家庭照顾责任对2型糖尿病患者自我管理行为的影响研究--快乐生活俱乐部^(TM)项目成果报告  

The Influence of Family Responsibility on the Self- management Behavior of Patients With Type 2 Diabetes Mellitus——The Happy Life Club^(TM)

作　　者：刘硕[1] 杨辉 Colette Browning Shane Thomas 张拓红[1] 

机构地区：[1]北京大学公共卫生学院,北京市100191 [2]VIC3168澳大利亚维多利亚州、Monash大学初级卫生保健学院 [3]VIC3182澳大利亚维多利亚州、皇家颐养中心研究所 [4]SA5005澳大利亚南澳大利亚州、阿德莱德大学

出　　处：《中国全科医学》2015年第13期1477-1482,共6页Chinese General Practice

基　　金：丰台区政府;丰台区卫生局社区卫生服务管理中心;参与本研究的10家社区卫生服务中心

摘　　要：目的探讨在中国传统文化背景下,家庭照顾责任对2型糖尿病患者自我管理行为的影响。方法采用社会学研究方法,对北京市丰台区10家社区卫生服务中心参与快乐生活俱乐部TM的33名2型糖尿病患者进行半结构个人深入访谈。结果中国的2型糖尿病患者的自我管理行为受到了传统中国文化背景下家庭照顾责任的影响,包括来自于代际间照顾责任和女性照顾者责任的消极影响。但照顾责任也有可能对患者的疾病管理产生积极影响。在中国传统文化背景下,代际照顾责任对2型糖尿病患者的自我管理行为产生消极影响;在女性患者中,代际间照顾责任的负面影响更明显。不过随着社会文化和社会经济的变迁,家庭照顾责任也处于变化之中,在利他基础上的利己主义可以对自我管理行为产生积极影响。结论传统文化中的家庭照顾责任对患者的自我管理行为产生消极影响,且该传统的演变对个体行为可以产生多样化影响。建议初级卫生保健专业人员在帮助患者改变行为时,基于全科医学以患者为中心的原则,运用照顾整体人和富于同理心的技术,充分考虑患者的社会文化因素影响,从而达到提高患者自我管理能力、健康水平以及改善生活质量的目的。Objective To explore the positive and/or negative effects of Chinese cultural related family responsibility on Chinese type 2 diabetes mellitus（T2DM）patients in their chronic disease self-management. Methods A qualitative method was applied in the Happy Life ClubTM a community-based research program of chronic disease management. Thirty three T2DM patients of 10 community health centres of Fengtai District of Beijing were participated in in-depth semi-structured individual interviews. Results The study findings illustrated that self-management behaviors among Chinese T2DM patients are affected by tradition of family responsibility under Chinese culture and social norm. Specifically,intergenerational carer role among family members displays negative influence on self-management,as the traditional role has conflicts of interest among giving,receiving and self-caring. The negative impact on self -management is more evident among female patients. However the tradition of family responsibility has changed along with sociocultural and socioeconomic transitions. Self - management could be a presentation of individual effect on base of altruism. The changes will present multifaceted influence on behaviours of chronic disease self- management. Conclusion Based on the findings, Authors concluded the family responsibility under Chinese cultural have both related promotion factors and barriers of T2DM patients in their chronic disease management. The influence is also dynamic. When helping patients to manage their T2DM and other chronic conditions,primary health care professionals should consider the sociocultural factors in forming self - management plan. Cultural sensitive advices and guides should be provided in general practice consultation. The holistic and empathetic approach under general practice patient-centred principle is essential of empowering effective self-management and further impact on patient＇s health and wellbeing.

关 键 词：糖尿病 2型 自我管理 文化 代际关系 家庭责任 

分 类 号：R197[医药卫生—卫生事业管理] R587.1[医药卫生—公共卫生与预防医学]