1型糖尿病患儿主要照顾者CHO饮食健康教育现状及需求调查  

Current status and needs of carbohydrate counting dietary health education for primary caregivers of children with type 1 diabetes mellitus

作　　者：刘静[1] 吴利平[1] 陈利平 刘晓琴 代红梅 陈海燕[2] Liu Jing;Wu Liping;Chen Liping;Liu Xiaoqin;Dai Hongmei;Chen Haiyan(Department of Nursing,Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Chongqing Key Laboratory of Pediatric Metabolism and lnflammatory Diseases,Chongqing 400014,China;Department of Endocrinology,Children's Hospital of Chongqing Medical University,Chongqing 400014,China;Department of Neurosurgery,Children's Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院护理部/国家儿童健康与疾病临床医学研究中心/儿童代谢与炎症性疾病重庆市重点实验室,重庆400014 [2]重庆医科大学附属儿童医院内分泌科,重庆400014 [3]重庆医科大学附属儿童医院神经外科,重庆400014

出　　处：《保健医学研究与实践》2024年第1期15-22,共8页Health Medicine Research and Practice

基　　金：重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0131);重庆医科大学未来医学青年创新团队支持计划(W0028)。

摘　　要：目的调查1型糖尿病(T1DM)患儿主要照顾者碳水化合物计数法(CHO)饮食健康教育现状及需求,为进一步提高T1DM患儿饮食管理水平提供参考。方法采用便利抽样法,于2022年8—10月对重庆医科大学附属儿童医院的318名T1DM患儿主要照顾者进行问卷调查。采用自行设计的问卷进行调查。统计学方法包括t检验、单因素方差分析,单因素中P<0.05的变量纳入多重线性回归模型。结果共调查318名主要照顾者,孩子年龄以7~12岁为主,占42.8%;孩子性别以女性为主,占50.3%;长期居住地以农村为主,占60.4%;首诊糖尿病患儿占75.8%;饮食管理方法采用CHO占22.3%;费用支付以自费为主,占54.4%。本调查结果显示248名(78.0%)调查对象知晓CHO,知晓途径:医务人员206名(83.1%)、相关健康教育手册及书籍110名(44.4%)、网络媒体宣传53名(21.4%)、家属或病友及周围人46名(18.5%)。210名(66.0%)主要照顾者接受过CHO饮食健康教育。210名调查对象CHO饮食知信行总分为(29.62±3.97)分,其中知识得分(1.78±1.31)分,信念得分(12.90±1.73)分,行为得分(14.95±2.67)分。单因素分析结果显示:糖化血红蛋白、主要照顾者不同的调查对象,CHO饮食知信行总分和各维度得分差异均具有统计学意义(P<0.05);患病时长不同的调查对象知识得分差异具有统计学意义(P<0.05);饮食管理方法不同的调查对象,知信行总分及知识维度得分差异具有统计学意义(P<0.05)。多重线性回归分析结果显示,糖化血红蛋白、主要照顾者是调查对象CHO饮食知信行得分的影响因素(P<0.05)。结论T1DM患儿主要照顾者对CHO的认知不足,但认可度及实践意愿较强;患儿糖化血红蛋白<7.5%、主要照顾者为父母的调查对象,CHO饮食知信行水平较高;主要照顾者在掌握CHO方面存在计算过程繁琐复杂、实操难度大、理解能力受限等困难,科室管理者应根据主要照顾者相关CHO饮食健康教育需求,在糖Objective To investigate the current status and needs of carbohydrate counting(CHO)dietary health education for pri-mary caregivers of children with type 1 diabetes mellitus(T1DM),and provide a reference for promoting dietary management of pe-diatric T1DM.Methods Convenience sampling was used to conduct a questionnaire survey among 318 primary caregivers of T1DM children at Children's Hospital of Chongqing Medical University from August to October 2022.A self-designed questionnaire was used for the survey.Statistical methods included t-test,one-way analysis of variance,and multiple linear regression analysis with variables with P<0.05 included in the model for statistical significance.Results A total of 318 primary caregivers were surveyed,with the majority of children aged 7-12 years(42.8%),female(50.3%),and living in rural areas(60.4%).First-diagnosed T1DM children accounted for 75.8%of the cases,and 22.3%of the caregivers adopted CHO dietary management methods.Self-payment was the main method of fee payment,accounting for 54.4%.The survey results showed that 248(78.0%)respondents were aware of CHO,with the following sources of awareness:medical staff(206,83.1%),relevant health education manuals and books(110,44.4%),online media promotion(53,21.4%),and family members or friends(46,18.5%).A total of 210(66.0%)primary caregivers had received CHO dietary health education The total score of CHO dietary knowledge,attitude,and practice(KAP)for the 210 respondents was(29.62±3.97)points,with knowledge score of(1.78±1.31)points,attitude score of(12.90±1.73)points,and practice score of(14.95±2.67)points.The results of the one-way analysis of variance showed statisti-cally significant differences in the subscale and total scores of CHO dietary KAP among different variables,including glycated hemo-globin and different primary caregivers(P<0.05).Statistically significant differences were also found in knowledge scores among different variables,including duration of illness and dietary management methods(P<0.05).Furtherm

关 键 词：1型糖尿病 儿童 碳水化合物计数法 主要照顾者 健康教育 

分 类 号：R587.1[医药卫生—内分泌]