成人初显期1型糖尿病患者社交回避与苦恼现状及其与自我管理水平和血糖控制的相关性  

Status of social avoidance and distress in emerging adults with Type 1 diabetes mellitus and its association with self-management and glycemic control

作　　者：刘芳[1,2] 李乐之[2] 徐蓉[1,2] 李霞[1] 谢雨婷[1] 张慧琳[2] LIU Fang;LI Lezhi;XU Rong;LI Xia;XIE Yuting;ZHANG Huilin(National Clinical Research Center for Metabolic Diseases,Department of Metabolism and Endocrinology,Second Xiangya Hospital,Central South University,Changsha 410011;Teaching and Research Section of Clinical Nursing,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院代谢内分泌科,国家代谢性疾病临床医学研究中心,长沙410011 [2]中南大学湘雅二医院临床护理教研室,长沙410011

出　　处：《中南大学学报（医学版）》2020年第7期834-839,共6页Journal of Central South University ：Medical Science

摘　　要：目的:1型糖尿病(Type 1 diabetes mellitus,T1DM)患者在成人初显期由于害怕和回避社交活动导致学习与锻炼的机会减少,学习、工作能力下降,社会支持程度减低。本研究旨在了解成人初显期T1DM患者社交回避与苦恼的现状,并探讨社交回避与苦恼和患者自我管理水平、血糖控制的相关性。方法:选取2014年9月至2019年2月在湖南省8所三级甲等医院门诊和住院部就诊的342例18~30岁的T1DM患者,采用一般资料问卷、社交回避与苦恼量表、成人T1DM自我管理量表进行问卷调查,将成人初显期T1DM患者社交回避与苦恼总分与常模总分进行比较;比较成人初显期T1DM患者社交回避与苦恼和糖化血红蛋白的相关性。结果:成人初显期T1DM患者社交回避与苦恼总分为11.13±6.18,显著高于健康常模(t=77.06,P<0.01);Pearson相关分析显示患者社交回避与苦恼总分、社交回避分量表得分、社交苦恼分量表得分均与成人T1DM自我管理量表得分呈负相关(均P<0.01),与患者的糖化血红蛋白水平呈正相关(均P<0.01);多元线性回归分析显示社交回避与苦恼、自我管理水平、性别、文化程度是成人初显期T1DM患者糖化血红蛋白的独立影响因素。结论:成人初显期T1DM患者社交回避与苦恼程度高于中国健康人群。患者社交回避与苦恼越严重,其自我管理水平越低,血糖控制越差。未来应关注成人初显期T1DM患者的社交回避与苦恼现象,并制订针对性干预措施。Objective:Emerging adult patients with Type 1 diabetes mellitus(T1DM)appear to have a reduced opportunities on learning and exercise,a decreased skill in learning and work,a lower degree of social support due to fear and avoidance of social interaction.This study aimed to assess the level of social avoidance and distress in emerging adults with T1DM,and to explore the correlation between social avoidance and distress and self-management or glycemic control.Methods:A total of 342 T1DM patients aged 18-30 years old were recruited from 8 tertiary hospitals in Hunan Province from September 2014 to February 2019.The questionnaire included general information questionnaire,the Social Avoidance and Distress Scale(SAD),and Self-management Scale of Type 1 Diabetes for Chinese Adults(SMOD-CA).The total scores of SAD in emerging adult patients with T1DM were compared with those of norm.Correlation between glycated hemoglobin(Hb A1 c)and social avoidance and distress of emerging adult patients with T1DM was analyzed.Results:The total score of SAD(11.13±6.18)in emerging adults with T1DM was significantly higher than that in healthy adults(t=77.06,P<0.01).Pearson correlation analysis showed that the scores of SAD,social avoidance subscale,and social distress subscale were negatively correlated with the scores of SMOD-CA(all P<0.01),and they were positively correlated with Hb A1 c(all P<0.01).Multivariate linear regression analysis showed that social avoidance and distress,self-management,gender,and educational level were independent influential factors for Hb A1 c in emerging adults with T1DM.Conclusion:The degree of social avoidance and distress of emerging adult patients with T1DM is higher than that of healthy people.The higher the degree of social avoidance and distress,the lower the level of self-management and the worse the control of blood sugar.Attention should be paid to social avoidance and distress in emerging adults with T1DM,and targeted interventions should be formulated.

关 键 词：1型糖尿病 成人初显期 社交回避 社交苦恼 自我管理 血糖控制 

分 类 号：R473.5[医药卫生—护理学]