个体化行为干预对2型糖尿病患者1年效果评价

目的评价个体化行为干预对2型糖尿病患者血糖控制、自护行为、自我效能及授权能力的影响。方法将108例2型糖尿病患者按随机信封法分为观察组55例与对照组53例。两组患者入组时均接受糖尿病教育、每月1次的面访或电话随访,对照组仅了解患者情况,给予适当指导,不做具体行为干预;观察组接受由糖尿病专科护士负责的个体化行为干预,根据患者的自身情况为其制定行为干预目标,定期随访评价既定计划实施情况,进行下一步计划的制定。在入组时、干预6个月和12个月时检测患者糖化血红蛋白,入组时及干预12个月后填写糖尿病自我管理行为量表、糖尿病管理自我效能量表及糖尿病授权简化量表,并进行比较。结果干预6个月、12个月观察组患者糖化血红蛋白较入组时均降低,比较差异有统计学意义,干预6个月观察组糖化血红蛋白改善优于对照组,比较差异有统计学意义;干预12个月后,患者的糖尿病自我管理行为量表总分、糖尿病管理自我效能量表总分及糖尿病授权简化量表总分,观察组均优于对照组,比较差异有统计学意义。结论以行为干预为核心的个体化管理能改善2型糖尿病患者的血糖控制,提高患者的自我管理能力。

One year's effect evaluation on individualized behavioral intervention for patients with type 2 diabetes

Objective To evaluate the effect of individualized behavioral intervention on blood glucose control, self-pro-tection behavior, self-efficacy and authorization capabilities for patients with type 2 diabetes. Method Divide 108 patients with type 2 diabetes into observation group and control group equally by random envelope method. Patients in observation group receive diabetes education and follow-up interview face to face or on phone once a month. Patients in control group only receive some guidance according to their situations without any intervention. Patients in observation group receive individual-ized behavioral intervention charged by diabetes nurses. Set goals for patients according to their individual situation. Evaluate the implementation situation by regular follow-up interview and make further plan. Test patients' glycosylated hemoglobin at the beginning and after 6 months', 12 months' intervention. Evaluate patients by Summary of Diabetes Self Care Activities (SDSCA), General Self-Efficacy Scale (GSES) and Diabetes Empowerment Scale-Short Form(DES-SF) and make compari-son at the beginning and after 12 months' intervention. Result Patients' glycosylated hemoglobin in two groups all reduce after 6 months' and 12 months' intervention. The difference is significant. Observation group has better improvement than control group on glycosylated hemoglobin after 6 months' intervention. The difference is significant.Total score on SDSCA, GSES and DES-SF are all higher in observation group than in control group after 12 months' intervention. The difference is signifi-cant. Conclusion Individualized management with the core of behavioral intervention can improve blood glucose control and self-management ability for patients with type 2 diabetes.