家庭风险认知教育对社区2型糖尿病患者服药依从性干预效果评价  

Effect of family-based risk perception health education intervention on medication compliance among type 2 diabetes mellitus patients with poor glucose control level

作　　者：冯钰珩 励晓红[1,2,3] 顾敏敏 赵雨曦 毛淋淇 袁红 朱添忆[1] 吕军 FENG Yu-heng;LI Xiao-hong;GU Min-min;ZHAO Yu-xi;MAO Lin-qi;YUAN Hong;ZHU Tian-yi;LU Jun(School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]复旦大学中国残疾问题研究中心,上海200032 [3]国民健康社会风险预警协同创新中心,上海200032 [4]上海市菊园新区社区卫生服务中心,上海201899 [5]上海市嘉定区疾病预防控制中心,上海201800

出　　处：《中国健康教育》2023年第10期890-896,共7页Chinese Journal of Health Education

基　　金：国家自然科学基金(72274036,71573049);国家社会科学重大项目(17ZDA078)。

摘　　要：目的 了解社区血糖控制不佳2型糖尿病患者的服药依从性情况,评价针对服药依从性的家庭风险认知教育效果。方法 结合防治指南与健康管理规范及健康行为相关理论研制家庭风险认知教育干预方案。于2019年3月—2020年3月选取上海市嘉定区中心城区下辖10个社会卫生服务站内228对血糖控制不佳的2型糖尿病患者及其家属,并随机均衡分为干预组和对照组。干预组进行3个月健康教育和9个月随访,对照组接受常规照护和9个月随访,基线情况于2019年2月1—28日在招募入组的研究对象进行调查,终末数据于2020年3月1—7日对完成干预的研究对象进行调查。干预前后使用含风险认知、家庭支持、服药依从性测量的问卷进行调查。结果 干预结束,共225对患者及家属完成随访,干预组服药依从性得分从(6.36±1.70)分上升至(6.79±1.55)分(t=2.373,P=0.019),服药依从性水平由一般上升为好(Z=2.487,P=0.013)。干预前后对照组患者服药依从性得分和水平比较,差异无统计学意义(P>0.05)。基线和终末患者服药依从性得分和水平的组间比较,差异均无统计学意义(P均>0.05)。倍差法结果显示,家庭风险认知教育可提升患者服药依从性(β=0.371,95%CI:0.002~0.740)、风险知识(β=0.874,95%CI:0.346~1.401)、个人风险控制(β=0.253,95%CI:0.112~0.393)、担心(β=0.235,95%CI:0.007~0.463)、正向支持(β=5.773,95%CI:3.330~8.216),P均<0.05。结论 针对血糖控制不佳的2型糖尿病患者家属进行家庭风险认知教育,可有效改善患者服药依从性,但效果有限。Objective To investigate the situation of medication compliance among type 2 diabetes mellitus(T2DM)patients with poor glucose control level,and to evaluate the effect of family-based risk perception health education intervention and on medication compliance.Methods The intervention program was developed and combined with health-behavior-related theories and the prevention guidelines of T2DM and health management standard.From March 2019 to March 2020,a total of 228 T2DM patients with poor glucose control and their families were selected from 10 social health service stationsin the central urbanarea of Jiading District,Shanghai,and randomly divided into intervention group and control group.The intervention group had 3 months of health education and 9-month follow-up,and the control group received routine care and 9-month follow-up.Baseline conditions were surveyed from 1 February to 28 February 2019 in the recruited participants,and final data were surveyed from 1 March to7 March 2020 in the participants who completed the intervention.A questionnaire survey include risk awareness,family support,and medication adherence measures were carried outbefore and after the intervention.Results At the end of the intervention,225 pairs of patients and their families were followed up.The medication compliance score of intervention group increased from(6.36±1.70)to(6.79±1.55)(t=2.373,P=0.019),and the level of medication complianceraised to good(Z=2.487,P=0.013).There was no significant difference in medication compliance scores and levels of control group before and after the intervention(P>0.05).No significant difference of medication compliance between baseline and follow-up was found(P>0.05).The results of the difference-in-difference method showed that family-based risk perception health education could improve medication compliance(β=0.371,95%Cl:0.002-0.740),risk knowledge(β=0.874,95%Cl:0.346-1.401),personal risk control(β=0.253,95%CI:0.112-0.393),worry(β=0.235,95%CI:0.007-0.463),and positive support(β=5.773,95%CI

关 键 词：2型糖尿病 风险认知 服药依从性 干预 

分 类 号：R193[医药卫生—卫生事业管理]