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目的分析参与我国6个省市2型糖尿病(T2DM)患者自我管理小组干预活动的糖尿病患者的生存质量及其影响因素,为提高社区糖尿病患者管理服务水平提供科学依据。方法于2013年9-10月选择曾开展过糖尿病患者自我管理工作、具备一定的工作基础的北京市、上海市、重庆市、江苏省、广东省和浙江省6个省(直辖市)的街道和乡镇为研究现场。以问卷形式共调查社区成年T2DM患者1 603例,收集入选患者的一般情况、患病情况、生存质量及自我效能评价信息,分析患者的生存质量得分及影响因素。结果 1 603例调查对象躯体健康得分为(70.38±13.90)分,心理健康得分为(76.07±17.03)分。调查对象一般健康状况得分最低,仅为(55.25±16.90)分。社会功能得分最高,为(88.16±20.04)分。患者的文化程度和收入水平与躯体健康得分呈正相关(t值分别为3.153、3.396),并发症与躯体健康得分呈负相关(t=-4.311),差异均有统计学意义(P<0.01)。患者的居住地和并发症与心理健康得分呈负相关(t值分别为-3.715、-3.134,P<0.01),患者的文化程度、收入水平与心理健康得分呈正相关(t值分别为2.794、4.157),差异均有统计学意义(P<0.01)。调查对象自我效能总分为(66.93±17.69)分,患者遵医嘱服药或注射胰岛素的自我效能得分最高,为(74.24±23.54)分,而血糖监测和足部护理的自我效能得分最低[分别为(62.30±20.76)、(62.59±22.89)分]。结论糖尿病患者的文化程度、收入水平和并发症显著影响其生存质量。在糖尿病患者的综合管理中,并发症的预防、血糖监测和足部护理以及对患者心理的关怀应得到进一步加强。
Objective To analyze the quality of life and its influencing factors of diabetes patients participating in the self-management group intervention of type 2 diabetes mellitus (T2DM) in 6 provinces and cities in China, and to provide scientific basis for improving the management and service level of patients with diabetes mellitus in community. Methods From September to October 2013, we selected the streets of Beijing, Shanghai, Chongqing, Jiangsu, Guangdong and Zhejiang Provinces and 6 provinces (municipalities directly under the Central Government) who had self-management of diabetes patients and had certain working basis Township for the study site. A total of 1 603 adult T2DM patients were surveyed in a questionnaire. The general condition, prevalence, quality of life and self-efficacy evaluation information of the selected patients were collected. The quality of life score and influencing factors were analyzed. Results The body health score of 1 603 cases was (70.38 ± 13.90) points and the mental health score was (76.07 ± 17.03) points. The general health status of the respondents scored the lowest, only (55.25 ± 16.90) points. The highest social function score was (88.16 ± 20.04) points. The level of education and income of patients were positively correlated with physical health scores (t = 3.153 and 3.366, respectively), and the complication was negatively correlated with physical health scores (t = -4.311) (P <0.01) . Patient’s place of residence and complications were negatively correlated with mental health scores (t = -3.715, -3.134, P <0.01, respectively). There was a positive correlation between education level and income level and mental health score (t = 2.794, 4.157), the differences were statistically significant (P <0.01). The self-efficacy score of the surveyed subjects was (66.93 ± 17.69) points, the highest score of self-efficacy was (74.24 ± 23.54) points for the patients taking the medicine or injecting insulin, while the lowest for the self-efficacy of blood glucose monitoring and foot care [ (62.30 ± 20.76), (62.59 ± 22.89) minutes]. Conclusion The educational level, income level and complications of diabetic patients significantly affect their quality of life. In the integrated management of patients with diabetes, the prevention of complications, blood glucose monitoring and foot care, as well as the psychological care of patients should be further strengthened.