健康自我管理对糖尿病患者知识、行为与自我效能的影响

目的评估健康自我管理对糖尿病患者知识、行为与自我效能的影响,为在社区推广应用健康自我管理提供依据。方法对招募确诊的糖尿病患者在参加健康自我管理活动前后进行问卷调查,比较干预前后知识与行为的改变采用χ2检验,比较干预前后自我效能的变化采用两配对样本Mc Nemar检验。结果 214名患者参加了自我管理,干预后糖尿病患者对糖尿病并发症（42.5%vs 76.7%）、防治措施（72.1%vs 95.7%）、合理膳食（3.2%vs 32.7%）、推荐运动量（7.2%vs 39.3%）、推荐每人每日盐（48.0%vs 83.6%）与食用油摄入量（22.2%vs 70.1%）的知晓率均较干预前显著上升,差异有统计学意义（P〈0.05）,干预后糖尿病患者与医生沟通交流的比例（52.9%vs 81.8%）、血糖监测（31.7%vs 47.2%）、自我足部检查（14.9%vs 56.1%）、达到推荐运动量的比例（38.9%vs 47.2%）均较干预前明显上升,差异有统计学意义（P〈0.05）,干预后患者自我效能较干预前明显上升（89.6±19.7 vs 102.9±17.3）,差异有统计学意义（P〈0.05）。结论健康自我管理可以有效提高糖尿病患者认知水平、自我管理的能力与自我效能,该干预措施是有效的、可推广的。

Influencing on knowledge,behavior and self-efficiency of diabetes patients who participated in the activity of health self-management

Objective To evaluate the effect of health self-management on knowledge,behavior and self-efficiency among diabetes patients, and provide evidence for promoting health self-management intervention model in community. Methods Diabetes patients were interviewed with a structured questionnaire before and after they participated in health self-management activity. The changes of knowledge and behavior between before and after the intervention were tested by Chi square test. The changes of self-efficiency before and after the intervention were tested by two paired sample Mc Nemar test. Results A total of 214 diabetes patients participated in the whole process of health self-management. After they participated in the activity,the proportions of awareness about the complication of diabetes（ 42. 5% vs 76. 7%）,the measure of prevention and control（ 72. 1% vs 95. 7%）,healthy diet（ 3. 2% vs 32. 7%）,recommended amount of physical activity（ 7. 2% % vs 39. 3%）,salt（ 48. 0% vs 83. 6%） and oil（ 22. 2% vs 70. 1%） was significant higher than that before the intervention（ P〈0. 05）. The proportions of patients who communicated with doctors（ 52. 9% vs 81. 8%）,monitored blood glucose（ 31. 7% vs 47. 2%）,examined foot by themselves（ 14. 9% vs 56. 1%）,reached the recommendation amount of physical activity（ 38. 9% vs 47. 2%） were increased significantly after the intervention（ P〈0. 05）. The score of self-efficiency after the intervention increased significantly（ 89. 6 ± 19. 7 vs 102. 9 ± 17. 3,P〈0. 05）. Conclusion The intervention model of health self-management raised the awareness,capability and self-efficiency of diabetes patients. This intervention is effective,feasible and should be promoted for diabetes control in community.