社区糖尿病患者获得社会支持与自我管理行为的相关关系  

Association between social support and self-management behaviors among patients with diabetes in community

作　　者：张旭熙 吴士艳 王冯彬[1,2] 玛依努尔·于苏甫 孙凯歌[1] 胡康[1] 张幸[1] 孙昕霙[1] Edwin B·FISHER 

机构地区：[1]北京大学公共卫生学院社会医学与健康教育学系,北京100191 [2]北京市卫生和计划生育委员会科教处,北京100053 [3]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科研究所,北京市眼科学与视觉科学重点实验室,北京100730 [4]University of North Carolina-Chapel Hill,Chapel Hill,NC27599-7440,US

出　　处：《北京大学学报（医学版）》2017年第3期455-461,共7页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(71673009)资助~~

摘　　要：目的:探讨中国社区糖尿病患者从家人或朋友获得直接支持和间接支持的现状,以及患者获得的直接支持与间接支持水平与其自我管理行为的相关关系。方法:研究对象的数据来自"北京市通州区社区诊断(2015)"专项调查,对符合要求的474名社区糖尿病患者进行问卷调查、体格检查和糖化血红蛋白(glycated hemoglobin,Hb A1c)测量。应用糖尿病自我管理行为量表(the summary of diabetes self-care activities measure,SDSCA)对自我管理行为进行测量,应用糖尿病直接支持和间接支持量表(directive and nondirective support scale among patients with diabetes,DNSS-PD)对直接支持和间接支持水平进行测量,分析患者获得的直接支持与间接支持水平与其自我管理行为的相关关系。结果:共有452名患者纳入分析,患者获得的直接支持实际情况平均得分为2.53±1.07,27.6%患者获得的直接支持水平较高。患者获得的间接支持实际情况平均得分为3.13±1.12,50.8%患者获得的间接支持水平较高。患者SDSCA平均总得分为35.38±14.21,得分率为45.95%,仅20.6%患者自我管理的总体情况较好。直接支持水平高组患者的SDSCA平均总得分、饮食和运动维度得分、自我管理总体情况、饮食和运动维度自我管理情况显著优于直接支持水平低组。间接支持水平高组患者的SDSCA平均总得分,饮食、运动、血糖监测、足部护理、吸烟维度得分,自我管理总体情况,饮食、运动、血糖监测、足部护理以及吸烟维度自我管理情况均显著优于间接支持水平低组。性别(OR=2.729)、间接支持水平(OR=4.890)、年龄(OR=0.969)和体质指数(body msss index,BMI)(OR=0.819)是自我管理行为的重要影响因素。结论:社区糖尿病患者的自我管理情况不太理想,患者获得的间接支持水平高于直接支持水平,但均有待提升。间接支持和间接支持水平高均与糖尿病患者较好的自我管理行为相关,间Objective: To study the status quo of directive and nondirective support from family or friends among patients with diabetes in community and to explore the association between directive,nondirective support from family or friends and self-management behaviors. Methods: The data of the subjects were from the 'Community Diagnosis in Tongzhou District,Beijing'survey. Questionnaire-based investigation,physical examination and glycated hemoglobin test were conducted on 474 eligible patients in community. The summary of diabetes self-care activities measure( SDSCA) was adopted to investigate the self-management behaviors,and directive and nondirective support scale among patients with diabetes( DNSS-PD) was adopted to measure the directive and nondirective support among patients with diabetes.Results: A total of 452 patients with diabetes were included in the analysis. The average score of directive support was 2. 53 ± 1. 07,and only 27. 6% patients had high level directive support. The average score of nondirective support was 3. 13 ± 1. 12 and 50. 8% patients had high level nondirective support.The average SDSCA total score was 35. 38 ± 14. 21 and the corresponding scoring percentage was45. 95%. Only 20. 6% patients had optimal self-management. The total score,score of diet and physical activity,general self-management situation,diet self-management situation and physical activity selfmanagement situation of the patients in high level directive support group were significantly better than in low level directive support group. The total score,score of self-management behaviors in five aspects( diet,physical activity,blood glucose self-monitoring,foot care and smoking),general self-management situation,self-management situation of five aspects of patients in high level nondirective support group were significantly better than in low level nondirective support group. Gender( OR = 2. 729),nondirective support level( OR = 4. 890),age( OR = 0. 969) and body mass index( BMI)( OR = 0. 819) were important influencing fact

关 键 词：糖尿病 社会支持 自我管理 

分 类 号：R193[医药卫生—卫生事业管理]