家属参与糖尿病教育管理临床分析  

Analysis of diabetes education and management with family member involvement

作　　者：于文[1] 董丽华[1] 孟丽珍[1] 韩静[1] 甄桂兰[1] 孙迎俊[1] 魏锋[1] 张栩[2] 

机构地区：[1]山东省滨州市人民医院内分泌科,256600 [2]山东省立医院内分泌科

出　　处：《中华糖尿病杂志》2013年第7期408-413,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：山东省医药卫生科技发展计划项目（2009HW058）;山东省科技发展计划优秀博士基金项目（2006BS03012）

摘　　要：目的 在医生、家属、患者、护士参与（MUST）的糖尿病教育模式研究基础上,观察不同家属与患者组合对糖尿病患者长期治疗依从性的影响.方法 选择2010年3至5月在山东省滨州市人民医院门诊就诊的居住于本市的2型糖尿病患者,按就诊顺序确定入选患者及其家属300对.按照不同的家属与患者关系分为妻管夫型、夫管妻型、晚辈管长辈型以及长辈管晚辈型4组.采用改良的Deborah糖尿病自我管理评价表进行24个月的患者依从性测定,分析依从性的影响因素.两组间均数比较采用独立样本t检验,多组均数比较采用方差分析.结果 家属中女性明显多于男性（60％比40％,x2=24.00,P＜0.05）,主要来源于妻管夫型组（31.0％）.各分组家属和患者年龄、家属主动联系次数和自愿参加糖尿病教育次数差异均有统计学意义（x2=61.18、107.77、35.45、44.79,均P ＜0.05）,其中最高的主动联系次数比例出现在妻管夫型（12.3％）,而主动联系医护人员的夫管妻型中的丈夫只有1.0％.家属主动参加糖尿病教育次数总体偏少,大部分为两年只参加了不到3次.24个月的观察期间,夫管妻型完全从医率呈持续上升趋势,各观察时期与观察前（33.9％）比较差异均有统计学意义（第6、12、18、24个月分别为60.3％、67.9％、70.9％、74.1％,x2=6.762、9.626、12.131、11.707,均P＜0.05）.晚辈管长辈型和妻管夫型完全从医率呈现上升并维持高平台趋势.长辈管晚辈患者完全从医率呈“∧”形分布.观察结束时,完全从医率以夫管妻型患者最高（74.1％）,其次为晚辈管长辈型（60.8％）、妻管夫型（48.3％）和长辈管晚辈型（29.0％）.所有患者的完全从医率为52.3％.以观察结束时完全从医为因变量分析影响因素显示,与患者完全从医相关的家属因素为性别、年龄、主动联系次数和分组（OR=3.593、0.251、2.734、0.692,均P＜0.05）.与患者Objective To explore the clinical regulation of diabetes education with family members involvement by comparing the influences of different types of family member/patient combination on the longterm therapeutic compliance of patients with type 2 diabetes mellitus. Methods Total of 300 voluntary pairs of patient-family member treated from March to May in 2010 were sampled and divided into 4 groups according to the relationships between patient and family member： wife supervising husband, husband supervising wife, younger supervising elder and elder supervising younger. The influencing factors on good therapeutic compliance were evaluated in different types of subjects combination after 24-month observation by means of the modified Deborah＇s diabetes knowledge, self-management skills and self-evaluation table established in previous study. The independent sample t test was implicated in data comparison between two groups and variance analysis in data comparison among groups. Results There were more female than male family members （60% vs 40% X2 = 24. 00, P 〈 0. 05 ）, and mainly from the group of wife supervising husband （31% ）. There were significant differences in age of patients and family members, number of active contacting by family members, voluntary participation in diabetic education of family members among the groups（X2 =61.18, 107.77, 35.45, 44. 79, all P 〈0. 05）. The active contacting came mainly from wives in group of wife supervising husband. Few family members voluntarily attended diabetes education program than expected with less than 3 times during 2 years of observation. Compared with that before observation （33.9%） , sustained rising trend of good therapeutic compliance in group of husband supervising wife was observed in following points of observation period （60. 3%, 67.9%, 70.9% , 74. 1% at the 6th, 12th, 18th, 24th months respectively, X2 = 6. 762, 9. 626, 12. 131, 11. 707, all P 〈 0.05 ）. Rising but keeping at relatively high level of the good compliance was obse

关 键 词：糖尿病 2型 糖尿病教育 患者依从性 家属 

分 类 号：R473.2[医药卫生—护理学]