社区糖尿病前期人群对健康行为干预的依从性及影响因素研究  

Compliance and influencing factors of health behavior intervention among community people with prediabetes

作　　者：段明香 莫明露 王太武[1] 熊鸿燕[1] 

机构地区：[1]第三军医大学军事预防医学院军队流行病学教研室,重庆400038

出　　处：《第三军医大学学报》2017年第13期1404-1409,共6页Journal of Third Military Medical University

基　　金：重庆市卫生和计划生育委员会资助项目(20141027)~~

摘　　要：目的分析社区糖尿病前期人群对健康行为干预的依从性及影响因素。方法以285人重庆社区糖尿病前期患者为对象,进行行为干预。通过定量和定性研究观察其1年后行为依从性程度、干预效果及依从性的正性和负性影响因素。结果被干预1年后,258人(92%)完成干预过程及追踪。其中,高度依从组116人(45%),中度依从组有101人(39%),低度依从组有41人(16%);125人(48.45%)血糖转归为正常。其中高度依从组69人(59.48%),中度依从组47人(46.53%),低度依从组9人(21.95%)。各组间血糖转归频率的差异具有统计学意义(χ~2=19.067,P<0.001)。多因素Logistics回归分析显示年龄、职业状态与依从性有关联(P<0.05);定性研究的结果显示,干预对象的自我健康意识强、干预平台的团队归属感以及干预信息的力度(权威性、先进性、发布频率)是促进依从性的主要因素;而对干预任务的认识不明确,缺乏耐心、不利的环境因素、短视行为是依从性的负性因素。结论行为干预的依从性是干预效果的重要环节;结合社区人群的特点,注重主观健康意识建立、增强自身管理能力、增加干预项目的团队趣味性活动是值得进一步探索的提高社区人群依从性的措施。Objective To analyze the compliance and influencing factors of health behavior intervention in the community people with prediabetes. Methods A total of 285 prediabetes from communities of Chongqing were selected as the subjects. The behavioral intervention was conducted. The behavioral compliance, intervention effect and influencing factors were observed by quantitative and qualitative analysis in 1 year later. Results In 1 year after intervention, 258 subjects （92%） completed the process of intervention and follow-up. Among them, 116 （45%） were assigned into the high compliance group, 101 （39%） into the moderate compliance group and 41 （16%） into the poor compliance group. In all the subjects, 125 patients （48.45%） had the blood glucose to normal level, including 69 （59.48%） from the high compliance group, 47 （46.53%） from the moderate compliance group, and 9 （21.95%） from the poor compliance group. Significant difference was seen in the rate of normal blood glucose between the groups （ Chi square = 19. 067, P 〈 0. 001 ）. Multivariate logistic regression analysis showed that age and state of occupation were associated with compliance （P 〈 0. 05 ）. Qualitative study results indicated that strong self-awareness for health, sense of belonging to the team, and power of the intervention message （authority, advanced and frequency） were the main factors to promote compliance; and unclear awareness of intervention task, lack of patience, adverse environmental factors and short-sighted behavior were the negative factors of compliance.Conclusion The compliance play an important role in the efficacy of behavior intervention. According to the characteristics of the community people, to enhance the awareness for health, self management ability, and interesting team activities are important measures which worthy of further exploration to improve the compliance of community people.

关 键 词：糖尿病前期 依从性 行为干预 影响因素 

分 类 号：R181.37[医药卫生—流行病学] R492[医药卫生—公共卫生与预防医学]