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目的了解健康自我管理对糖尿病患者不同自我效能的影响,为完善与推广健康自我管理提供建议。方法对重庆市九龙坡区与沙坪坝区12个社区招募确诊的221名糖尿病患者在参加健康自我管理活动前后进行问卷调查,调查内容包括人口学特征、糖尿病防治相关知识与行为,采用糖尿病自我效能量表评价自我效能得分。采用非参数wilcoxon检验比较管理前后自我效能的变化。结果招募的221名糖尿病患者中214名患者[平均年龄(65.8±7.5)岁]参加6次健康自我管理并接受问卷调查,随访率为96.8%。参加健康自我管理后自我效能、总饮食控制效能、运动效能、自我监测效能、护理效能与并发症应对效能均明显提高,差异有统计学意义(Z=-7.72、-4.44、-5.00、-5.89、-7.76与-6.67,均P<0.001),药物治疗效能在管理前后差异无统计学意义(Z=-1.54,P=0.123)。“在同一类食物中,我能够按热量进行食物替换”[2.0(1.0~3.0)vs.3.0(2.0~4.0)]、“即使再忙,我都能特别抽出时间去做运动”[3.0(2.0~5.0)vs.4.0(3.0~5.0)]、“当出门在外时,我仍照常测量血糖或尿糖”[3.0(2.0~4.0)vs.3.5(3.0~4.0)]、“能依照医生建议,进行正确的足部自我检查和护理”[2.0(1.0~4.0)vs.4.0(3.0~5.0)]条目管理前后均得分较低,但管理后高于管理前,差异有统计学意义(P<0.05)。结论健康自我管理可以有效地提高患者的自我效能,但不同的效能存在差异,应针对得分较低的效能开展健康自我管理的培训。
Objective To understand the impact of health self-management on different self-efficacy of diabetic patients and to provide suggestions for improving and promoting health self-management. Methods A total of 221 diabetes patients recruited from 12 communities in Jiulongpo district and Shapingba district of Chongqing were surveyed before and after taking part in the health self-management activities. The survey included demographic characteristics, knowledge and behaviors related to diabetes prevention and treatment, and diabetes self-efficacy Table evaluation self-efficacy score. The non-parametric wilcoxon test was used to compare changes in self-efficacy before and after management. Results Out of 221 patients with diabetes (mean age 65.8 ± 7.5 years) enrolled in six healthy self-management and questionnaires, the follow-up rate was 96.8%. Self-efficacy, total diet control efficacy, motor performance, self-monitoring efficacy, nursing efficacy and complication response performance after self-management were significantly improved, with statistical significance (Z = -7.72, -4.44, -5.00, -5.89 , -7.76 and -6.67, all P <0.001). There was no significant difference in the efficacy of drug treatment before and after management (Z = -1.54, P = 0.123). “In the same type of food, I was able to replace food by heat” [2.0 (1.0-3.0) vs.3.0 (2.0-4.0)], “Even when I was busy, I was able to take some time out for exercise / ”[3.0 (2.0 ~ 5.0) vs.4.0 (3.0 ~ 5.0)], “ When I was away from home, I still measure blood sugar or urine sugar as usual ”[3.0 (2.0-4.0) vs 3.5 (3.0-4.0) ], “According to the doctor’s advice, the correct foot self-examination and care ” [2.0 (1.0 ~ 4.0) vs.4.0 (3.0 ~ 5.0) Before the difference was statistically significant (P <0.05). Conclusions Health self-management can effectively improve patients’ self-efficacy, but there are differences in efficacy. Health self-management training should be carried out in response to lower scores.