农村老年糖尿病患者自我效能和自我管理行为与血糖控制的相关性分析

目的了解农村老年糖尿病患者自我效能感、自我管理行为及血糖控制现状；分析影响血糖控制主要因素。方法采用分阶段整群抽样方法，在浙江省杭州市和宁波市选择两个区，在所选区内各选择一个街镇，在所选择街镇社区卫生服务中心慢病管理档案中抽取符合标准的农村老年糖尿病患者。采用现场问卷调查法，由患者填写一般资料问卷、糖尿病自我效能量表及自我管理活动问卷。运用频数百分比描述被调查样本的人口学特征资料、自我效能、自我管理行为与血糖控制的现状，采用多重线性回归法分析自我管理行为的主要影响因素，并通过二分类logistic回归法分析影响血糖控制的主要因素。结果共调查老年糖尿病患者800例，实际回收有效问卷777份，有效回收率为97．13％。调查对象血糖自我效能感平均得分为（3．67±1．22）分，其中感觉自我效能较弱的占22．70％（176例）；自我管理行为平均得分为（3．08±1．25）分，其中管理行为较差的200例（25．74％）；调查对象空腹血糖平均值为（7．19±1．99）分，血糖控制情况较差的437例，占56．24％。二分类logistic回归分析显示：影响血糖控制效果的前三位因素依次为自我效能水平、自我管理行为和并发症种类数。结论农村老年糖尿病患者自我效能和自我管理行为水平不佳，良好的自我效能和自我管理行为有助于患者的血糖控制。

Correlation between self-efficacy,self-management and glycemic control among seniors with diabetes in rural areas

Objective To assess the correlation between self-efficacy, self-management and glycemic control among the elderly with diabetes from rural areas, and to analyze the major factors influencing blood glucose control. Methods A multi-stage cluster sampling method was used to enroll elder patients with diabetes from rural areas into the survey. All subjects were required to complete a couple of questionnaires, including demographic questionnaire, diabetes self-efficacy scale （DSES） and diabetes self-management behavioral questionnaire. Multiple linear regression and binary logistic regression analysis were used to analyze the data. Results Out of 800 seniors surveyed, only 777 questionnaires were retrieved and analyzed. The average score of self-efficacy was 3. 67±1.22, and 22.7% claimed of having poor self-efficacy. Meanwhile, the average score of self-management was 3.08±1.25, and 25.7% admitted that their self-management ability were not strong. In addition, the mean fasting blood glucose was 7.19±1.99, 56.2% of seniors were unable to effectively control their blood glucose levels. Binary logistic regression analysis showed that the top three factors affecting blood glucose control were selSefficacy level , self-management behavior and types of complications. Conclusions The self-efficacy and self-management abilities among elder patients with diabetics are not satisfactory and need to be further improved which can be very helpful for the control of blood glucose level.