家庭医生心理疏导对社区“1+1+1”签约2型糖尿病患者心理状况的影响

目的 了解潍坊社区签约2型糖尿病患者心理状况,分析家庭医生进行心理疏导后糖尿病患者心理状况的变化。 方法 运用系统抽样法,随机抽取2010年至今潍坊街道常住人口,并已进行"1+1+1"签约服务的476例社区签约糖尿病患者为研究对象,对其行SCL-90心理健康症状自评量表、社会支持评定量表等问卷调查,对社区签约2型糖尿病患者的心理状况及社会支持情况进行分析,由签约家庭医生对其进行为期3个月的心理疏导及健康教育,评估患者心理疏导及健康教育前后签约2型糖尿病患者的心理状况、社会支持评分变化及血糖控制情况。 结果 社区签约2型糖尿病患者的SCL-90总分及各因子分均高于全国常模;心理疏导前患者的糖化血红蛋白指标为(7.99±2.08)%;心理疏导后为(6.95±0.84)%,差异有统计学意义。心理疏导后社区签约2型糖尿病患者SCL-90总分及各因子分均低于心理疏导前,而社会支持评分均高于心理疏导前,且差异均有统计学意义。 结论 社区签约2型糖尿病患者的心理状况不容乐观,签约家庭医生对"1+1+1"签约2型糖尿病患者进行心理疏导联合健康教育有助于改善其血糖控制情况、心理状况以及社会支持度,提高患者的生活质量。 

The influence of family doctor's psychological counseling on the psychological status of type 2 diabetes mellitus with 1+1+1 contracted service in the community

Objective To understand the psychological status of patients with type 2 diabetes in Weifang community, and to analyze the changes of mental state of diabetic patients after psychological counseling. Methods A total of 476 patients who live in Weifang community from 2010 till now and have already enrolled in "1+1+1" contracted service were surveyed by systematic sampling method and health questionnaire of Symptom Checklist 90 (SCL-90) and social support revalued scale. At the same time, the psychological status and social support condition of contracted type 2 diabetes were analyzed. The General Practitioner was engaged in a 3-month psychological counseling and healthy education, and compared the psychological status changes, social support condition changes and blood glucose control of contracted type 2 diabetes before and after psychological counseling and healthy education. Results In this study, all the factorial scores of patients with type 2 diabetes mellitus in contracting community health service were higher than the national norm. The glycosylated hemoglobin of patients before psychological counseling was (7.99±2.08)% and (6.95±0.84)% after psychological counseling, with a statistical difference. After psychological counseling, the total scores of SCL-90 and the scores of each factor were lower than that before psychological counseling, and the social support score was higher than that before psychological counseling. The difference was statistically significant. Conclusion The psychological health of the contracted patients with type 2 diabetes mellitus is not optimistic. The General Practitioner's psychological counseling on "1+1+1" contracted service for Type 2 diabetes patients is helpful to improve their blood glucose control, psychological status and social support. It can improve the quality of life of patients.