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目的评价60岁及以上老年2型糖尿病患者(T2DM)自我效能(SE)和生命质量(QOL)现状,以期为今后提高患者管理质量提供依据。方法于2015年9-12月分别使用糖尿病自我效能量表(DSES)和中文版SF-36量表评价537例60岁及以上老年T2DM患者SE和QOL。用SPSS 11.5软件进行t检验和方差分析,比较不同人口特征的患者SE和QOL,使用Pearson相关分析患者SE和QOL间的相关关系,分别用多元线性回归分析SE和QOL的影响因素。结果被调查患者平均年龄(69.9±6.3)岁,患T2DM病程为5~12年,中位数为7年。SE和QOL总评分分别为(94.2±20.6)和(114.8±15.6)分,得分率分别为88.2%和76.0%。SE以药物使用效能最高(90.9%),血糖监测效能最低(75.8%);QOL以情感职能得分率最高(88.7%),而社会功能得分率最低(58.7%)。患者运动、高或低血糖预防与处理及总SE与8个分维度和总QOL均呈正相关(P<0.05);多元线性回归结果显示,总QOL对总SE有影响,高或低血糖预防和处理、运动及饮食效能对总QOL有影响。结论 60岁及以上T2DM患者总体SE尚可,而QOL偏低,SE和QOL相互影响,建议针对T2DM开展社区健康自我管理小组活动,通过提高患者SE而进一步提高患者QOL。
Objective To evaluate the status of self-efficacy (SE) and quality of life (QOL) in elderly patients with type 2 diabetes mellitus (T2DM) aged 60 and over in order to provide the basis for improving patient management in the future. Methods From September to December 2015, the Diabetes Self-Efficacy Scale (DSES) and the Chinese SF-36 scale were used to evaluate the SE and QOL of 537 T2DM patients aged 60 years and over. SPSS 11.5 software was used for t-test and analysis of variance to compare the SE and QOL of patients with different demographic characteristics. Pearson correlation analysis was used to analyze the correlation between SE and QOL. Multivariate linear regression was used to analyze the influencing factors of SE and QOL. Results The mean age of patients surveyed was 69.9 ± 6.3 years. The duration of T2DM was 5 to 12 years with a median of 7 years. The total scores of SE and QOL were (94.2 ± 20.6) and (114.8 ± 15.6) points respectively, with the scores of 88.2% and 76.0% respectively. SE had the highest drug use efficiency (90.9%) and the lowest blood glucose monitoring efficiency (75.8%). QOL had the highest emotional score (88.7%) and lowest social function score (58.7%). Patients with exercise, high or low blood sugar prevention and treatment and total SE with 8 dimensions and total QOL were positively correlated (P <0.05); multiple linear regression results showed that total QOL had effects on total SE, high or hypoglycemia prevention and Processing, exercise and diet performance have an impact on overall QOL. CONCLUSIONS: Overall SE is acceptable in patients with T2DM at 60 years of age, but QOL is low and SE and QOL influence each other. It is recommended that community health self-management group activities should be conducted for T2DM and QOL should be further improved by improving patients’ SE.