中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2013年
7期
408-413
,共6页
于文%董丽华%孟丽珍%韩静%甄桂兰%孙迎俊%魏锋%张栩
于文%董麗華%孟麗珍%韓靜%甄桂蘭%孫迎俊%魏鋒%張栩
우문%동려화%맹려진%한정%견계란%손영준%위봉%장허
糖尿病,2型%糖尿病教育%患者依从性%家属
糖尿病,2型%糖尿病教育%患者依從性%傢屬
당뇨병,2형%당뇨병교육%환자의종성%가속
Diabetes mellitus,type 2%Diabetes education%Patient compliance%Family members
目的 在医生、家属、患者、护士参与(MUST)的糖尿病教育模式研究基础上,观察不同家属与患者组合对糖尿病患者长期治疗依从性的影响.方法 选择2010年3至5月在山东省滨州市人民医院门诊就诊的居住于本市的2型糖尿病患者,按就诊顺序确定入选患者及其家属300对.按照不同的家属与患者关系分为妻管夫型、夫管妻型、晚辈管长辈型以及长辈管晚辈型4组.采用改良的Deborah糖尿病自我管理评价表进行24个月的患者依从性测定,分析依从性的影响因素.两组间均数比较采用独立样本t检验,多组均数比较采用方差分析.结果 家属中女性明显多于男性(60％比40％,x2=24.00,P＜0.05),主要来源于妻管夫型组(31.0％).各分组家属和患者年龄、家属主动联系次数和自愿参加糖尿病教育次数差异均有统计学意义(x2=61.18、107.77、35.45、44.79,均P ＜0.05),其中最高的主动联系次数比例出现在妻管夫型(12.3％),而主动联系医护人员的夫管妻型中的丈夫只有1.0％.家属主动参加糖尿病教育次数总体偏少,大部分为两年只参加了不到3次.24个月的观察期间,夫管妻型完全从医率呈持续上升趋势,各观察时期与观察前(33.9％)比较差异均有统计学意义(第6、12、18、24个月分别为60.3％、67.9％、70.9％、74.1％,x2=6.762、9.626、12.131、11.707,均P＜0.05).晚辈管长辈型和妻管夫型完全从医率呈现上升并维持高平台趋势.长辈管晚辈患者完全从医率呈“∧”形分布.观察结束时,完全从医率以夫管妻型患者最高(74.1％),其次为晚辈管长辈型(60.8％)、妻管夫型(48.3％)和长辈管晚辈型(29.0％).所有患者的完全从医率为52.3％.以观察结束时完全从医为因变量分析影响因素显示,与患者完全从医相关的家属因素为性别、年龄、主动联系次数和分组(OR=3.593、0.251、2.734、0.692,均P＜0.05).与患者自身相关的完全从医影响因素为性别、文化程度和分组(OR=0.497、2.558、0.443,均P＜0.05).结论 夫管妻型长期完全从医率最佳.同等辈分中女性作为监管者比男性效果好,不同辈分中晚辈监管长辈效果好,这种良好的效果与家属联系医护人员的主动性有关.
目的 在醫生、傢屬、患者、護士參與(MUST)的糖尿病教育模式研究基礎上,觀察不同傢屬與患者組閤對糖尿病患者長期治療依從性的影響.方法 選擇2010年3至5月在山東省濱州市人民醫院門診就診的居住于本市的2型糖尿病患者,按就診順序確定入選患者及其傢屬300對.按照不同的傢屬與患者關繫分為妻管伕型、伕管妻型、晚輩管長輩型以及長輩管晚輩型4組.採用改良的Deborah糖尿病自我管理評價錶進行24箇月的患者依從性測定,分析依從性的影響因素.兩組間均數比較採用獨立樣本t檢驗,多組均數比較採用方差分析.結果 傢屬中女性明顯多于男性(60％比40％,x2=24.00,P＜0.05),主要來源于妻管伕型組(31.0％).各分組傢屬和患者年齡、傢屬主動聯繫次數和自願參加糖尿病教育次數差異均有統計學意義(x2=61.18、107.77、35.45、44.79,均P ＜0.05),其中最高的主動聯繫次數比例齣現在妻管伕型(12.3％),而主動聯繫醫護人員的伕管妻型中的丈伕隻有1.0％.傢屬主動參加糖尿病教育次數總體偏少,大部分為兩年隻參加瞭不到3次.24箇月的觀察期間,伕管妻型完全從醫率呈持續上升趨勢,各觀察時期與觀察前(33.9％)比較差異均有統計學意義(第6、12、18、24箇月分彆為60.3％、67.9％、70.9％、74.1％,x2=6.762、9.626、12.131、11.707,均P＜0.05).晚輩管長輩型和妻管伕型完全從醫率呈現上升併維持高平檯趨勢.長輩管晚輩患者完全從醫率呈“∧”形分佈.觀察結束時,完全從醫率以伕管妻型患者最高(74.1％),其次為晚輩管長輩型(60.8％)、妻管伕型(48.3％)和長輩管晚輩型(29.0％).所有患者的完全從醫率為52.3％.以觀察結束時完全從醫為因變量分析影響因素顯示,與患者完全從醫相關的傢屬因素為性彆、年齡、主動聯繫次數和分組(OR=3.593、0.251、2.734、0.692,均P＜0.05).與患者自身相關的完全從醫影響因素為性彆、文化程度和分組(OR=0.497、2.558、0.443,均P＜0.05).結論 伕管妻型長期完全從醫率最佳.同等輩分中女性作為鑑管者比男性效果好,不同輩分中晚輩鑑管長輩效果好,這種良好的效果與傢屬聯繫醫護人員的主動性有關.
