扬州市农村社区糖尿病自我管理项目实施效果评价

目的评价扬州市农村社区实施糖尿病自我管理项目6个月后的效果。方法按照以社区为基础的随机对照试验研究设计,将246例糖尿病患者随机分成干预组和对照组,干预组患者接受6个月的糖尿病自我管理健康教育项目课程。6个月后比较两组患者自我管理行为、自我效能、健康状况和卫生服务利用方面的变化。结果干预后两组患者自我管理行为中的认知性症状管理实践及与医生交流评分间差别有统计学意义(P<0.01);症状管理自我效能和疾病共性管理自我效能间差别有统计学意义(P<0.01);健康状况评价指标的9个方面(整体健康自评、精力、健康担忧、疲劳、气短、疼痛、疾病对患者生活影响、情绪低落及社会活动/角色受限)得分间差别有统计学意义(P<0.05)。干预后6个月内,两组患者看门诊次数和急诊次数间差别有统计学意义(P<0.05)。结论农村社区糖尿病自我管理项目实施6个月后,增加了参加者的自我管理知识,培养了健康的行为,改善了躯体和精神部分健康状况、自我效能,减少看门诊次数和看急诊次数。

Evaluation on the Effectiveness for Self - Management Program of Diabetes in the Rural Community of Yangzhou

Objective To evaluate the six-month effectiveness of implementation of diabetes self-management program in the rural community in Yangzhou.Methods A community-based randomized controlled trial was taken.Totally 324 voluntary participants with diabetes were at random divided as trial group and control group.The patients in the trial group received the education of diabetes self-management program for six months.Then the changes in self-management of behaviors,self-efficacy,health condition,and health service utilization between the two groups were compared.Results There were significant differences in scores in practice of cognitive symptom management and communication with physician between the two groups (P<0.01).There were significant differences in scores in self-efficacies of management of symptom and disease generality (P<0.01).And also there were significant differences in scores of nine items of health status (self-rated health,energy,health distress,fatigue,shortness of breath,pain,illness intrusiveness,depression and social/role activities limitation) (P<0.05).After six-month intervention,the patients in the trial group had fewer times of clinic and emergent visit than those in the control group (P<0.05).Conclusion Six-month implementation of diabetes self-management program can improve the knowledge of self-management,cultivate healthy behavior,improve bodily and mental health condition partly and self-efficacy,reduce the times of clinic and emergent visit for the participators.