自我管理教育对糖尿病伴抑郁症患者的影响  

Effect of self-management education on diabetes patients with depression

作　　者：卞美娟[1] 张紫娟[2] 蒋菊芳[2] 

机构地区：[1]南京医科大学附属无锡精神卫生中心内科,214151 [2]南京医科大学附属无锡精神卫生中心精神科,214151

出　　处：《中华现代护理杂志》2011年第35期4268-4270,共3页Chinese Journal of Modern Nursing

摘　　要：目的探讨自我管理教育对糖尿病伴抑郁症患者的影响，旨在提高患者自我管理能力。方法将85例患者随机分为教育组43例和对照组42例，对照组接受一般说教式健康教育，教育组患者参与自我管理教育活动，采用自行设计的自我管理行为问卷及抑郁自评量表（SDS）和汉密尔顿抑郁量表（HAMD）调查患者自我管理行为和抑郁状况，8周后比较两组患者自我管理行为、抑郁状况、空腹血糖、餐后2h血糖控制状况。结果干预前两组患者自我管理行为评分、SDS、HAMD、空腹血糖、餐后2h血糖比较差异均无统计学意义（P〉0．05）；8周后教育组患者服药依从性得分为（1．77±0．504）分，并发症的管理为（2．19±0．588）分，SDS（29．3±4．8）分、HAMD（11．5±6．9）分、空腹血糖（5．3±1．4）mmol／L、餐后2h血糖（8．6±1．1）mmol／L，对照组分别为（1．32±0．744），（1．83±0．590），（36．5±5．4），（18．3±1．3）分，（9．2±2．1），（11．1±2．2）mmol／L，差异均有统计学意义（t=2．813，3．358，2．91，2．34，2．65，2．78；P〈0．01），教育组患者自我管理行为问卷其他4项评分也高于对照组（P〈0．01）。结论自我管理教育能有效提高患者自我管理能力，控制患者血糖水平和改善抑郁症状，值得临床推广应用。Objective To explore the influence of serf-management education on the diabetes patients with depression with a view to improve patient self-management skills. Methods 85 cases were randomly divided into two groups ： the experimental group （ n = 43 ） and the control group （ n = 42 ）, general health knowledge education was applied to patients in control group, and patients in experimental group took part in the self- management education activity, the status of self-management education and depression were tested by Zung＇ S Depression self-rating scale （SDS） and Hamilton Depression Rating Scale （24, HAMD）, the self-management, depression, fasting plasma glucose （FPG）, postprandial 2 h blood glucose （2 h PG） were compared between the two groups after eight weeks later. Results The score of self-management, SDS, HAMD, fasting plasma glucose and postprandial 2 h blood glucose were similar between the two groups before intervention （ P 〉 0. 05 ）. After 8 weeks, the results of compliance of the self-management, manage of complications, SDS, HAMD, fasting plasma glucose, postprandial 2 h blood glucose were （ 1.77± 0.504）, （2.19 ± 0.588 ）, （29.3 ± 4.8）, （ 11.5 ± 6.9 ）, （ 5.3 ± 1.4） and （ 8.6 ±1.1 ） in experimental group, respectively; but were （ 1.32 ± 0.744）, （ 1.83 ± 0.590）, （36.5±5.4） ,（ 18.3 ±1.3）, （9.2±2. 1 ）, （ 11.1 ±2. 2） in control group, there were significantly different between the two groups （ t = 2. 813,3. 358,2. 91,2. 34,2. 65,2. 78 ; P 〈0. 01 ）. another four items of selfmanagement were obviously higher than in control group （ P 〈 0. 01 ）. Conclusions Self-management education can improve the patients＇ ability of self-management, it also can control the blood glucose level and improve the depression status, it is worthy of spreading in clinical.

关 键 词：糖尿病 抑郁症 健康教育 自我管理 

分 类 号：R473.5[医药卫生—护理学]