共同照护门诊对2型糖尿病患者自我管理行为的影响  

Effect of co-care outpatient clinic on self-management behavior of type 2 diabetes patients

作　　者：符静 林琳[1] 张雪梅 刘佳[1] 王广[1] Fu Jing;Lin Lin;Zhang Xuemei;Liu Jia;Wang Guang(Department of Endocrinology,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京100020

出　　处：《中国临床保健杂志》2022年第2期184-189,共6页Chinese Journal of Clinical Healthcare

基　　金：上海市医药卫生发展基金会糖尿病临床研究项目(Ⅰ期05研究);北京市朝阳区科技计划项目(CYSF2110)。

摘　　要：目的探讨共同照护门诊对2型糖尿病患者血糖及自我管理行为的改善以及改善程度的影响。方法以2018年1月至2019年12月在北京朝阳医院内分泌科共同照护门诊规律就诊1年以上的2型糖尿病患者作为研究对象,收集每次随访的一般资料及糖化血红蛋白水平。在初诊及随访1年时,通过糖尿病自我管理行为量表6(SDSCA-6)评分来评估患者糖尿病自我管理能力,并采用广义线性模型分析干预前后患者自我管理总体和分量表行为改善程度。结果在接受共同照护门诊为期1年的照护和治疗后,患者的糖化血红蛋白水平较基线显著降低(7.49%±1.48%比6.70%±0.93%,P<0.001),糖化血红蛋白和LDL-C达标率均明显提高(分别为40.32%比65.32%,P<0.001;42.74%比55.65%,P=0.042)。干预后,SDSCA-6总分及其中关于运动和自我监测血糖的评分较基线升高(P值均<0.001),而胰岛素的使用可显著提高患者整体自我管理水平(β=1.150,P=0.015)。结论共同照护门诊不仅能改善患者血糖、血脂的控制,也能改善糖尿病患者的自我管理行为。Objective To explore the improvement of glycemic and self-management behavior of type 2 diabetes patients in co-care outpatient department and the influencing factors of the improvement degree.Methods Patients with type 2 diabetes who regularly visited the joint care Clinic of Endocrinology Department of Beijing Chaoyang Hospital for more than 1 year from January 2018 to December 2019 were selected as subjects.General information and HbA1c level of each follow-up visit were collected.Changes in self-management ability of patients with diabetes were assessed by sdSCA-6 score at initial diagnosis and 1 year follow-up,and factors influencing the improvement of overall self-management and subscale behavior were analyzed by generalized linear model before and after intervention.Results After one-year diabetes shared care,the HbA1c level of patients showed a significant decrease(7.49%±1.48%vs.6.70%±0.93%,P<0.001),and their HbA1c and LDL-C compliance rates were significantly higher(40.32%vs.65.32%,P<0.001;42.74%vs.55.65%,P=0.042,respectively).After the intervention,total SDSCA-6 scores,as well as exercise and self-monitored glucose scores,were higher than baseline(all P<0.001),while insulin use significantly improved overall self-management(β=1.150,P=0.015).Conclusions The co-care clinic can not only improve the control level of blood glucose and lipids,but also improve the self-management behavior of patients with diabetes.

关 键 词：糖尿病 2型 自我管理 血糖自我监测 运动疗法 健康促进 

分 类 号：R47[医药卫生—护理学]