目的 了解社区老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者健康自助行为现状及其影响因素,为老年慢病患者健康自助行为相关研究提供科学依据.方法 于2022年11月-2023年5月,采用系统抽样的方法,选取上海市817名社区老年T2DM患者为研究对象,采用一般资料调查表、健康自助行为量表、糖尿病健康信念问卷、社会支持评定量表(Social Support Rating Scale,SSRS)、老年抑郁量表(Geriatric Depression Scale,GDS-15)以及日常生活能力量表(Activities of Daily Living,ADL)进行调查.采用SPSS 25.0软件进行独立样本t检验、方差分析、Kruskal-Wallis秩和检验、Pearson相关分析、Spearman相关分析和多重线性逐步回归分析.结果 社区老年T2DM患者健康自助行为总得分为(93.75±12.35)分.健康自助行为总分与糖尿病健康信念总分(r=0.416)、客观支持得分(r=0.118)和对支持的利用度得分(r=0.194)呈正相关(P＜0.01),与主观支持得分(r=-0.171)、GDS-15得分(r=-0.224)和ADL得分(r=-0.243)呈负相关(P＜0.01).多重线性回归分析结果显示,家庭月收入(β=0.175)、糖尿病健康信念(β=0.325)、客观支持(β=0.168)和对支持的利用度(β=0.254)与社区老年T2DM患者健康自助行为正相关;年龄(β=-0.080)、仅与子女居住(β=-0.148)、糖尿病并发症(β=-0.127)、抑郁症状(β=-0.231)、主观支持(β=-0.457)及日常生活能力(β=-0.160)与社区老年T2DM患者健康自助行为负相关,共解释总变异的47.3％.结论 年龄较大、仅与子女居住、有糖尿病并发症、抑郁症状、主观支持较强及日常生活能力较差的社区老年T2DM患者健康自助行为水平较低,应对此类患者做重点关注.
Study on healthy self-help behavior and influencing factors of elderly with type 2 diabetes mellitus in the community of Shanghai under the view of active health
Objective To understand the current status and influencing factors of health self-help behavior of elderly with type 2 diabetes mellitus(T2DM)in the community,and provide the scientific basis for research related to healthy self-help behaviors of elderly with chronic diseases.Methods From November 2022 to May 2023,the systematic sampling method was used to select 817 elderly with T2DM in the community of Shanghai as the subjects.The cross-sectional investigation was conducted using the general information questionnaire,Healthy Self-Help Behavior Scale,Diabetes Health Beliefs questionnaire,Social Support Rating Scale(SSRS),Geriatric Depression Scale(GDS-15)and Activities of Daily Living Scale(ADLS).Independent samples t test,x2,analysis of variance(ANOVA),Kruskal-Wallis rank sum test,Pearson correlation analysis,Spearman correlation analysis,and multiple linear stepwise regression analysis were used to analyze the data.The used software was SPSS 25.0.Results The total healthy self-help behavior score of elderly with T2DM in the community was(93.75±12.35).The total health self-help behavior score with the total diabetes health beliefs score(r=0.416),the objective support score(r=0.118),and the support utilization score(r=0.194)showed positively correlation(P＜0.01);subjective support score(r=-0.171),GDS-15 score(r=-0.224)and ADLS score(r=-0.243)showed the negative correlation(P＜0.01).The results of multiple linear regression analysis showed that monthly household income(β=0.175),diabetes health beliefs(β=0.325),objective support(β=0.168),and the support utilization score(β=0.254)positively correlated with health self-help behaviors of community-based elderly with T2DM;age(β=-0.080),only living with sons and daughters(β=-0.148),diabetes complication(β=-0.127),depression(β=-0.231),subjective support(β=-0.457)and activity of daily living(β=-0.160)negatively correlated with health self-help behaviors of community-based elderly with T2DM,which explained a total of 47.3％of the total variance.Conclusion The levels of healthy self-help behaviors in T2DM patients with older age,only living with their children,diabetic complication,depression,more subjective support and poorer activity of daily living are lower.It should pay attention to those patients.
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