【摘要】 目的探索老年2型糖尿病患者认知功能与自我管理行为、自我效能的关系,为制订延缓糖尿病性认知功能障碍措施提供依据。方法以社区卫生服务机构管理的老年2型糖尿病患者(年龄>65岁)81例为研究对象,分为干预组(46例)和常规组(35例),使用中国疾病预防控制中心设计问卷进行自我管理行为和自我效能调查,用修订的长谷川智能筛查量表评估患者的认知状况,并进行比较分析。结果基线时,干预组和常规组在认知功能障碍比例、自我管理行为和自我效能方面的差异均无统计学意义(P值均>0.05)。干预后,两组出现认知功能障碍的比例分别是13.0%和42.9%,差异有统计学意义(P=0.002);干预组的患者遵循糖尿病饮食持续天数[(5.9±1.6)d]高于常规组[(4.9±1.9)d],差异有统计学意义(P=0.011);干预组自我效能得分[(107.3±15.1)分]高于常规组[(98.1±18.3)分],差异有统计学意义(P=0.016)。以认知功能变化为应变量进行logistic回归分析显示,增加遵循糖尿病饮食天数和增强自我效能可使患者认知功能改善的能力是保持认知功能不变的1.31倍(95%CI:1.02~1.68)和1.04倍(95%CI:1.01~1.07)。结论在社区开展老年2型糖尿病人自我管理活动,可防止患者进一步出现认知功能障碍,遵循糖尿病饮食和提高自我效能是保护患者认知功能的有效措施。更多还原

【Abstract】 Objective To evaluate relationship between cognitive function,self-management behavior and self-efficacy in elderly patients with type 2diabetes mellitus(T2D);to provide basis for making measures to delay diabetic cognitive impairment.Methods A total of 81 T2 Dpatients aged 65 years or older were recruited from qualified primary health centers in Guangzhou,who were randomly assigned to diabetes self-management(DSM)group(46cases)or continuation of standard diabetes care(control)group(35cases).Questionnaires designed by the National CDC were used for investigation of self-management behavior and self-efficacy.Hasegawa Dementia Scale(HDS)was used for evaluating cognitive function.The results were subjected to statistical analysis.Results Baseline investigation showed no significant differences were observed for cognitive impairment,self-management behavior and self-efficacy between intervention group and control group(all P>0.05).After intervention,the cognitive impairment rates of the above 2groups were 13.0% and 42.9%,respectively,with statistical difference(P=0.002).The diabetes diet duration of intervention group [(5.9±1.6)d]was more than that of control group[(4.9±1.9)d],the difference was statistically significant(P=0.011);self efficacy scores of intervention group[(107.3±15.1)points]was higher than that of control group[(98.1±18.3)points],the difference was statistically significant(P=0.016).Using the change of cognitive function as the dependent variable,logistic regression analysis showed that the improvement of following the diabetes diet duration and self-efficacy increased cognitive function of patients for 1.31times(95%CI:1.02-1.68)and 1.04times(95%CI:1.01-1.07)compared with constant cognitive function.Conclusion T2Dself-management in primary health care centers can prevent further cognitive impairment.Follow the diabetes diet and improve self-efficacy were effective measures to protect patients’cognitive function.更多还原