社区糖尿病自我管理项目实施效果的评价

目的评价扬州市社区实施糖尿病自我管理项目6个月后的效果。方法以社区为基础,将自愿参加该项目的324名糖尿病患者随机分为干预组和对照组,采用协方差和χ2检验,比较项目基线时和开展6个月后自我管理行为、自我效能、健康状况和卫生服务利用等方面的变化。结果项目实施6个月后,与对照组相比,干预组认知性症状管理方法实践评分增加2.5分,与医生交流评分提高1.2分;症状管理自我效能和疾病共性管理自我效能评分分别比对照组高1.02和0.99分;健康状况(整体健康自评、精力、健康担忧、疲劳、气短、疼痛、失能、疾病对患者生活影响、情绪低落及社会活动/角色受限)10个方面均得到改善(P<0 05);干预组6个月内比对照组看门诊次数减少3.06次,看急诊次数减少1.89次。结论社区糖尿病自我管理项目实施6个月后,参加者自我管理知识增高,学会了自我管理,培养了健康行为,改善了躯体和精神部分健康状况、自我效能,减少看门诊次数和看急诊次数。

EVALUATION ON THE EFFECTIVENESS FOR SELF-MANAGEMENT PROGRAM OF DIABETES IN THE COMMINITY

Objective To evaluate the six-month effectiveness of diabetes self-management program in a Ynagzhou community.Methods 324 voluntary participants with diabetes were randomized into intervention group or control group.Analysis of covariance and χ~2() test was used to compare six-month changes for self-management behaviors,self-efficacy,health status and health service utilization.Results Compared with control group,intervention group treatment subjects of intervention group averagely increased 2.5 scores in practice of cognitive symptom management and 1.2 scores of patient communication with physician.Intervention group increased 1.02 and 0.99 scores separately in self-efficacy to manage symptom and self-efficacy to manage disease generally.They demonstrated significant improvement in ten of health status(self-rated health,energy,health distress,fatigue,shortness of breath,pain,disability,illness intrusiveness,depression and social/role activities limitation)(all P<0.05).They also had fewer visits of 3.06 times to clinic room and of 1.89 times to emergency room on average(P<0.05).Conclusion After six-month implemented diabetes self-management program improved their emotion,healthy behavior,parts body and energy of health status,self-efficacy,fewer visits to clinic and emergency.