2型糖尿病患者饮食控制行为及其相关信念的研究

目的　研究 2型糖尿病患者饮食控制行为与相关信念的关系。方法　采用个人基本资料问卷、饮食控制行为量表、结果预期量表和自我效能量表对 130例 2型糖尿病门诊患者进行调查。结果　 2型糖尿病患者对饮食控制的结果预期和自我效能均与饮食控制行为呈正相关 (P <0 .0 0 1) ;多元逐步回归分析 ,自我效能可解释患者饮食控制行为 6 2 8%的变异量。结论　结果预期和自我效能是 2型糖尿病患者控制饮食的重要影响因素 ,且自我效能具有决定性作用。     

社区2型糖尿病121例自我效能感调查分析

目的:调查社区2型糖尿病患者自我效能感水平,为样本群体中处于中、低水平的患者制定针对性的社区护理干预措施提供依据。方法:采用自我效能量表(DSES),以随机抽样法调查121例社区2型糖尿病患者。结果:社区2型糖尿病患者自我效能总分为(83.2±18.7)分,其中高水平20例,占16.5%;中水平86例,占71.1%;低水平15例,占12.4%。5个最低得分条目中,仅极少数患者表现为有较强信心。结论:社区2型糖尿病患者总体自我效能水平较低,迫切需要采取针对性的社区护理干预措施提高患者的自我效能,从而改善患者自护行为。     

社区2型糖尿病患者自我效能与心理痛苦相关性分析

目的通过对社区2型糖尿病患者自我效能与心理痛苦的水平及相关性分析,为制定干预对策提供参考依据.方法采用中文版糖尿病自我效能量表和中文版糖尿病痛苦量表,对某社区5个社区卫生站或服务中心的252例2型糖尿病患者进行调查,分析两者的水平及其相关性.结果本组患者的自我效能得分总均分8.25分,属中等偏上水平;糖尿病痛苦量表结果显示,患者因糖尿病导致的与生活规律相关痛苦维度、情感负担维度的表现较明显,其情感负担处于轻中度占29.4%,生活规律相关痛苦处于轻中度者占30.9%;心理痛苦总分及其4个维度得分与自我效能得分呈一定负相关(r=-0.430~-0.230,P<0.01).结论社区2型糖尿病患者的自我效能属中等偏上水平,且自我效能水平越高则心理痛苦程度越轻.提示应侧重对患者加强糖尿病导致的与生活规律相关痛苦、情感方面痛苦的干预;提高患者控制血糖的自信心,以消除负面情绪.     

社区2型糖尿病患者自我效能及自护行为对其生活质量的影响

目的：了解2型糖尿病患者自我效能及自护行为对其生活质量的影响。方法：采用自我效能量表（DSES）和自护行为量表（DSCS）和生活质量综合评定问卷（GQOLI-74）,以目的抽样法,调查了214例大庆社区2型糖尿病患者,了解社区2型糖尿病患者自我效能的水平、自护行为的执行情况和生活质量,并采用专家授课、多媒体健康教育、护理技能培训等集体指导方法和个体针对性指导相结合方式,实施社区护理干预半年。结果：2型糖尿病患者自我效能感和自护行为能力干预前、后比较有统计学差异（P〈0.001）;生活质量的躯体功能、心理功能、社会功能和生活总分,干预前后有统计学差异（P〈0.05）,物质生活状态干预前后无统计学差异（P〉0.05）。结论：通过社区护理干预,可以增强2型糖尿病患者的自我效能感、自护行为能力,提高其生活质量。     

2型糖尿病患者饮食控制行为及其影响因素调查

目的调查社区2型糖尿病患者自我饮食管理现状及其影响因素。方法采用个人基本资料问卷,饮食控制行为量表和自我效能量表对210例社区2型糖尿病患者进行调查。结果 2型糖尿病患者饮食控制行为平均得分为21.14分,自我效能平均得分为21.56分;2型糖尿病患者饮食控制行为与自我效能呈正相关(r=0.568,P<0.01);饮食控制行为与年龄、病情、在职与非在职有显著性差异(P<0.05);多元逐步回归分析,自我效能可解释患者自我饮食行为60.5%的变异量。结论自我效能是2型糖尿病患者控制饮食的重要因素。在实施护理干预和健康教育时应重视提高患者自我效能,增强自我管理能力,提高其生存质量。     

