社区干预对老年糖尿病患者自我管理能力的影响

目的 通过对老年糖尿病患者实施社区干预,观察其对患者自我管理能力的影响,为临床治疗和改善患者生活质量提供帮助.方法 将上海某社区201 1年1月～2012年3月的104例老年糖尿病患者随机分为干预组和对照组各52例,对照组采用常规药物及胰岛素治疗,干预组在常规治疗方法的基础上进行针对性社区干预治疗,包括健康教育、运动指导、饮食、心理和定期遵医行为及病情监测等.12个月后观察两组患者治疗前后多项指标的差异.结果 两组空腹血糖、餐后2h血糖干预后均明显下降,且干预组下降更明显（P＜0.001）,而干预后干预组的糖化血红蛋白明显下降,对照组则下降不明显,干预后两组比较差异有统计学意义（P＜0.001）;干预组在合理饮食、按时用药、坚持运动及自我监测血糖方面也显著优于对照组,差异有统计学意义（P＜0.05或0.01）.结论 对老年糖尿病患者实施社区干预治疗,可有效锻炼患者的自控能力,改善生活质量,减少并发症,提高治疗效果,值得推广和应用.

Effect of community intervention on the self-management ability of elderly diabetes

Objective To observe the effect of community intervention on self-management ability of elderly diabetic patients, so as to provide help for clinical treatment and the improvement of patients＂ quality of life.Methods 104 cases of elderly diabetic patients in a community of Shanghai from January, 2011 to March, 2011, were randomly divided into intervention group and control group with 52 cases in each group.The control group took conventional drugs and got insulin treatment, based on which the intervention group was added with targeted community intervention including health education, exercise guidance, diet, mentality, compliance behavior and regular monitoring, etc. 12 months later, difference in multiple indexes of two groups before and after treatment was observed. Results After the community intervention, fasting blood glucose and blood glucose of the 2nd h after dinner of both groups obviously decreased,but that of the intervention group decreased more significantly（P〈0. 001 ）.Glycosylated hemoglobin of the intervention group significantly decreased after intervention,but that of the control group did not decrease obviously, so the difference was statistically significant （P〈0. 001 ）. The intervention group was significantly better than the control group in reasonable diet, medication on time, adherence to exercise and blood sugar self-monitoring, so the difference was statistically significant （ P〈 0. 05 or 0.01 ）. Conclusion Community intervention for elderly patients with diabetes can effectively train their self-control ability, improve their quality of life, reduce complications and enhance treatment effect. Thus ,it is worthy of popularization and application.