浦东新区糖尿病自我管理健康教育项目实施效果评价

目的 评价糖尿病自我管理健康教育项目实施的效果.方法 按照以社区为基础的随机对照试验研究设计,将362名自愿参加该项目的糖尿病病人随机分为干预组和对照组.采用协方差分析,比较基线时和6个月、12个月后3次问卷调查数据,观察240名干预组病人和122名对照组病人在项目实施6个月、12个月后在自我管理行为、自我效能、健康状况和卫生服务利用等方面的变化.结果 与对照组比较,干预组在自我管理行为方面:6个月后"运动相关自我效能"、"疾病共性管理自我效能"、"总体自我效能"评分分别平均比对照组提高0.29、0.34、0.21分,差异均有统计学意义(P＜0.05);干预组在健康功能状况:"疾病对生活的影响"改善程度、空腹血糖水平、糖化血红蛋白水平方面分别平均比对照组多下降3.94分、0.06 mmol/L、0.53,差异有统计学意义(P＜0.05);12个月后,干预组空腹血糖水平、糖化血红蛋白水平分别平均比对照组多下降0.54 mmol/L、0.41%,差异有统计学意义(P＜0.05).结论 浦东新区糖尿病自我管理健康教育项目6个月后可改善参加者的自我管理行为、自我效能、部分健康状况;12个月后可改善参加者的部分健康状况.

Effect Assessment of Health Education for Diabetics' Self-management in Pudong New Area of Shanghai

Objective To assess the effect on implementation of self-management health education program for patients with diabetes mellitus.Methods A community-based randomized controlled trial was conducted in 362 volunteer patients with diabetes mellitus who were divided as intervention group (n=240) and control group (n=122).Rank test based on covariance was used to compared the data between the two groups on self-management behavior,self-efficacy,health status and health service utilization before and six-months,twelve months later after the implementation of the program.Results Compared with controls,six months later after intervention in the intervention group,the average scores of self-management behaviors increased respectively by 0.29 in exercise-related self-efficiency,0.34 in disease-commonness management self-efficiency and 0.21 in general self-efficiency (P＜0.05); and in health status,the average score in degree of impact of disease on living decreased by 3.94,level of fasting blood glucose (FBG) decreased by 0.06 mmol/L and level of glycosylated hemoglobin (HbA1c) by 0.53 (P＜0.05).Twelve months later after intervention the average levels of FBG and HbA1c decreased respectively by 0.54 mmol/L and 0.41%(P＜0.05).Conclusion The self-management health education program for diabetics in Pudong New Area of Shanghai can improve self-management behavior,self-efficacy,and a part of health status six months later after implementation; and improve more of health status twelve months later implementation.