南阳地区在管2型糖尿病患者健康管理现状调查

doi:10.12183/j.scjpm.2022.1188

摘要/Abstract

摘要： 目的分析南阳地区在管2型糖尿病患者规范管理率及血糖控制达标情况。方法 2021年6—12月在南阳市辖区内社区服务中心采用方便抽样法招募登记在册的2型糖尿病患者作为研究对象,对患者进行问卷调查,并收集患者在社区服务中心的管理情况,采用描述性分析方法对结果进行分析,并采用单、多因素分析方法对2型糖尿病患者健康管理影响因素进行分析。结果共获得1 796例2型糖尿病患者,有效研究对象1 643例,有效率91.48%。其中男性852例,女性791例。年龄35~78岁,以55~64岁所占比例较高,为33.35%;BMI以18.5~23.9 kg/m²为主,占57.33%;病程以5~10年为主,占48.20%。规范管理810例,规范管理率49.30%,血糖控制达标839例,血糖控制达标率51.07%;规范管理者血糖控制达标率显著高于未规范管理者（P<0.01）。多因素Logistic回归分析结果显示,年龄（OR=3.672）、病程（OR=0.463）、糖尿病痛苦（OR=0.244）、糖尿病管理自我效能（OR=3.543）、社会支持度（OR=2.161）是2型糖尿病患者规范管理的影响因素。结论南阳地区在管2型糖尿病患者规范管理率未及一半,规范管理的2型糖尿病患者血糖控制达标率更高,可针对在管2型糖尿病规范管理的影响因素采取有效干预措施,提高规范管理率,促进患者血糖控制达标。

关键词: 2型糖尿病, 健康管理, 血糖, 自我效能, 社会支持, 影响因素

Abstract: Objective To analyze the standardized management rate and compliance of blood glucose control in patients with type 2 diabetes mellitus （T2DM） under supervision in Nanyang. Methods From June to December 2021, T2DM patients registered in community service centers in Nanyang City were recruited by the convenient sampling method. A questionnaire survey was conducted on the patients, and the management of the patients in the community service centers was collected. The descriptive analysis method was used to analyze the results, and univariate and multivariate analysis methods were used to analyze the influencing factors of health management in T2DM patients. Results A total of 1 796 T2DM patients were enrolled, and 1 643 subjects were effective, with an effective rate of 91.48%. There were 852 males and 791 females. The age ranged from 35 to 78 years old, with a high proportion of 55 to 64 years old （33.35%）. The body mass index （BMI） was mainly 18.5-23.9 kg/m2, accounting for 57.33%. The disease duration was mainly 5 to 10 years, accounting for 48.20%. There were 810 cases that were managed in a standardized way, the standardized management rate was 49.30%, 839 cases reached the standard of blood glucose control, and the compliance rate was 51.07%. The compliance rate of blood glucose control in standardized patients was significantly higher than that of non-standardized patients （P＜0.01）. Multivariate Logistic regression analysis showed that age （OR＝3.672）, course of disease （OR＝0.463）, diabetes distress （OR＝0.244）, self-efficacy of diabetes management （ OR＝3.543）, and social support （OR＝2.161） were the influencing factors of standardized management in T2DM patients. Conclusions The standardized management rate of T2DM patients under supervision in Nanyang is less than half, and the compliance rate of blood glucose control in standardized patients is higher. Effective interventions can be taken to improve the standardized management rate of T2DM and promote the blood glucose control of patients.

Key words: Type 2 diabetes mellitus, Health management, Blood glucose, Self-efficacy, Social support, Influencing factor

中图分类号:

R197.21

曹卫华, 张红瑾, 高扬, 王霞. 南阳地区在管2型糖尿病患者健康管理现状调查[J]. 华南预防医学, 2022, 48(10): 1188-1191.

CAO Wei-hua, ZHANG Hong-jin, GAO Yang, WANG Xia. Health management status of type 2 diabetes mellitus patients under supervision in Nanyang[J]. South China Journal of Preventive Medicine, 2022, 48(10): 1188-1191.

参考文献

[1] 中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室. 国家基层糖尿病防治管理指南(2018)[J]. 中华内科杂志,2018,57(12):885-893.
[2] 卫生部办公厅. 防治糖尿病宣传知识要点[EB/OL]. (2008-07-08)[2022-06-24]. http://www.nhc.gov.cn/jkj/s5878/200807/ef4b1c8dfdf8466f9671cb32a4a33972.shtml.
[3] 国家卫生计生委.国家基本公共卫生服务规范(第三版))[EB/OL].( 2017-03-28)[2022-06-24]. http://www.nhc.gov.cn/jws/s3578/201703/6bd1e336ba3c448f8d03c65a9eff9cf8.shtml.
[4] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
[5] 杨青,刘雪琴.中文版糖尿病痛苦量表信效度评价[J].护理学报,2010,17(17):8-10.
[6] McDowell A, Courtney M, Edwards H, et al. Validation of the Australian /English version of the diabetes management self- efficacy scale[J]. Int J Nursing Practice,2005,11(4):177-184.
[7] 彭鑫,崔焱,李燕,等. 糖尿病管理自我效能量表在2型糖尿病病人应用中的效果评价[J]. 全科护理,2010,8(11):946-947.
[8] 汪向东,王希林,马弘,等.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:264-266.
[9] 王宇,徐健康,宋荣维,等. 社区健康管理下的糖尿病患者生命质量评价[J]. 健康教育与健康促进,2022,17(1):25-29,33.
[10] Dehnavi Z, Ayatollahi H, Hemmat M, et al.Health information technology and diabetes management: A Review of motivational and inhibitory factors[J].Curr Diabetes Rev,2021,17(3):268-279.
[11] Liang G, Jiang H, Huang C, et al.Diabetes health management strategy based on internet plus graded diagnosis and treatment strategy[J].Ann Palliat Med,2020,9(6):3915-3922.
[12] 刘美岑,杨凌鹤,陈新月,等. 中国2型糖尿病患者国家基本公共卫生服务利用情况及与管理效果的关系研究[J]. 中国全科医学,2022,25(1):43-49.
[13] 徐嘉玲,江淑琴,赵丽丽,等. 2010—2020年国内外糖尿病痛苦研究现状与热点的可视化分析[J]. 解放军护理杂志,2021,38(12):57-60.
[14] 王鹏,王云轩,田佳禾,等. 2型糖尿病患者糖尿病痛苦现状及影响因素分析[J]. 实用临床医药杂志,2021,25(2):70-73.
[15] 王晓燕. 中老年2型糖尿病患者糖尿病痛苦影响因素及对策的研究[J]. 井冈山大学学报(自然科学版),2021,42(4):103-106.
[16] 李乾,鲁华鹏. 自我效能在住院2型糖尿病患者健康素养和自我管理行为间的中介效应[J]. 右江民族医学院学报,2021,43(2):284-287.
[17] 卫薇,张硕,玉洁. 中国三省居民糖尿病管理自我效能及影响因素分析[J]. 中国慢性病预防与控制,2021,29(10):725-728.
[18] 刘宏杰,石红梅,邢丽丽,等. 同伴支持模式对2型糖尿病患者自我效能、自我管理及血糖控制的远期影响研究[J]. 中国全科医学,2018,21(7):861-866.
[19] 仲学锋. 基于社会支持理论的糖尿病自我管理研究进展[J]. 中国健康教育,2021,37(12):1117-1120.