南京市糖尿病患者社区自我管理小组活动前后生活质量评价

目的 探索糖尿病患者生活质量的影响因素，评估自我管理小组活动前后生活质量变化情况。方法 采用患者自我管理小组活动的干预方式对社区糖尿病患者进行管理，在小组活动前后分别采用中国疾病预防控制中心设计的评估问卷进行调查。结果 共登记自愿参加自我管理小组的糖尿病患者521例，完成全部6次小组活动的患者494例，应答率为94.8%。生活质量各维度评分，除躯体疼痛（bodily pain，BP）、活力（vitality，VT）、精神健康（mental health，MH）外，其他5个方面评分均较中国一般人群低，差异均有统计学意义（均有P<0.05）。糖尿病患者生活质量的主要影响因素为并发症（t=-3.235，P=0.001）、慢性病史（t=-3.197，P=0.002）、血糖监测（t=2.303，P=0.022）、饮食习惯（t=2.341，P=0.020）、每周参与中等强度体力活动频次（t=-5.643，P<0.001）。糖尿病患者生存质量在不同维度上得分，活动后均较活动前升高（均有P<0.001）。结论 社区自我管理小组活动能够有效提高糖尿病患者生活质量。

Evaluation on quality of life among patients with diabetes before and after community self-management activities in Nanjing

Objective To explore the influencing factors of the quality of life in patients with diabetes, and to evaluate the quality of life before and after community self-management activities. Methods Diabetes patients recruited from communities of Nanjing were interviewed with a structured questionnaire designed by center for disease control and prevention (CDC) of China before and after they participated in health self-management activity. The medical outcomes study 36-item short form health survey (SF-36) was applied to measure the scores of life quality and to analyze the related influencing factors for patients. Results A total of 521 patients were recruited. 494 completed the 6-session activities, with the respond rate of 94.8%. The scores of general health (GH), physical functioning (PF), role physical (RP), role emotional (RE), social functioning (SF) in 494 subjects were lower than those of Chinese general population (all P<0.05). Stepwise regression analysis showed that complications (t=-3.235,P=0.001), other chronic disease (t=-3.197,P=0.002), blood glucose monitoring (t=2.303,P=0.022), dietary habit (t=2.341,P=0.020), physical exercise(t=-5.643,P<0.001) were main factors that influenced the patients' quality of life. Statistically significant improvement on the scores of the quality of life were observed in all eight dimensions after community self-management activities (all P<0.001). Conclusions Communtiy self-management activities are effective in improving the quality of life among patients with diabetes.