和足部护理普遍表现较差,患者居住地、文化程度、糖尿病知识知晓程度是影响糖尿病患者自我效能的因素.
目的 調查參與社區糖尿病患者自我管理小組活動的糖尿病患者的自我血糖鑑測及自我效能水平,併分析其影響因素.方法 于2012年9-10月選擇曾開展過慢性病患者自我管理工作、具備一定工作基礎的北京市、上海市、重慶市、江囌省、廣東省、浙江省的街道和鄉鎮為研究現場.以街道(社區)為單位,通過從街道(社區)健康檔案中篩選、電話通知、張貼招募海報、髮送招募邀請函等多種形式,共調查成年糖尿病患者1 401例,以調查問捲形式進行調查,收集其一般情況、患病情況、糖尿病知識的知曉情況、自測血糖及自我效能信息.採用多元線性迴歸方法,分析自我效能影響因素與自我效能得分之間關繫.結果 1 401例糖尿病患者中,男性佔37.0% (519/1 401),女性佔63.0% (882/1 401),城市患者佔48.0% (672/1 401),農村患者佔52.0% (729/1 401),年齡為(64.9±8.9)歲.糖尿病患者自我血糖鑑測分析結果顯示,79.9%(1 120/1 401)的患者進行過自我血糖鑑測,自測1~3次/月比例最高,為33.3% (446/1 401).其中,農村患者、小學文化程度患者、新型農村閤作醫療覆蓋患者從未進行過自我血糖鑑測的比例較高,分彆為21.9%(160/729)、24.2%(160/662)、26.3%(125/475).糖尿病患者自我效能得分分析結果顯示,自我效能總分為(69.24±16.30)分(百分製);其中,血糖鑑測和足部護理的得分最低,分彆為(64.09 ±20.08)、(63.63±21.40)分,遵醫囑服藥或註射胰島素得分最高,為(76.10 ±22.00)分.自我效能影響因素與自我效能得分多元線性迴歸分析結果顯示,患者居住地與自我效能得分呈負相關(β'=-0.076),患者文化程度、糖尿病知識知曉程度與自我效能得分呈正相關(β'值分彆為0.114、0.193),均有統計學意義(t值分彆為-2.46、3.71、7.18,P值均<0.05).結論 我國6省份社區糖尿病患者自我管理仍處于較低水平,經濟和文化程度較低的患者自我管理水平更低.患者血糖鑑測和足部護理普遍錶現較差,患者居住地、文化程度、糖尿病知識知曉程度是影響糖尿病患者自我效能的因素.
목적 조사삼여사구당뇨병환자자아관리소조활동적당뇨병환자적자아혈당감측급자아효능수평,병분석기영향인소.방법 우2012년9-10월선택증개전과만성병환자자아관리공작、구비일정공작기출적북경시、상해시、중경시、강소성、광동성、절강성적가도화향진위연구현장.이가도(사구)위단위,통과종가도(사구)건강당안중사선、전화통지、장첩초모해보、발송초모요청함등다충형식,공조사성년당뇨병환자1 401례,이조사문권형식진행조사,수집기일반정황、환병정황、당뇨병지식적지효정황、자측혈당급자아효능신식.채용다원선성회귀방법,분석자아효능영향인소여자아효능득분지간관계.결과 1 401례당뇨병환자중,남성점37.0% (519/1 401),녀성점63.0% (882/1 401),성시환자점48.0% (672/1 401),농촌환자점52.0% (729/1 401),년령위(64.9±8.9)세.당뇨병환자자아혈당감측분석결과현시,79.9%(1 120/1 401)적환자진행과자아혈당감측,자측1~3차/월비례최고,위33.3% (446/1 401).기중,농촌환자、소학문화정도환자、신형농촌합작의료복개환자종미진행과자아혈당감측적비례교고,분별위21.9%(160/729)、24.2%(160/662)、26.3%(125/475).당뇨병환자자아효능득분분석결과현시,자아효능총분위(69.24±16.30)분(백분제);기중,혈당감측화족부호리적득분최저,분별위(64.09 ±20.08)、(63.63±21.40)분,준의촉복약혹주사이도소득분최고,위(76.10 ±22.00)분.자아효능영향인소여자아효능득분다원선성회귀분석결과현시,환자거주지여자아효능득분정부상관(β'=-0.076),환자문화정도、당뇨병지식지효정도여자아효능득분정정상관(β'치분별위0.114、0.193),균유통계학의의(t치분별위-2.46、3.71、7.18,P치균<0.05).결론 아국6성빈사구당뇨병환자자아관리잉처우교저수평,경제화문화정도교저적환자자아관리수평경저.환자혈당감측화족부호리보편표현교차,환자거주지、문화정도、당뇨병지식지효정도시영향당뇨병환자자아효능적인소.
Objective To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.Methods Beijing,Shanghai,Chongqing,Jiangsu,Guangdong,and Zhejiang were selected as the study sites considering patients management experiences they had.1 401 adult diabetes patients were recruited from communities via health records system screening,telephone notification,poster advertisement,letters invitation ways.Face to face questionnaire survey was applied to obtain patients' general information,diabetes history,diabetes knowledge awareness,SMBG,and self-efficacy information.Multiple linear regression was used to analyze the relationship between factors and self efficacy.Results There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9)years old.Patients lived in city accounted for 48.0% (672/1 401)and rural patients accounted for 52.0% (729/1 401).Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401)patients conducted blood glucose monitoring 1-3 times per month.Rural patients,primary school educated,and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729),24.2% (160/662),and 26.3% (125/475),respectively.Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40),as well as a highest score in taking medicine and insulin injections (76.10-± 22.00).Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' =-0.076) and a positive correlation between education and self-efficacy (β' =0.114) as well as between diabetes knowledge awareness and self-efficacy (β' =0.193) (t =-2.46,3.71,7.18,P < 0.05).Conclusion Community diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients.The worst parts were SMBG and foot care.Place of residence,education,and diabetes knowledge awareness are factors that influence patients' self efficacy.