2型糖尿病患者自我管理、饮食依从性、心理负担与血糖水平的相关研究  

Correlation of self-management,dietary compliance and psychological burden with glycemic level in patients with type 2 diabetes mellitus

作　　者：杨楠 贺圣文[1] 宋桂花[2] 王子兵 李艳杰 YANG Nan;HE Sheng-wen;SONG Gui-hua;WANG Zi-bing;LI Yan-jie(School of Public Health,Weifang Medical University,Weifang,Shandong 261053,China;The First Affiliated Hospital of Weifang Medical University,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053 [2]潍坊医学院第一附属医院,山东潍坊261053

出　　处：《实用预防医学》2021年第7期774-779,共6页Practical Preventive Medicine

基　　金：山东省自然科学基金资助课题(ZR2010HL058);潍坊市科技发展计划项目资助课题(2017YX043)。

摘　　要：目的了解2型糖尿病患者的自我管理知识态度行为、饮食依从性、心理负担的现状,探讨其与血糖水平之间的关联。方法采用随机抽样法选取2019年9月—2020年10月在潍坊市某三甲医院就诊的2型糖尿病患者330例为调查对象,应用一般资料调查表、人体指标检测表、糖尿病患者自我管理知识态度行为评价简化量表、糖尿病患者饮食行为依从性测评量表、糖尿病痛苦量表进行问卷调查,采用二元logistic回归分析自我管理、饮食依从性、心理负担的影响因素,应用Spearman相关分析自我管理、饮食依从性、心理负担的相关性,采用多重线性逐步回归分析血糖水平的影响因素。结果330例研究对象中HbA1c<7%者共99例(30.00%),自我管理合格、饮食依从性合格、略微心理负担者分别为184、189、150例(占比:55.76%、57.27%、45.45%)。二元logistic回归分析结果显示,居住地(OR=0.495,95%CI:0.280~0.874)、病程(OR=1.771,95%CI:1.421~2.206)、因糖尿病住院次数(OR=2.481,95%CI:1.396~4.408)、是否接受过专业系统宣教(OR=3.649,95%CI:1.239~10.751)、药物饮食运动联合控制(OR=4.354,95%CI:2.419~7.838)是自我管理的影响因素;年龄(OR=1.525,95%CI:1.119~2.078)、性别(OR=2.543,95%CI:1.465~4.415)、是否接受过专业系统宣教(OR=3.085,95%CI:1.368~6.960)、药物饮食运动联合控制(OR=11.910,95%CI:6.323~22.432)是饮食依从性的影响因素;年龄(OR=0.739,95%CI:0.559~0.979)、病程(OR=0.543,95%CI:0.449~0.657)是心理负担的影响因素。自我管理与饮食依从性、与心理负担,饮食依从性与心理负担相关(r=0.586、-0.443、-0.168,P<0.05)。多重线性逐步回归分析结果显示,饮食依从性、握力、药物饮食运动联合控制、心理负担是2型糖尿病患者血糖水平的影响因素(P<0.05)。结论2型糖尿病患者血糖水平与饮食依从性、心理负担、联合控制方式等密切相关;制定综合防控措施,着力提高饮食依从性,提升�Objective To understand the current status of knowledge,attitude and behavior about self-management,dietary compliance and psychological burden in patients with type 2 diabetes mellitus,and to explore their associations with glycemic level.Methods A random sampling method was used to select 330 patients with type 2 diabetes mellitus hospitalized in a grade-A tertiary hospital in Weifang City from September 2019 to October 2020 to serve as the research subjects.General information questionnaire,human index test table,Diabetes Self-management Knowledge,Attitude,and Behavior Assessment Scale,Dietary Behavior Compliance Scale and Diabetes Distress Scale were used to carry out questionnaire surveys.Binary logistic regression analysis was applied to identifying the factors influencing self-management,dietary compliance and psychological burden.Spearman correlation analysis was employed to analyze the correlation among self-management,dietary compliance,and psychological burden.Multiple linear stepwise regression analysis was conducted to analyze the factors affecting glycemic level.Results Among the 330 research subjects,there were 99(30.00%)cases with HbA1 c<7%,184(55.76%)cases with qualified self-management,189(57.27%)cases with qualified diet compliance and 150(45.45%)cases with slight psychological burden.Binary logistic regression analysis showed that residence(OR=0.495,95%CI:0.280-0.874),course of the disease(OR=1.771,95%CI:1.421-2.206),hospitalization frequency of diabetes(OR=2.481,95%CI:1.396-4.408),whether or not receiving professional systematic education(OR=3.649,95%CI:1.239-10.751)and combined control based on medicine,diet and exercise(OR=4.354,95%CI:2.419-7.838)were the factors influencing self-management.Age(OR=1.525,95%CI:1.119-2.078),gender(OR=2.543,95%CI:1.465-4.415),whether or not receiving professional systematic education(OR=3.085,95%CI:1.368-6.960)and combined control based on medicine,diet and exercise(OR=11.910,95%CI:6.323-22.432)were the factors influencing dietary compliance.Age(OR=0.739,95%CI

关 键 词：自我管理 饮食依从性 心理负担 血糖水平 

分 类 号：R587.1[医药卫生—内分泌]