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目的探讨家庭医生式服务对老年糖尿病患者自我管理的影响。方法选取2011年1月—2013年12月大红门社区卫生服务中心的门诊病例中104例2型老年糖尿病患者为研究对象,随机分为干预组53例和对照组51例。对照组开展糖尿病的常规社区管理,干预组实施家庭医生式服务。干预1年后,比较两组患者随访前后的空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数及自我管理情况的变化。结果两组干预前空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数间差异均无统计学意义(P>0.05),而干预后差异均有统计学意义(P<0.05);干预组的自我管理行为总分高于对照组,差异有统计学意义(P<0.05),自我管理的饮食行为、运动行为、血糖监测、遵医嘱用药和足部护理5个项目在干预前后差异亦均有统计学意义(P<0.05)。结论对老年糖尿病患者提供家庭医生式服务,使患者的自我管理意识提高,自我管理的积极性和主动性改善,能够维持老年糖尿病患者血糖的稳定性,减少并发症发生,提高生存质量,具有非常重要的公共卫生学意义。
Objective To explore the influence of family doctor service on the self-management of elderly diabetic patients. Methods A total of 104 outpatients with type 2 diabetes mellitus in outpatients from January 2011 to December 2013 in Dahongmen Community Health Center were randomly divided into intervention group (n = 53) and control group (n = 51). Control groups conducted routine community-based management of diabetes and intervention groups conducted family-doctor services. One year after the intervention, the changes of fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin, body mass index and self-management were compared before and after follow-up. Results There was no significant difference in fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin and body mass index (P> 0.05) between the two groups before intervention, but there were significant differences after intervention (P <0.05) The total score of self-management behavior was higher than that of the control group (P <0.05). There were also differences in self-managed diet behavior, exercise behavior, blood glucose monitoring, prescribed medication and foot care before and after intervention Statistical significance (P <0.05). Conclusion It is very important to provide family doctor service to senile patients with diabetes so as to improve patients’ awareness of self-management, self-management enthusiasm and initiative, maintain the stability of blood glucose in elderly patients with diabetes, reduce the incidence of complications and improve the quality of life Public health significance.