团体认知行为干预对2型糖尿病患者血糖和自我管理水平的影响研究  

Effect of group cognitive behavioral interventions on blood glucose and self-management levels in patients with type 2 diabetes

作　　者：金戈 董宗美 娄荷清 朱娟[1] 张盼[2] 王琦 乔程[2] 李婷[2] 朱璇 JIN Ge;DONG Zong-mei;LOU He-qing;ZHU Juan;ZHANG Pan;WANG Qi;QIAO Cheng;LI Ting;ZHU Xuan(Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院,江苏徐州221009 [2]徐州市疾病预防控制中心

出　　处：《中国校医》2022年第12期884-888,896,共6页Chinese Journal of School Doctor

基　　金：徐州市卫健委青年医学科技创新项目(XWKYHT20200030)。

摘　　要：目的探讨团体认知行为干预对2型糖尿病患者的自我管理行为及血糖的影响。方法944例患者以社区为单位随机分配到研究组和对照组。对照组开展常规随访,研究组在常规随访的基础上开展团体认知行为干预。比较3个月后研究组和对照组自我管理能力、糖化血红蛋白的差异。用密西根糖尿病自我管理评定量表(DCP)评估干预前后糖尿病患者的自我管理水平。干预前后2组自身情况比较采用重复测量方差分析;干预后的组间比较采用混合效应线性模型。结果干预后,研究组HbAlc值较干预前下降,差异有统计学意义[(7.97±1.92)%vs(7.25±1.39)%;F=45.673,P<0.001],而对照组干预前后HbAlc值差异无统计学意义[(7.92±1.77)%vs(7.68±1.93)%;F=3.691,P=0.055]。干预前后2组自身比较,研究组除患者自我管理的坚持性因子得分差异无统计学意义之外(P=0.618),其他9个自我管理水平因子均较干预前有所提高(P值均<0.05),对照组患者仅药物治疗问题、运动锻炼、病情控制、糖尿病知识理解自评和对疾病的态度5个因子得分较干预前有所提高(P均<0.001);干预后,研究组的自我管理能力、饮食的依从性、病情控制问题和糖尿病知识的掌握程度均优于对照组(P<0.05)。结论团体认知行为干预可以提高患者的自我管理能力,改善患者的血糖水平。Objective To investigate the effects of group cognitive behavioral interventions on self-management behavior and blood glucose in patients with type 2 diabetes.Methods A total of 944 patients were randomly assigned to a study group and a control group in the community.The control group carried out the routine follow-up,and the study group carried out group cognitive behavioral interventions on the basis of the routine follow-up.The differences in self-management ability and glycated hemoglobin(HbAlc)between the study group and the control group after 3 months were compared.The Michigan Diabetes Self-Management Rating Scale(DCP)was used to assess the level of self-management in people with diabetes before and after the intervention.Repeated measurement ANOVA was used to compare the two groups before and after the intervention.Mixed-effects linear models were used for post-intervention comparisons between the two groups.Results After the intervention,the HbAlc value in the study group decreased compared with that before the intervention,and the difference was statistically significant:(7.97±1.92)%vs(7.25±1.39)%.F=45.673,P<0.001,but there was no significant difference in HbAlc values before and after the intervention in the control group:(7.92±1.77)%vs(7.68±1.93)%.F=3.691,P=0.055.Compared with the two groups before and after the intervention,except for the non-significant difference in the scores of adherence factors of self-management in the study group(P=0.618),the other nine self-management level factors were improved compared with those before the intervention(P value<0.05).The scores of the five factors of drug treatment,exercise,disease control,diabetes knowledge understanding,and attitude towards disease were improved in the control group compared with those before the intervention(P value<0.001).After the intervention,the self-management ability,dietary compliance,disease control problems,and diabetes knowledge of the study group were better than those of the control group(P<0.05).Conclusion Group cognit

关 键 词：2型糖尿病 团体认知行为干预 自我管理水平 

分 类 号：G479[文化科学—教育学]