山东省2型糖尿病患者家庭支持现状及对自我管理行为的影响

姚静静; 王海鹏; 黄小敏; 李奇; 孙强

doi:10.16462/j.cnki.zhjbkz.2019.05.016

山东省2型糖尿病患者家庭支持现状及对自我管理行为的影响

doi: 10.16462/j.cnki.zhjbkz.2019.05.016

250012 济南, 山东大学医药卫生管理学院, 国家卫生健康委员会卫生经济与政策研究重点实验室

基金项目:

山东省自然科学基金青年项目 ZR2016GQ02

详细信息

通讯作者:
孙强, E-mail: qiangs@sdu.edu.cn

中图分类号: R587.1;R181
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- 文章访问数: 564
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出版历程
- 收稿日期: 2018-10-03
- 修回日期: 2019-03-01
- 刊出日期: 2019-05-10

Association between family support and self-management behavior among patients with type 2 diabetes mellitus in China

School of Health Care Management, Shandong University, NHC Key Laboratory of Health Economics and Policy Research, Jinan 250012, China

Funds:

The Shandong Province Natural Science Foundation of China ZR2016GQ02

More Information

Corresponding author: SUN Qiang, E-mail: qiangs@sdu.edu.cn

摘要

摘要: 目的调查山东省2型糖尿病患者的家庭支持现状，分析家庭支持与患者自我管理行为之间的关系，为患者自我管理行为干预提供依据。方法采用多阶段分层随机抽样的方法，选取山东省4个地市的2 520名2型糖尿病进行问卷调查；运用非条件Logistic回归分析探索家庭支持与不同自我管理行为之间的关系。结果患者家庭支持的平均得分为(16.3±5.3)分；患者进行饮食控制、体育锻炼、服药依从和血糖监测(≥ 1次/周)的比例分别为75.4%、61.6%、38.5%和17.1%。Logistic分析结果显示，家庭支持得分越高，患者进行饮食控制、体育锻炼和血糖监测的可能性越大，OR值分别1.03(95%CI：1.01~1.05，P < 0.001)、1.07(95%CI：1.06~1.09，P < 0.001)和1.03(95%CI：1.01~1.04，P < 0.05)；但家庭支持对患者服药依从行为的影响差异无统计学意义(P=0.68)。结论家庭支持对患者的饮食控制、体育锻炼和血糖监测的行为有着作积极的作用，但对患者服药依从的作用较小；应探索构建医疗机构-社区-家庭全面的自我管理支持模式。
- 2型糖尿病 /
- 家庭支持 /
- 自我管理行为 /
- 山东省
Abstract: Objective To evaluate the relationship between family support and self-management behaviors among patients with type 2 diabetes mellitus (T2DM) in Shandong province, China. Methods A multi-stage stratified random sampling was used and 2 520 patients with T2DM were selected from urban and rural and communities in Shandong province. The correlation between family support and self-management behavior were analyzed using logistic regression analysis. Results A total of 1 866 patients with T2DM prescribed with drug were included for analysis, comprising 938 patients from urban areas and 928 patients from rural area.The mean C-DFBC scores were (16.3±5.3).The Logistic regress analysis revealed that the family support was associated with the dietary control (OR=1.03, 95%CI: 1.01-1.05, P < 0.001), physical excise (OR=1.07, 95%CI: 1.06-1.09, P < 0.001) and blood monitoring(OR=1.03, 95%CI: 1.01-1.04, P < 0.05))but not with medication adherence (P=0.68). Conclusion The family support can improve the self-management indietary control, physical excise and blood monitoring.
- T2MD /
- Family support /
- Self-management behavior /
- Shangdong Province

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图 1 不同家庭支持水平组自我管理行为状况变化趋势

Figure 1. Changes of self-management behavior by family support

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表 1 调查患者的基本特征状况

Table 1. The characteristic of the patients with type 2 diabetes mellitus in Shandong province

变量	频数	频率(%)
城乡
城市	938	50.3
农村	928	49.7
性别
男	637	34.1
女	1 229	65.9
年龄组(岁)
35~	100	5.4
50~	849	45.5
65~79	917	49.1
婚姻状况
非在婚	246	13.2
在婚	1 620	86.8
文化程度
未接受过教育	611	32.7
小学	613	32.9
初中及以上	642	34.4
人均家庭收入^a (元)
< 2 950	461	24.7
2 950~	518	27.8
6 000~	442	23.7
≥12 000	445	23.8
患病时长(年)
< 5	630	33.8
5~	606	32.5
> 10	630	33.8
并发症
有	1 153	61.8
无	713	38.2
饮食控制
是	1 406	75.4
否	460	24.7
体育锻炼
是	1 149	61.6
否	717	38.4
服药依从
是	718	38.5
否	1 148	61.5
血糖监测
是	319	17.1
否	1 547	82.9
家庭成员支持得分	16.3±5.3
注：^a人均家庭收入依据四分位间距划分。

