Ⅱ型糖尿病患者心理卫生社区干预效果与影响因素分析  

Community Intervention on Mental Health of Patients with Type 2 Diabetes Mellitus

作　　者：赵仲堂[1] 张颖[1] 郝风荣[1] 王束枚[1] 贾存显[1] 冯月秋[1] 潘玉珍[1] 李光荣[2] 

机构地区：[1]山东大学公共卫生学院流行病与卫生统计研究所,250012 [2]山东省滨州医学院附属医院内科

出　　处：《中国心理卫生杂志》2003年第6期376-379,共4页Chinese Mental Health Journal

基　　金：山东省医药卫生"九五"攻关项目资助

摘　　要：目的 :探讨糖尿病社区干预措施对Ⅱ型糖尿病患者心理卫生状况干预的有效性及其影响因素 ,为适宜的社区干预对策与措施的制定提供科学依据。方法 :按群体实验流行病学方法 ,选取山东省两城市社区分别作为干预社区与对照社区。 1997年 ,收集基线资料 ,同时开始在干预社区实施糖尿病综合干预措施。2 0 0 1年 ,再次以相同的方法收集两社区相关资料 ,通过两社区基线与 4年后资料的比较 ,分析社区干预对Ⅱ型糖尿病患者焦虑总标准分、抑郁指数和社会支持分的影响。并通过对干预社区干预后的病例对照分析 ,探讨上述心理卫生指标与Ⅱ型糖尿病的关系及其影响因素。结果 :4年后 ,干预社区患者的焦虑总标准分、抑郁严重度指数和社会支持总分及主、客观支持分各指标均有显著性改善 ,而对照社区患者各项指标的改变无统计学意义。干预后干预社区患者各心理卫生指标仍与一般健康人群有显著性差异。排除了年龄、性别、职业等因素的潜在混杂作用后 ,焦虑总标准分、抑郁严重度指数及客观支持总分仍与Ⅱ型糖尿病有显著关联 ,OR值分别为 1 41,1 79,0 69。多元逐步回归分析显示 ,文化程度越高患者的心理卫生健康状况越好 ,而同时患其它慢性病则为影响患者心理卫生健康的危险因素。结论Objective: To study the effect of community intervention on mental health of patients with type 2 diabetes mellitus (DM) Method:Two communities in a city of Shandong province were chosen as intervention community and control community respectively after an epidemiological investigation of diabetes mellitus in 1997 After four years intervention, a case-control study was done by assessing mental status with SAS (self-rating anxiety scale), SDS (self-rating depression scale) and SSRS (social support rating scale) Result:Compared with baseline levels, after intervention for 4 years, the SAS score, SDS score and SSRS score (including subject score and object score) of patients in intervention community improved significantly, while the counterparts of patients in control community had no improvement But patients in intervention community still had poorer results than health controls By adjustment of the potential confounding effect of age, sex and occupations, diabetes mellitus still had influence on anxiety, depression and social support with ORs of 1 41, 1 69 and 0 69 respectively Multivariable stepwise analysis showed that, suffering from other chronic diseases was risk factor for mental health of diabetes patients, and the higher the education level, the better results of intervention Conclusion:The DM community intervention program improves mental health of patients significantly, but patients still have poorer mental health than healthy control Education level and suffering from other chronic disease are main factors having influence on effects of the intervention

关 键 词：Ⅱ型糖尿病 心理卫生 社区干预 影响因素 

分 类 号：R587.1[医药卫生—内分泌] R395.6[医药卫生—内科学]