太原市迎泽区2型糖尿病患者自我管理现状调查及干预研究

目的调查社区2型糖尿病患者糖代谢指标情况、糖尿病知识掌握情况及自我管理水平的现状,并对采用自我管理模式干预后作出评价。方法采用"中国2型糖尿病病人自我管理情况调查问卷"进行调查分析自我管理现状。将428例社区2型糖尿病患者随机分为同伴教育模式管理组(试验组)216例和社区常规教育管理模式组(对照组)212例。对照组按照社区常规教育管理模式对糖尿病患者进行健康教育、发放健康教育宣传资料进行干预;试验组采用自我管理模式,由教育者组织糖尿病患者进行自我管理课程的学习,定期开展各项主题活动,并有针对性地进行干预。比较干预3、6个月后,2组患者的评价指标即糖代谢指标达标率、糖尿病知识水平达标率和自我管理得分等方面的变化情况。结果 1干预前2组患者的糖代谢指标达标率、糖尿病知识掌握达标率、自我管理水平得分比较,差异无统计学意义(P>0.05);干预后3、6个月,2组患者的糖代谢指标达标率、糖尿病知识掌握达标率、自我管理水平得分均有上升,但试验组比对照组上升率大,差异均有统计学意义(P<0.05)。2从糖尿病患者自我管理的各个分量表中得出,在干预前,干预后3、6个月,试验组和对照组的药物依存性平均分最高,监测依存性平均分最低。结论糖尿病自我管理模式明显优于社区常规教育管理模式。采用自我管理模式的方式进行教育,能使患者的自我管理水平明显提高。在糖尿病自我管理的4项内容中,告知患者自我监测的重要性是医护人员健康宣教的重点。

A survey and interventional study on self-management among patients with type 2 diabetes in Yingze district of Taiyuan city

Objective To investigate the current situation of glucose metabolism indexes, awareness of dia-betes, and self-management of type 2 diabetics in the community, and to evaluate the effect of intervention on self-management pattern. Method The questionnaire on self-management in Chinese type 2 diabetics was used to ex-amine and analyze the current situation of patients′ self-management. 428 cases of the type 2 diabetics in the com-munity were randomly divided into two groups： 216 cases with peer-education management （experimental group） and 212 cases with routine community education management （control group）. For the control group, the diabetics were in-tervened by health education and handouts according to the routine community education management pattern; for the experimental group, the diabetics were organized to take courses of self-management and to attend various theme ac-tivities periodically by instructors as well to achieve the targeted intervention on the basis of peer-education manage-ment pattern. After 3 and 6 months of intervention, the changes in the evaluation indexes, including the control rate of glucose metabolism, intended awareness of diabetes, and the score of self-management level were compared between two groups. Results ①Before the intervention, there were no statistical differences in the control rate of glucose metabolism, awareness of diabetes and self-management score between the two groups （P〉0.05）. After 3 and 6 months of the intervention, these figures were improved in the both groups; however, the experimental group showed greater increases than the control group （all P〈0.05）. ②Of all domains of self-management, the mean sub-score of compliance to medication was the highest and that of compliance to monitoring was the lowest in both the experimental group and control group, before intervention, after 3-month intervention, and after 6-month intervention. Conclusion For diabetics, self-management pattern has obvious advantage over the routine community ed