广州市社区2型糖尿病自我管理小组活动对患者自我效能的影响  

Effect of Community-based health self-management group activities on Self-efficacy in patients with type 2 diabetes in Guangzhou

作　　者：潘冰莹[1] 阮慧红 何国鹏 陈雄飞[1] 吴雪霁[1,4] 刘览 PAN Bing-ying;RUAN Hui-hong;HE Guo-peng;CHEN Xiong-fei;WU Xue-ji;LIU Lan(Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,Guangdong Province,China;Station for Chronic Disease Control and Prevention of Panyu District,Guangzhou 511400,Guangdong Province,China;Nansha Center for Disease Control and Prevention,Guangzhou 511458,Guangdong Province,China;Institute of Public Health,Guangzhou Medical Universityy Guangzhou 511436,Guangdong Province,China)

机构地区：[1]广州市疾病预防控制中心,广州510440 [2]广州市番禺区慢性病防治站,广州510440 [3]广州市南沙区疾病预防控制中心,广州511458 [4]广州医科大学公共卫生研究院,广州511436

出　　处：《预防医学情报杂志》2022年第3期353-358,共6页Journal of Preventive Medicine Information

基　　金：广州市医药卫生科技项目(项目编号:20151A011053);广州市卫生健康科技项目(项目编号:20201A011060);广州市医学重点学科建设项目(项目编号:No.2021-2023-12);广州市重点实验室基础研究计划项目(项目编号:2021BRP004)。

摘　　要：目的探讨社区自我管理小组活动对社区2型糖尿病患者自我效能的影响。方法 2018-08/2019-03在广州市11个区各选取1家社区卫生服务中心作为研究现场,每个中心分别招募12~15名确诊2型糖尿病患者作为干预组,同时招募与干预组年龄差±2岁、同性别、确诊2型糖尿病患者作为对照组。干预组参与自我管理小组活动,对照组不参加。在干预前和干预后1年对所有研究对象进行基本情况和糖尿病自我效能量表调查,分析干预对患者自我效能的影响。结果干预1年后,干预组自我效能各维度得分最高的为药物使用自我效能(86.67±19.89)分,得分最低的为运动自我效能(69.30±26.41)分,提升幅度最大的为足部护理自我效能(中位数8.00分);干预组总自我管理效能、饮食自我效能、药物使用自我效能、血糖监测自我效能、足部护理自我效能得分提升幅度均高于对照组(P=0.002、0.012、0.031、0.002、0.001);多因素分析显示,基线总自我效能得分低(β=-0.387,P<0.001)、病程≥7年(β=4.059,P=0.009)及干预组(β=4.528,P=0.001)的总自我管理效能得分增长更多。结论社区自我管理小组活动可提升2型糖尿病患者的自我效能,在糖尿病健康教育中需更强调非药物治疗的重要性。Objective To evaluate the impact of community-based health self-management group activities on self-efficacy in patients with type 2 diabetes. Methods From August 2018 to March2019, one community healthcare center in each of 11 districts in Guangzhou was selected as the study site, and 12-15 patients diagnosed with type 2 diabetes were recruited as the intervention group in each study site. Patients with age difference of ±2 years from the intervention group,with the same gender and also diagnosed with type 2 diabetes were recruited as the control group at the same time. The intervention group participated in self-management group activities,while the control group did not. One year before and after the intervention, all the subjects were investigated with the basic information and diabetes self-efficacy scale to analyze the effect of the intervention on patients′ self-efficacy. Results After one year of the intervention,the highest score of self-efficacy of the intervention group in all dimensions was drug use(86.67 ± 19.89);the lowest score was exercise(69.30 ± 26.41);and the biggest improvement was foot care(median 8.00). The improvement of total self-management efficacy, diet, drug use, blood glucose monitoring and foot care self-efficacy of the intervention group were higher than those of the control group(P=0.002,0.012, 0.031, 0.002, 0.001, respectively). Multiple linear regression analysis showed that the lower baseline total self-efficacy score (β =-0.387, P<0.001), longer duration of disease (β =4.059,P=0.009) and intervention group (β=4.528,P<0.001) had a bigger improvement in total self-efficacy score. Conclusions The community-based health self-management group activities could effectively improve the self-efficacy of patients with type 2 diabetes. The importance of non-drug treatment should be emphasized in diabetes health education.

关 键 词：糖尿病 社区 自我管理 自我效能 

分 类 号：R587.1[医药卫生—内分泌] R181.3[医药卫生—内科学]