2型糖尿病患者自我管理行为的质性研究

目的了解2型糖尿病患者自我管理行为不依从的原因,为制订有效措施改善糖尿病患者自我管理行为提供参考依据。方法采用半结构式访谈收集10例2型糖尿病患者的自我管理资料,利用现象学研究法进行资料分析。结果 2型糖尿病患者自我管理行为主要受以下因素影响:①患者对自我管理的重要性认识不足,包括健康教育力度不够、患者对信息的分辨有误及对疾病的严重性认识不足;②对自我管理的好处感知不足,包括安于现状的惰性、生活习惯改变初期的不适应及对他人评价的顾虑;③采用自我管理的态度不积极,包括患者情绪、护患关系与失败经历的影响。结论多种因素影响2型糖尿病患者的自我管理行为,医护人员在进行糖尿病自我管理教育中可运用动机性访谈,纠正患者的认知误区,强化自我管理的重要性,引导患者体会进行自我管理的好处,让患者主动参与自我管理,进而改善其自我管理行为。

Qualitative research in self-management behaviors of the patients with type 2 diabetes

Objective To explore the causes of un-compliance in type 2 diabetic patients so as to provide relevant measures for improving their self-management. Methods 10 type 2 diabetic patients were involved in the individual investigation in their self-management behavior by semi-structured interview. The data were analyzed with the phenomenological method. Results The self-management behaviors of the patients were affected by the following factors： ① the inadequate recognition of the self-management importance including deficiency in health education and misunderstanding of information, inadequate understanding of the disease risks; ② the inadequate recognitions of self-management-related benefits including the inability to change habits , the maladjustment from initial change and the worry about others′ judgment ; ③the passive attitude to self- management including the negative emotions, the relationship of nurse-patient and the unsuccessful experience. Conclusions Many factors influence the self-management behavior of diabetic patients. The mistakes can be corrected by using motivation-oriented interviews to strengthen the importance of self-management, guide them to recognize the benefits of self-management so that the patients can be active to participate in self- management and better their behaviors.