糖尿病患者健康素养与健康管理的关系  

Association of health literacy with health management among diabetics

作　　者：曾庆奇[1] 蒋莹[1] 袁雁飞[2] 温秀芹[3] 孙亚慧[4] 田丁[5] 王潇怀[6] 常春[1] 

机构地区：[1]北京大学公共卫生学院社会医学与健康教育系,100191 [2]中国疾病预防控制中心政策研究与健康传播中心 [3]北京市西城区德胜社区卫生服务中心 [4]北京市海淀区北京交通大学社区卫生服务中心 [5]厦门市疾病预防控制中心健康教育所 [6]宁波市疾病预防控制中心健康教育所

出　　处：《中华预防医学杂志》2014年第8期715-719,共5页Chinese Journal of Preventive Medicine

基　　金：高等学校博士学科点专项科研基金（20110001110018）

摘　　要：目的 了解城市糖尿病患者的健康素养水平和糖尿病健康管理情况,分析健康素养与糖尿病患者健康管理的关系.方法 于2012年10-11月,按照两阶段整群随机抽样原则,在北京、宁波、厦门市调查了1 130例糖尿病患者.纳入标准为被当地一级及以上医院诊断为糖尿病的患者,排除标准为存在视力障碍、认知障碍、严重疾病、人户分离等情况而无法接受调查的糖尿病患者.本次调查共发放问卷1 130份,回收有效问卷1 083份,有效率96.87％.用多元logistic回归模型,分析健康素养与糖尿病健康管理行为和血糖控制水平的关联.结果 1 083例糖尿病患者中,男性为517例,占47.7％,女性为566例,占52.3％,年龄为（67.0±9.5）岁.73.7％（798/1 083）糖尿病患者为低健康素养水平,26.1％（283/1 083）为基本健康素养水平.健康素养与糖尿病患者管理行为独立关联,具备基本健康素养的患者接受健康教育、进行免费体检、接受生活方式指导、自我监测血糖、每周至少监测1次血糖、遵照医嘱使用降糖药的概率分别是低健康素养患者的1.40（95％ CI：1.03 ～1.91）、1.65（95％CI：1.19 ～2.28）、2.70（95％ CI：1.98 ～ 3.69）、2.05（95％CI：1.34～3.15）、2.56（95％CI：1.85 ～ 3.56）、1.484（95％CI：1.07～2.06）倍（P值均＜0.05）.结论 健康素养水平可能会影响糖尿病患者健康管理的相关行为,建议更多开展旨在提高患者健康素养水平的活动,并加强对低健康素养者糖尿病管理的技能培训.Objective To understand status of health literacy among diabetics and their health management behaviors,and analyze the relationship of health literacy and health management.Methods A two-staged cluster randomized sampling method was used to investigate 1 130 diabetics in Beijing,Ningbo and Xiamen from October to November in 2012.All participants should be diagnosed by primary hospital and above and have lived in the community over six months.Diabetic patients who indicated that they had severely impaired vision or cognitive disorder,or had severe physical deterioration,or did not live in the address provided were excluded.A total of 1 130 questionnaires were sent out and 1 083 eligible questionnaires were taken back,accounting for 96.87%.Multivariate logistic regression was adopted to analyze the association between health literacy and health management behaviors and blood glucose level.Results Among those participants,47.7% （517） were men,52.3% （566） were women,the age was （67.0 ±-9.5）.According to diabetes health literacy scores,73.7% （798/1 083） of them were classified as poor health literacy and 26.1% （283/1 083） as essential health literacy.Health literacy was associated with health management behaviors independently,demonstrating that the probability of utilizing health education,free physical examination,lifestyle guidance,monitoring blood glucose on their own,measuring blood glucose more than once a week and taking hypoglycemic agent regularly among diabetics with essential health literacy were 1.40（95% CI：1.03-1.91）,1.65 （95% CI：1.19-2.28）,2.70（95% CI：1.98-3.69）,2.05 （95% CI：1.34-3.15）,2.56 （95% CI：1.85-3.56）,1.48 （95% CI：1.07-2.06） times of those in diabetics with poor health literacy （P 〈 0.05）.Conclusion Health literacy may affect health management behaviors among diabetics.More activities targeted on diabetics with low health literacy were suggested to improve their＇ health literacy and their skills about diabetes mellitus management.

关 键 词：健康素养 糖尿病 健康教育 健康管理 

分 类 号：R587.1[医药卫生—内分泌]