认知行为疗法对类固醇性糖尿病患者低血糖恐惧感及自我管理行为的影响  

Effect of cognitive-behavioral therapy on fear of hypoglycemia and self-management behavior in patients with steroid diabetes mellitus

作　　者：赵晓茜[1] 胡雁 濮益琴[1] 范磊[1] Zhao Xiaoqian;Hu Yan;Pu Yiqin;Fan Lei(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院血液科,210029

出　　处：《中国实用护理杂志》2021年第31期2425-2431,共7页Chinese Journal of Practical Nursing

摘　　要：目的探讨认知行为疗法对类固醇性糖尿病患者低血糖恐惧感及自我管理行为的影响,为临床提供参考。方法将2018年8月至2019年10月南京医科大学第一附属医院收治的76例类固醇性糖尿病患者按照入组时间分为试验组和对照组,每组38例。对照组给予常规护理干预,试验组在常规护理干预基础上实施为期8周的认知行为疗法。干预前和干预8周后,采用中文版低血糖恐惧调查-忧虑量表(CHFSⅡ-WS)和糖尿病自我管理行为量表(SDSCA)评价2组干预效果。结果2组干预前的CHFSⅡ-WS、SDSCA评分比较差异无统计学意义(P>0.05)。干预8周后,试验组担忧畏惧得分、CHFSⅡ-WS总分为(6.61±1.66)、(8.75±1.73)分,低于对照组的(7.60±1.44)、(9.69±1.77)分,差异有统计学意义(t值为2.678、2.247,P<0.05);试验组SDSCA中的饮食行为、运动行为、血糖监测行为、用药行为得分分别为(20.36±1.91)、(11.86±2.27)、(7.19±1.56)、(6.86±0.99)分,高于对照组的(18.51±1.50)、(9.89±2.29)、(5.71±1.45)、(5.31±1.18)分,差异有统计学意义(t值为3.644~5.983,P<0.05)。结论认知行为疗法能缓解类固醇性糖尿病患者低血糖恐惧,提升患者自我管理行为。Objective To explore the effect of cognitive-behavioral therapy on fear of hypoglycemia and self-management behavior of patients with steroid diabetes mellitus.Methods A total of 76 patients with steroid diabetes mellitus from August 2018 to October 2019 in the First Affilated Hospital of Nanjing Medical University were selected and divided into experimental group and control group according to the admission time,and each group contained 38 cases.The control group recieved routine therapy and nursing care,on the basis of this,the experimental group was given cognitive-behavioral therapy for 8 weeks.Before and after 8 weeks of intervention,the effects were assessed by Chinese version Hypoglycemia Fear Surgey-Worry Scale(CHFSⅡ-WS)and Sumary of Diabetes Self Care Activities(SDSCA),respectively.Results There was no significant difference in the score of CHFSⅡ-WS,SDSCA before intervention between the two groups(P>0.05).After 8 weeks of intervention,the scores of worry&fear and total CHFSⅡ-WS scores were(6.61±1.66),(8.75±1.73)points in the experimental group and(7.60±1.44),(9.69±1.77)points in the control group,the differences were statistically significant(t values were 2.678,2.247,P<0.05);in addition,the scores of diet,exercise,blood sugar testing,medications in SDSCA were(20.36±1.91),(11.86±2.27),(7.19±1.56),(6.86±0.99)points in the experimental group,and(18.51±1.50),(9.89±2.29),(5.71±1.45),(5.31±1.18)points in the control group,the differences were statistically significant(t values were 3.644-5.983,P<0.05).Conclusions Cognitive-behavioral therapy can effectively alliviate fear of hypoglycemia and promote self-management behavior of steroid diabetes mellitus patients.

关 键 词：认知行为疗法 类固醇性糖尿病 低血糖恐惧 自我管理行为 

分 类 号：R473.5[医药卫生—护理学]