2型糖尿病患者自我效能与生活质量的相关性研究

目的 探讨2型糖尿病患者自我效能与生活质量之间的关系.方法 采用2型糖尿病管理自我效能量表和糖尿病患者特异性量表,以方便抽样方法调查116例住院的2型糖尿病患者,并对结果进行分析.结果 2型糖尿病患者自我效能与生活质量不够理想;不同类型2型糖尿病患者自我效能与生活质量得分比较,差异有统计学意义;2型塘尿病患者自我效能与生活质量呈中等程度正相关(r=0.43,P＜0.01).结论 在临床实践中,必须注重2型糖尿病患者自我效能和生活质量水平的提高,应以自我效能理论为依据,采用各种方法调动患者的自身潜能,以增加自我效能,提高患者的生活质量.     

D型人格对2型糖尿病患者自我效能的影响研究

目的调查D型人格对2型糖尿病患者自我效能的影响。方法采用便利抽样法选取200例2型糖尿病患者为研究对象,采用一般资料调查表、D型人格量表和糖尿病自我效能问卷进行调查。结果 2型糖尿病患者自我效能总分为(29.51±5.93)分,D型人格患者84例,占42.0%;D型人格患者自我效能总分及饮食效能和病情控制效能维度得分均低于非D型人格患者,差异有统计学意义(P<0.05);多元逐步回归分析显示,性别、是否为D型人格是自我效能的影响因素。结论 D型人格2型糖尿病患者自我效能较低,需重视D型人格患者心理特征,及早识别并合理疏导,提高其自我效能。     

2型糖尿病患者自我效能与自我管理水平的相关性研究

目的研究2型糖尿病患者自我效能与自我管理水平之间的关系.方法采用糖尿病自我效能量表和自我管理评估量表,以方便抽样方法调查139例门诊随访2型糖尿病患者.结果2型糖尿病患者自我效能与自我管理水平普遍低下;2型糖尿病患者自我效能与自我管理呈正相关.结论加强健康教育,尤其注重患者自我效能与自我管理水平的提高,科学运用自我效能理论,设计和开展糖尿病自我管理健康促进项目,从而提高临床护理质量、提高糖尿病患者的生活质量.     

2型糖尿病患者自我效能与自我管理水平的相关性研究

目的研究2型糖尿病患者自我效能与自我管理水平之间的关系.方法采用糖尿病自我效能量表和自我管理评估量表,以方便抽样方法调查139例门诊随访2型糖尿病患者.结果2型糖尿病患者自我效能与自我管理水平普遍低下;2型糖尿病患者自我效能与自我管理呈正相关.结论加强健康教育,尤其注重患者自我效能与自我管理水平的提高,科学运用自我效能理论,设计和开展糖尿病自我管理健康促进项目,从而提高临床护理质量、提高糖尿病患者的生活质量.     

社区2型糖尿病患者自我管理行为及影响因素的调查分析

目的调查社区2型糖尿病患者自我管理现状并探讨其影响因素。方法对在北京市某社区卫生服务站就诊的252例2型糖尿病患者采用糖尿病自我管理行为量表、糖尿病痛苦量表、慢性病资源问卷、糖尿病知识问卷、简易疾病认知问卷、糖尿病自我效能量表进行调查,并监测生理生化指标。结果糖尿病患者的自我管理行为标准得分为61．90分。各维度标准得分为：饮食73．42分;运动32．66分;血糖监测21．29分;足部护理40．00分;遵医嘱用药78．00分。自我效能、慢性病资源、糖尿病疾病认知和腰围是社区2型糖尿病患者自我管理行为的主要影响因素,可以解释社区2型糖尿病患者自我管理行为总变异的31．5％。结论我国社区2型糖尿病患者自我管理行为现状欠理想,应根据患者的需要实施针对性干预措施,使其建立科学的自我管理行为。     

社区护理干预对提高糖尿病患者生活质量的作用

目的探讨社区护理干预对提高社区2型糖尿病患者生活质量的作用。方法采用自我效能量表、自护行为量表和生活质量综合评定问卷,调查214例社区2型糖尿病患者,了解社区2型糖尿病患者自我效能的水平、自护行为的执行情况和生活质量;并采用专家授课、多媒体健康教育、护理技能培训等集体指导方法和个体针对性指导相结合方式,实施社区护理干预半年。结果2型糖尿病患者自我效能感和自护行为能力干预前、后比较差异有统计学意义（P〈0．01）;生活质量的躯体功能、心理功能、社会功能和生活总分干预前后差异有统计学意义（P〈0．05）,物质生活状态干预前后无统计学意义（P〉0．05）。结论通过社区护理干预,可以增强2型糖尿病患者的自我效能感、自护行为能力,进而提高其生活质量。     