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表 2 2型糖尿病患者不同自我管理行为的多因素Logistic回归分析结果

Table 2. The influencing factors of self-management behavior of patients with T2DM by Logistic regression analysis

变量	单因素模型		多因素模型
变量	OR(95%CI)值	P值	OR(95%CI)值	P值
饮食控制
家庭支持得分	1.07(1.05~1.10)	< 0.01	1.03(1.01~1.05)	< 0.001^a
性别
男	1.00		1.00
女	1.81(1.46~2.25)	< 0.01	1.78(1.40~2.27)	< 0.001^a
年龄(岁)
35~	1.00		1.00
50~	1.75(1.14~2.71)	0.011	1.57(1.00~2.47)	0.050
65~79	1.98(1.28~3.05)	0.002	1.74(1.10~2.77)	0.020^*
文化程度
文盲/半文盲	1.00		1.00
小学	0.80(0.62~1.05)	0.110	0.97(0.73~1.29)	0.831
初中及以上	0.70(0.54~0.90)	0.007	1.02(0.74~1.39)	0.922
体育锻炼
家庭支持得分	1.08(1.06~1.10)	< 0.001	1.07(1.06~1.09)	< 0.001^a
地区
城市	1.00		1.00
农村	0.66(0.55~0.80)	< 0.001	0.74(0.61~0.91)	0.011^a
性别
男	1.00		1.00
女	0.72(0.59~0.87)	0.001	0.90(0.72~1.13)	0.382
文化程度
文盲/半文盲	1.00		1.00
小学	1.43(1.14~1.80)	0.002	1.28(1.00~1.64)	0.049^a
初中及以上	2.02(1.60~2.54)	< 0.001	1.80(1.36~2.38)	< 0.001^a
人均家庭收入(元)
< 2 800	1.00		1.00
2 800~	1.11(0.86~1.45)	0.422	1.05(0.80~1.37)	0.744
6 000~	1.33(1.02~1.73)	0.033	1.09(0.82~1.46)	0.556
≥12 000	1.63(1.25~2.13)	< 0.001	1.34(1.00~1.80)	0.046
患病时长(年)
< 5	1.00		1.00
5~	1.07(0.85~1.34)	0.553	1.07(0.85~1.36)	0.562
> 10	1.37(1.09~1.72)	0.008	1.37(1.07~1.75)	0.013^a
服药依从
家庭支持得分	0.99(0.98~1.01)	0.446	1.00(0.98~1.01)	0.678
年龄组别(岁)
35~	1.00		1.00
50~	1.51(0.94~2.42)	0.090	1.51(0.93~2.45)	0.094
65~79	2.42(1.51~3.87)	< 0.001	2.49(1.53~4.06)	< 0.001^a
血糖监测
家庭支持得分	1.02(1.00~1.04)	0.030	1.01(1.00~1.02)	0.009
地区
城市	1.00		1.00
农村	0.34(0.26~0.45)	< 0.001	0.36(0.27~0.49)	< 0.001^a
性别
男	1.00		1.00
女	0.65(0.51~0.83)	0.001	0.75(0.56~0.99)	0.164
文化程度
文盲/半文盲	1.00		1.00
小学	1.04(0.75~1.45)	0.816	0.73(0.51~1.04)	0.373
初中及以上	2.10(1.56~2.84)	< 0.001	1.22(0.81~1.74)	0.127
人均家庭收入(元)
< 2 800	1.00		1.00
2 800~	1.47(0.99~2.2)	0.058	1.23(0.81~1.85)	0.595
6 000~	1.8(1.23~2.65)	0.003	1.18(0.79~1.79)	0.346
≥12 000	2.9(2.01~4.19)	< 0.001	1.79(1.21~2.66)	< 0.001^a
患病时长(年)
< 5	1.00		1.00
5~	1.39(1.01~1.93)	0.046	1.19(1.10~0.95)	0.101
> 10	2.09(1.54~2.84)	< 0.001	1.27(1.13~1.41)	< 0.001^a
并发症
无	1.00		1.00
有	1.37(1.07~1.75)	0.013	1.01(1.02~1.04)	0.023^a
^a表示P＜0.05。

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