목적 재의생、가속、환자、호사삼여(MUST)적당뇨병교육모식연구기출상,관찰불동가속여환자조합대당뇨병환자장기치료의종성적영향.방법 선택2010년3지5월재산동성빈주시인민의원문진취진적거주우본시적2형당뇨병환자,안취진순서학정입선환자급기가속300대.안조불동적가속여환자관계분위처관부형、부관처형、만배관장배형이급장배관만배형4조.채용개량적Deborah당뇨병자아관리평개표진행24개월적환자의종성측정,분석의종성적영향인소.량조간균수비교채용독립양본t검험,다조균수비교채용방차분석.결과 가속중녀성명현다우남성(60％비40％,x2=24.00,P＜0.05),주요래원우처관부형조(31.0％).각분조가속화환자년령、가속주동련계차수화자원삼가당뇨병교육차수차이균유통계학의의(x2=61.18、107.77、35.45、44.79,균P ＜0.05),기중최고적주동련계차수비례출현재처관부형(12.3％),이주동련계의호인원적부관처형중적장부지유1.0％.가속주동삼가당뇨병교육차수총체편소,대부분위량년지삼가료불도3차.24개월적관찰기간,부관처형완전종의솔정지속상승추세,각관찰시기여관찰전(33.9％)비교차이균유통계학의의(제6、12、18、24개월분별위60.3％、67.9％、70.9％、74.1％,x2=6.762、9.626、12.131、11.707,균P＜0.05).만배관장배형화처관부형완전종의솔정현상승병유지고평태추세.장배관만배환자완전종의솔정“∧”형분포.관찰결속시,완전종의솔이부관처형환자최고(74.1％),기차위만배관장배형(60.8％)、처관부형(48.3％)화장배관만배형(29.0％).소유환자적완전종의솔위52.3％.이관찰결속시완전종의위인변량분석영향인소현시,여환자완전종의상관적가속인소위성별、년령、주동련계차수화분조(OR=3.593、0.251、2.734、0.692,균P＜0.05).여환자자신상관적완전종의영향인소위성별、문화정도화분조(OR=0.497、2.558、0.443,균P＜0.05).결론 부관처형장기완전종의솔최가.동등배분중녀성작위감관자비남성효과호,불동배분중만배감관장배효과호,저충량호적효과여가속련계의호인원적주동성유관.
Objective To explore the clinical regulation of diabetes education with family members involvement by comparing the influences of different types of family member/patient combination on the longterm therapeutic compliance of patients with type 2 diabetes mellitus.Methods Total of 300 voluntary pairs of patient-family member treated from March to May in 2010 were sampled and divided into 4 groups according to the relationships between patient and family member:wife supervising husband,husband supervising wife,younger supervising elder and elder supervising younger.The influencing factors on good therapeutic compliance were evaluated in different types of subjects combination after 24-month observation by means of the modified Deborah's diabetes knowledge,self-management skills and self-evaluation table established in previous study.The independent sample t test was implicated in data comparison between two groups and variance analysis in data comparison among groups.Results There were more female than male family members (60％ vs 40％,x2 =24.00,P ＜ 0.05),and mainly from the group of wife supervising husband (31％).There were significant differences in age of patients and family members,number of active contacting by family members,voluntary participation in diabetic education of family members among the groups(x2 =61.18,107.77,35.45,44.79,all P＜0.05).The active contacting came mainly from wives in group of wife supervising husband.Few family members voluntarily attended diabetes education program than expected with less than 3 times during 2 years of observation.Compared with that before observation (33.9％),sustained rising trend of good therapeutic compliance in group of husband supervising wife was observed in following points of observation period (60.3％,67.9％,70.9％,74.1％ at the 6th,12th,18th,24th months respectively,x2 =6.762,9.626,12.131,11.707,all P ＜0.05).Rising but keeping at relatively high level of the good compliance was observed in both groups of younger supervising elder and wife supervising husband but a ' ∧ '-like distribution in group of elder supervising younger.At the end of observation,the total patients' good compliance rate was 52.3％,it was 74.1％ in group of husband supervising wife,60.8％ in group of younger supervising elder,48.3％ in group of wife supervising husband and 29.0％ in group of elder supervising younger.Logistic analysis showed that gender,age,frequency of active connection and grouping of family members (OR =3.593,0.251,2.734,0.692,all P ＜ 0.05) as well as gender,degree of education and grouping of patients (OR =0.497,2.558,0.443,all P ＜ 0.05)were significant independent influencing factors on the total good therapeutic compliance.Conclusions The best long term good therapeutic compliance is found in group of husband supervising wife.As supervisor,female is better than male and the younger generation is better than the elder.