Improving foot self-care behaviors with Pies Sanos

Participants who received Pies Sanos, a 15-min intervention designed to improve diabetes self-efficacy and foot self-care behaviors in adult patients with type 2 diabetes who lived in a predominantly Mexican American community, performed more-complete foot self-care 1 month later in their homes. Recruited when they presented for nonurgent care to the emergency department in two community hospitals near the U.S.-Mexico border, participants were randomized into one of three groups. At follow-up, there was a significant difference in observed foot self-care behaviors between groups, F(2, 135) = 2.99, p < .05, as well as a significant difference within the intervention, t (47) = -4.32, p < .01, and control group, t (46) = -2.06, p < .05, for baseline and follow-up self-reported foot self-care behaviors. Baseline diabetes self-efficacy was significantly and positively correlated with both baseline (r = .335, p < .001) and follow-up ( r = .174, p < .05) foot self-care behaviors.     

应用目标设定策略改变糖尿病患者行为的实践

目的 ：应用目标设定理论促进2型糖尿病患者行为的改变。方法 ：将95位住院患者分为实验组（48例）和对照组（47例）,对照组采用常规护理教育,实验组采用目标设定策略进行干预,观察其在血糖、糖化血红蛋白、自护行为以及自我效能等方面的差异。结果 ：实验组在空腹血糖、餐后2h血糖、糖化血红蛋白及自我效能等方面的改变与对照组之间存在统计学差异（P〈0.05）;在饮食、血糖监测和足部护理等自护行为方面,实验组的改善情况也比对照组明显（P〈0.05）。结论：在糖尿病教育实践中,目标设定是一种有效、可行的行为改变策略。     

Measuring diabetes self-care: a psychometric analysis of the Self-Care Inventory-Revised with adults

OBJECTIVE: To examine psychometric properties of the Self-Care Inventory-revised (SCI-R), a self-report measure of perceived adherence to diabetes self-care recommendations, among adults with diabetes. RESEARCH DESIGN AND METHODS: We used three data sets of adult type 1 and type 2 diabetic patients to examine psychometric properties of the SCI-R. Principal component and factor analyses examined whether a general factor or common factors were present. Associations with measures of theoretically related concepts were examined to assess SCI-R concurrent and convergent validity. Internal reliability coefficients were calculated. Responsiveness was assessed using paired t tests, effect size, and Guyatt's statistic for type 1 patients who completed psychoeducation. RESULTS: Principal component and factor analyses identified a general factor but no consistent common factors. Internal consistency of the SCI-R was alpha = 0.87. Correlation with a measure of frequency of diabetes self-care behaviors was r = 0.63, providing evidence for SCI-R concurrent validity. The SCI-R correlated with diabetes-related distress (r = -0.36), self-esteem (r = 0.25), self-efficacy (r = 0.47), depression (r = -0.22), anxiety (r = -0.24), and HbA(1c) (r = -0.37), supporting construct validity. Responsiveness analyses showed SCI-R scores improved with diabetes psychoeducation with a medium effect size of 0.62 and a Guyatt's statistic of 0.85. CONCLUSIONS: The SCI-R is a brief, psychometrically sound measure of perceptions of adherence to recommended diabetes self-care behaviors of adults with type 1 or type 2 diabetes.     

中青年2型糖尿病患者自护行为的调查分析

目的 通过对中青年2型糖尿病自护行为调查,了解其现状。 方法 采用糖尿病患者自护行为量表对94例患者的饮食控制、运动锻炼、遵医嘱服药、血糖监测、足部护理、高血糖与低血糖的预防处理6个方面进行问卷调查。 结果 总体自护行为良好的20例,一般的有51例,较差的有23例。 结论 中青年2型糖尿病患者总体自护行为较差,加强对中青年2型糖尿病患者的健康教育刻不容缓。     

The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus

This article summarizes the development and validation of a scale to measure the level of self-efficacy of patients with type 2 diabetes mellitus. Self-efficacy is described as people's belief in their capability to organize and execute the course of action required to deal with prospective situations. This self-efficacy scale was developed based on the self-care activities these patients have to carry out in order to manage their diabetes. The following psychometric properties of this scale were established: content validity, construct validity, internal consistency and stability. The original scale contained 42 items. A panel of five experts in diabetes and four self-efficacy experts evaluated the original scale two times for relevance and clarity. This content validity procedure resulted in a final scale which consisted of 20 items. Subsequently, patients with type 2 diabetes were asked to complete this 20-item scale and further tests were done with the 94 usable responses. Factor analysis identified four factors, all of which were related to clusters of self-care activities used to manage diabetes which comprised this scale. The internal consistency of the total scale was alpha=0.81 and the test-retest reliability with a 5-week time interval was r=0.79 (P < 0.001).     

