摘要
【目的】了解血糖控制不良的2型糖尿病患者控糖相关行为及其影响因素,为指导社区糖尿病患者开展血糖自我管理提供依据。【方法】2015年1月至3月,采用方便抽样的方式在上海市长宁区新华街道社区卫生服务中心4个家庭医生工作室对门诊200例血糖控制不良的2型糖尿病患者进行调查,内容包括性别、出生日期、教育程度、职业、经济收入、与家庭医生签约情况、糖尿病相关知识和行为方法等。【结果】糖尿病诊断标准、空腹血糖控制良好标准及糖化血红蛋白控制良好的标准知晓率分别为37.0%、91.0%及83.5%。61.5%的患者表示能做到按医嘱用药,32.5%的患者每周至少测一次血糖,37.5%的患者能做到每季度测一次糖化血红蛋白。饮食控制方面做到少吃油腻、甜食、定时定量用餐的比例分别为91.0%、77.0%和40.0%。47.0%的患者表示能做到经常锻炼。与家庭医生签约对患者在按医嘱用药、测量血糖和身体锻炼方面有较好的促进作用。配偶健在对患者在控制饮食方面具有较好的促进作用。患并发症、病程长、伴发高血脂等疾病因素对患者形成良好的血糖管理行为具有促进作用。【结论】血糖控制不良糖尿病患者在糖尿病相关知识的掌握情况和自我血糖管理行为方面不理想,建议通过进一步落实家庭医生签约制度,规范并加强家庭医生对患者的有效管理,提高患者知识水平以促进行为改变进而改善血糖控制水平。
[Objective]To ascertain the self-management behavior and its influencing factors in diabetic patients with poor glycemic control.[Methods]From January to March 2015,200 diabetic patients with poor blood glucose control were selected by means of convenience sampling when they visited 4 family doctor clinics in Xinhua Street Community Health Service Center of Changning District for investigation of their gender,birth date,education,profession,income,and contract with family doctor,related knowledge and behavior method about diabetes and so on.[Results]The awareness rate of diabetes mellitus diagnostic standard,fasting blood glucose control standard and HbAlc control standard were 37.0%,91.0%and 83.5%,respectively.Among the participants,61.5%said they were able to take medication according to doctor′s advice,32.5%measured blood glucose at least once a week,and 37.5%measured HbAlc at least once a quarter of a year.The proportion of taking dietary control measures to eat less greasy,sweet and timed meals were 91.0%,77.0%and 40.0%,respectively.The rate of exercising regularly was 47.0%.The signing up with a family doctor has good effect on the patient′s medication,blood glucose measurement and physical exercise.Male patients were poor in diet,smoking and drinking.Spouse had good effect on the control of the diet.Older patients were less likely to smoke but were poor in diet controlled sugar and the purchase of blood glucose meters.Disease factors such as complications,long course of disease,and hyperlipidemia also had good effect on the patient′s blood glucose management.[Conclusion]Diabetic patients with poor glycemic control are not ideal in terms of diabetes related knowledge and self blood glucose management behavior.It is suggested to improve blood glucose control level by improving the signing rate of family doctors and improving their knowledge level.
作者
刘红联
赵玉章
周鹏
夏庆华
姜玉
LIU Hong-lian;ZHAO Yu-zhang;ZHOU Peng;XIA Qing-hua;JIANG Yu(Xinhua Street Community Health Service Center of Changning District,Shanghai 200052,China;Changning Center for Disease Control and Prevention,Shanghai 200051,China)
出处
《上海预防医学》
CAS
2018年第6期497-503,共7页
Shanghai Journal of Preventive Medicine
基金
上海市长宁区科委课题(CNKW2014S02)
关键词
糖尿病
血糖控制
知识
行为
影响因素
diabetes
blood glycemic control
knowledge
behavior
influencing factors
