2型糖尿病患者糖尿病痛苦现状及影响因素分析

目的调查2型糖尿病患者糖尿病痛苦状况,并分析影响因素。方法采用问卷调查方式收集患者人口社会学资料及疾病治疗相关资料。采用反刍思维量表(RRS)、心理弹性量表(CD-RISC)和糖尿病痛苦量表(DDS)分别评定患者反刍思维、心理弹性和糖尿病痛苦状况。结果223例患者中,217例(97.3%)患者糖尿病痛苦轻度,5例(2.2%)中度,1例(0.4%)重度。DDS量表4个维度方差分析结果显示,患者生活规律相关痛苦最高,其次是情感负担相关痛苦,最后是人际关系相关痛苦和医生相关痛苦(P<0.05)。单因素分析显示,年龄>70岁、吸烟、3个及以上合并症、低血糖、空腹血糖≥10.0 mmol/L、反刍思维高、心理弹性低者DDS评分更高(P<0.05)。多因素Logistic回归分析显示,吸烟(P=0.048)、反刍思维高(P=0.029)是糖尿病痛苦中重度的独立影响因素。结论2型糖尿病患者糖尿病痛苦比率较高,患者生活规律相关痛苦最高,其次是情感负担相关痛苦。患者糖尿病痛苦受多种因素影响,吸烟和反刍思维是主要影响因素。

Status of diabetes distress in patients with type 2 diabetes and its influencing factors

Objective To investigate the status of diabetes distress of type 2 diabetes patients and analyze its influencing factors.Methods Demographic and sociological data as well as disease treatment related data were collected by questionnaire survey.The Ruminative Responses Scale(RRS),Connor-Davidson Resilience Scale(CD-RISC)and Diabetes Distress Scale(DDS)were used to assess patients′ruminative responses,mental resilience and diabetes distress status.Results In 223 patients,217 patients(97.3%)had mild diabetes distress,5 patients(2.2%)had moderate distress,and 1 patient(0.4%)had severe distress.The DDS 4-dimension results by variance analysis showed that life-related distress was the highest,followed by emotional burden-related distress,and finally interpersonal relationship-related distress and doctor-related distress(P<0.05).Univariate analyses showed that DDS scores were higher among patients aged over 70 years,with smoking and three kinds of comorbidities or more,hypoglycemia,fasting blood glucose≥10.0 mmol/L,high ruminative responses,and low mental resilience(P<0.05).Multivariate Logistic regression analysis showed that smoking(P=0.048)and high ruminative responses(P=0.029)were independent influencing factors for patients with moderate to severe diabetes distress.Conclusion Type 2 diabetes patients with diabetes distress have higher proportion of diabetes distress,and life-related distress is the highest,followed by emotional burden-related distress.Patients with diabetes distress are affected by many factors,especially smoking and ruminative responses.