Testing a conceptual framework for diabetes self-care management

Diabetes is a major source of morbidity, mortality, and economic expense in the United States. The majority of researchers and clinicians believe that diabetes is a self-care management disease, and that patients should be reliable, capable, and sufficiently responsible to take care of themselves. However, individuals with diabetes may or may not have diabetes knowledge, social support, self-care agency (an individual's capability to perform self-care actions), and self-efficacy (an individual's beliefs in his or her capability to perform self-care actions) that would help them to engage in diabetes self-care management. Therefore, this study examined the relationship among those factors using a cross-sectional model testing design. A convenient sample of 141 insulin-requiring individuals with either diabetes type 1 or type 2, 21 years old and over, was recruited from an outpatient diabetes care center located in a Southeast region of the United States. Simple linear regression, multiple standard regression, and multiple hierarchical regression were used to analyze the data. Individuals with greater diabetes knowledge had greater self-care agency and self-efficacy. Those with a higher score in social support had greater self-care agency and better diabetes self-care management, and those with greater self-efficacy had better diabetes self-care management. In addition, self-care agency mediated the effects of diabetes knowledge on self-efficacy and the effects of social support on diabetes self-care management. Self-efficacy mediated the effects of self-care agency on diabetes self-care management. Furthermore, the linear combination of diabetes knowledge, social support, self-care agency, and self-efficacy, taken together, positively affected diabetes self-care management. Enhancing an individual's diabetes knowledge, social support, self-care agency, and self-efficacy may be a strategy which can promote better engagement in diabetes self-care.     

直肠癌结肠造口康复期患者自我护理能力状况及影响因素

目的了解直肠癌结肠造口术后6个月以上患者的自我护理能力状况,并分析其与健康行为自我效能、社会支持的相关关系。方法采用造口自我护理能力量表、健康行为能力自评量表、领悟社会支持量表测评104例直肠癌结肠造口术后6个月以上患者的自我护理能力、健康行为自我效能、社会支持状况,同时收集患者的一般资料,并进行统计分析。结果104例患者自我护理能力总分为（57．1±7．7）分,处于较高水平自我护理意愿（37．4±5．1）分,自我护理知识（15．6±3．5）分,自我护理技能（4．1±1．1）分,健康行为自我效能总分（82．66±17．43）,得分率为（73．80±15．56）％;社会支持总分（64．71±13．20）,其中家庭内支持得分（24．10±3．95）分,家庭外支持（40．62±11．10）分。单因素分析发现自我护理能力与年龄（r=-0．214,P〈0．05）、文化程度（r=0．341,P〈O．01）、家庭人均月收入（r=0．271,P〈0．01）、参加造口联谊会情况（r=O．227,P〈0．05）、健康行为自我效能（r=0．422,P〈0．01）、家庭内支持（r=0．224,P〈O．05）、家庭外支持（r=0．530,P〈0．01）相关。多元逐步线性回归分析发现自我护理能力的主要影响因素是家庭外支持、健康行为自我效能（调整后R。=0．316,F=23．827,P〈0．01）。结论直肠癌结肠造口康复期患者的造口自我护理能力处于较好水平,家庭外支持和健康行为自我效能有利于患者自我护理能力的提高。     

社区2型糖尿病病人足部自我护理行为现状及影响因素分析

[目的]了解社区2型糖尿病病人足部自我护理行为现状,分析其相关因素并找出薄弱环节,提出相应的对策。[方法]随机抽取咸宁市3个社区,对已建立健康档案的150例2型糖尿病病人进行问卷调查。[结果]社区2型糖尿病病人足部自我护理行为呈中等水平(59.60%),足部护理知识和技能、年龄、病程、家庭平均月收入等是护理行为的重要影响因素。[结论]社区2型糖尿病病人足部护理自我护理行为有待提高,应加大社区2型糖尿病病人足部护理健康教育的力度,以帮助其建立良好的足部自我护理行为,减少糖尿病足的发生。