首页|授权原理结合路径化理论管理对糖尿病患者健康行为和用药依从性的影响

授权原理结合路径化理论管理对糖尿病患者健康行为和用药依从性的影响

The impact of principle of empowerment combined with pathway theory on health behaviors and medication adherence in patients with diabetes mellitus

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目的 分析授权原理结合路径化理论管理干预糖尿病患者健康行为对代谢水平及用药依从性的影响.方法 146例2 型糖尿病患者根据健康行为干预方法不同分为观察组和对照组各73 例.对照组接受常规健康行为干预,观察组接受基于授权原理和路径化理论的健康行为干预.入院时、出院时及出院后 3 个月,采用中文版糖尿病授权简化量表(C-DES-SF)评估患者授权能力,采用糖尿病自我管理及障碍问卷(PDQ)评估患者自我管理能力,采用糖尿病自我效能量表(DSES)评估患者自我效能感,采用Morisky用药依从性问卷评估患者依从性.比较 2 组干预前后各量表得分、糖化血红蛋白(HbA1 C)、空腹血糖(FBG)、餐后 2h血糖(2 hPBG)、甘油三酯(TG)水平和体重指数(BMI).结果 组别和时间对 C-DES-SF、PDQDSES、Morisky问卷得分均有影响,且两者存在交互作用(F组别×时间=9.304、31.215、60.939、8.905,P<0.01).观察组出院时和出院后 3 个月的C-DES-SF得分均高于对照组(P<0.05).组别和时间对 HbA1 C 和 2 hPBG 均有影响,且两者存在交互作用(F组别×时间=13.402、6.895,P<0.05).组别对FBG无影响,时间对FBG有影响,但两者存在交互作用(F组别×时间=15.194,P<0.001).组别对TG无影响,时间对TG有影响,但两者不存在交互作用(F组别×时间=0.565、1.519,P=0.570、0.222).观察组出院时和出院后 3 个月的HbA1 C、FBG、2 hPBG、TG低于对照组,差异均有统计学意义(P<0.05).结论 基于授权原理和路径化理论的健康行为干预,可显著提高糖尿病患者的授权能力,改善其自我管理能力和自我效能,提高患者依从性,利于调节糖代谢水平.
Objective To analyze the impact of management intervention combining the principle of empowerment with pathway theory on the health behaviors and medication compliance of diabetic patients,providing a reference for clinical diagnosis and treatment.Methods A total of 146 patients with type 2 diabetes mellitus(T2DM)were divided into an observation group and a control group,with 73 patients in each group,based on different health behavior intervention methods.The control group only received routine health behavior interventions,while theobservation group received health behavior intervention based on empowerment principle and pathway theory.At admission,discharge,and three months after discharge,the Chinese version of the diabetes empowerment simplified scale(C-DES-SF)was used to assess patient empowerment,the patient diabetes questionnaire(PDQ)was used to assess patient self-management ability,and the diabetes self-efficacy scale(DSES)was used to assess patients'self-efficacy.Medication adherence was evaluated using the Morisky medication adherence questionnaire.The scores of the various scales,as well as levels of glycated hemoglobin(HbA1 C),fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),triglycerides(TG),and body mass index(BMI)were compared before and after the interventions in both groups.Results Both group assignment and time had an impact on the C-DES-SF scores,and there was an interaction between the two(Fgroup×time=9.304,31.215,60.939,8.905,P<0.01).The C-DES-SF scores at discharge and three months post-discharge were higher in the observation group than in the control group(P<0.05).Group assignment and time also affected HbA1c and 2 hPBG levels,with an interaction between the two(Fgroup×time=13.402,6.895,P<0.05).Group assignment had no effect on FBG,but time did,although there was no interaction between the two(Fgroup×time=15.194,P<0.001).Group assignment had no effect on TG,while time had an impact on TG,and there was no interaction between the two(Fgroup×time=0.565,1.519,P=0.570,0.222).The HbA1c,FBG,2 hPBG,and TG levels at discharge and three months post-discharge were lower in the observation group than in the control group,with all differences being statistically significant(P<0.05).Conclusions Health behavior intervention based on the principles of empowerment and pathway theory can significantly enhance the empowerment of patients with diabetes,improve their self-management abilities and self-efficacy,enhance patient adherence,and facilitate the regulation of glucose metabolism levels.

diabeteshealthy behaviorprinciple of empowermentpathway theorymetabolic levels

王芳、陶小清、余婷

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武义县第一人民医院 内分泌科,浙江 武义 321200

糖尿病 健康行为 授权原理 路径化理论 代谢水平

2024

健康研究
杭州师范大学

健康研究

影响因子:0.823
ISSN:1674-6449
年,卷(期):2024.44(4)