社区糖尿病自我管理模式健康教育效果研究

  目的  探究糖尿病患者服药依从性的影响因素，为提高糖尿病患者服药依从性水平提供依据。  方法  于2017年3 — 4月在北京市城市地区采用整群抽样方法，抽取2个行政区，在每个行政区各抽取3个社区，每个社区以卫生服务站为单位，对其管辖范围内的糖尿病患者就基本信息、糖尿病一般情况、自我管理知识和技能、自我管理行为、自我管理行为动机、自我效能等方面进行调查。使用单因素方差分析和logistic回归分析服药依从性的影响因素。  结果  调查对象为607例，平均年龄（64.8 ± 8.4）岁，男女比例1 : 1.83，知识、技能、自我效能和动机得分分别为（47.2 ± 14.8）、（62.8 ± 14.2）、（74.3 ± 18.0）、（61.7 ± 18.1）分。服药依从性方面，服药遗忘率较高（47.1 %）。服药依从性与自我效能（OR = 1.012，95 % CI = 1.006～1.018）和病程长短（OR = 1.046，95 % CI = 1.016～1.076）存在相关，自我效能得分越高、病程越长的患者服药依从性越好。  结论  提高自我效能对提高服药依从性具有积极意义。

How to achieve better effect of peer support among adults with type 2 diabetes: a meta-analysis of randomized clinical trials

  Objective  To explore influencing factors of medication compliance among community diabetes patients and to provide evidences for improving diabetes patients′ medication compliance.  Methods  We conducted a self-administered questionnaire survey among 607 type 2 diabetes mellitus patients selected with cluster sampling in 6 communities of 2 administrative regions in Beijing city during March to April, 2017. We collected the patients′ information on demographics, general condition of the disease, self-management knowledge/skill/behavior/motivation, and self-efficiency using a self-designed questionnaire. Analysis of variance (ANOVA) and logistic regression were adopted to assess the correlation between self-efficiency and medication compliance.  Results  For all the participants, the average age was 64.8 ± 8.4 years and the male to female ratio was 1 : 1.83; the mean scores were 47.2 ± 14.8, 62.8 ± 14.2, and 61.7 ± 18.1 for self-management knowledge, skill, and motivation and the mean score was 74.3 ± 18.0 for self-efficacy. About a half (47.1%) of the participants reported ever forgetting to take the medicine. Medication compliance was positively correlated with self-efficacy (odds ratio [OR] = 1.012, 95% confidence interval [95% CI]: 1.006 – 1.018) and duration of the disease (OR = 1.046, 95% CI: 1.016 – 1.076).  Conclusion  Self-efficacy promotion has positive impact on enhancing medication compliance among community type 2 diabetes mellitus patients.