自我管理教育对糖尿病伴抑郁症患者的影响

目的探讨自我管理教育对糖尿病伴抑郁症患者的影响，旨在提高患者自我管理能力。方法将85例患者随机分为教育组43例和对照组42例，对照组接受一般说教式健康教育，教育组患者参与自我管理教育活动，采用自行设计的自我管理行为问卷及抑郁自评量表（SDS）和汉密尔顿抑郁量表（HAMD）调查患者自我管理行为和抑郁状况，8周后比较两组患者自我管理行为、抑郁状况、空腹血糖、餐后2h血糖控制状况。结果干预前两组患者自我管理行为评分、SDS、HAMD、空腹血糖、餐后2h血糖比较差异均无统计学意义（P〉0．05）；8周后教育组患者服药依从性得分为（1．77±0．504）分，并发症的管理为（2．19±0．588）分，SDS（29．3±4．8）分、HAMD（11．5±6．9）分、空腹血糖（5．3±1．4）mmol／L、餐后2h血糖（8．6±1．1）mmol／L，对照组分别为（1．32±0．744），（1．83±0．590），（36．5±5．4），（18．3±1．3）分，（9．2±2．1），（11．1±2．2）mmol／L，差异均有统计学意义（t=2．813，3．358，2．91，2．34，2．65，2．78；P〈0．01），教育组患者自我管理行为问卷其他4项评分也高于对照组（P〈0．01）。结论自我管理教育能有效提高患者自我管理能力，控制患者血糖水平和改善抑郁症状，值得临床推广应用。

Effect of self-management education on diabetes patients with depression

Objective To explore the influence of self-management education on the diabetes patients with depression with a view to improve patient self-management skills.Methods 85 cases were randomly divided into two groups: the experimental group ( n =43) and the control group ( n =42),general health knowledge education was applied to patients in control group,and patients in experimental group took part in the selfmanagement education activity,the status of self-management education and depression were tested by Zung' S Depression self-rating scale (SDS) and Hamilton Depression Rating Scale (24,HAMD),the self-management,depression,fasting plasma glucose (FPG),postprandial 2 h blood glucose (2 h PG) were compared between the two groups after eight weeks later.Results The score of self-management,SDS,HAMD,fasting plasma glucose and postprandial 2 h blood glucose were similar between the two groups before intervention ( P ＞ 0.05 ).After 8 weeks,the results of compliance of the self-management,manage of complications,SDS,HAMD,fasting plasma glucose,postprandial 2 h blood glucose were ( 1.77 ±0.504),(2.19 ±0.588),(29.3 ±4.8),( 11.5 ±6.9),(5.3 ± 1.4) and (8.6 ± 1.1 ) in experimental group,respectively; but were ( 1.32 ± 0.744),( 1.83 ± 0.590),(36.5 ± 5.4),( 18.3 ± 1.3 ),(9.2 ± 2.1 ),( 11.1 ± 2.2 ) in control group,there were significantly different between the two groups (t =2.813,3.358,2.91,2.34,2.65,2.78; P ＜ 0.01 ).another four items of selfmanagement were obviously higher than in control group (P ＜ 0.01 ).Conclusions Self-management education can improve the patients' ability of self-management,it also can control the blood glucose level and improve the depression status,it is worthy of spreading in clinical.