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夏章, 姜莹莹, 毛凡, 董文兰, 张伟伟, 董建群. 中国六省市糖尿病患者自我管理2年随访生存质量变化及其影响因素分析[J]. 中国公共卫生, 2022, 38(3): 285-290. DOI: 10.11847/zgggws1131688
引用本文: 夏章, 姜莹莹, 毛凡, 董文兰, 张伟伟, 董建群. 中国六省市糖尿病患者自我管理2年随访生存质量变化及其影响因素分析[J]. 中国公共卫生, 2022, 38(3): 285-290. DOI: 10.11847/zgggws1131688
XIA Zhang, JIANG Ying-ying, MAO Fan, . Quality of life and its influencing factors among diabetic patients two years after a self-management intervention in six provinces and cities in China: a follow-up study[J]. Chinese Journal of Public Health, 2022, 38(3): 285-290. DOI: 10.11847/zgggws1131688
Citation: XIA Zhang, JIANG Ying-ying, MAO Fan, . Quality of life and its influencing factors among diabetic patients two years after a self-management intervention in six provinces and cities in China: a follow-up study[J]. Chinese Journal of Public Health, 2022, 38(3): 285-290. DOI: 10.11847/zgggws1131688

中国六省市糖尿病患者自我管理2年随访生存质量变化及其影响因素分析

Quality of life and its influencing factors among diabetic patients two years after a self-management intervention in six provinces and cities in China: a follow-up study

  • 摘要:
      目的  了解中国六省市糖尿病患者自我管理2年后随访的生存质量变化情况及其影响因素,为提高社区糖尿病患者服务管理水平提供参考依据。
      方法  于2013年8 — 10月在北京市、上海市、重庆市、江苏省、广东省和浙江省的84个社区招募1 653例糖尿病患者开展为期2个月的糖尿病自我管理小组活动,于2015年9 — 12月对患者进行随访调查,分析自我管理前后糖尿病患者生存质量的变化情况及其影响因素。
      结果  2013年中国六省市招募的1 653例患者中,完成基线调查者1 603例,应答率为96.98 %;2015年随访糖尿病患者1 299例,失访者304例,失访率为18.96 %。中国六省市糖尿病患者自我管理2年后随访的生理健康得分为76.50(23.75)分,较患者自我管理前得分的75.00(25.00)分有所提升,差异有统计学意义(Z = – 2.53,P = 0.011);糖尿病患者自我管理2年后随访的心理健康得分为78.44(25.03)分,与患者自我管理前得分的78.44(23.31)分比较,差异无统计学意义(P > 0.05)。多因素非条件logistic回归分析结果显示,病程 > 5年和有吸烟行为的糖尿病患者自我管理2年后生理健康得分未提高,自我效能提高的糖尿病患者自我管理2年后生理健康得分提高;女性、医疗费用支出方式为职工医保、合并其他慢性病、有吸烟行为、掌握和无需掌握胰岛素注射方法的糖尿病患者自我管理2年后心理健康得分未提高。
      结论  中国六省市糖尿病患者自我管理2年后生存质量有所改善,性别、医疗费用支出方式、病程、是否合并其他慢性病、自我效能是否提高、掌握胰岛素注射情况和有无吸烟行为是糖尿病患者生存质量变化情况的主要影响因素。

     

    Abstract:
      Objective  To analyze the quality of life (QoL) and its influencing factors among diabetes mellitus patients two years after undergoing a community-based diabetes self-management and to provide references for improving medical service to diabetes.
      Methods  From August to October of 2013, 1 653 diabetic patients were recruited in 84 communities in three cities (Beijing, Shanghai and Chongqing) and three provinces (Jiangsu, Guangdong and Zhejiang) to carry out a 2-month diabetes self-management group intervention. A follow-up survey was conducted during September – December 2015 to analyze changes in QoL and its influencing factors before and after the self-management intervention. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used in QoL evaluation.
      Results  Among the 1 653 diabetic patients recruited in 2013, 1 603 (96.98%) completed a baseline survey, of which, 1 299 patients were followed up and 304 (18.96%) were lost to follow-up in 2015. Compared to those before the intervention, the patients′ median (quartile range, QR) of SF-36 physical health score increased significantly two years after the self-management intervention (76.50 23.75 vs. 75.00 25.00, Z = – 2.53; P = 0.011), but the patients′ median (QR) of SF-36 mental health score was not significantly different (78.44 25.03 vs. 78.44 23.31, P > 0.05). The results of unconditional multivariate logistic regression analysis demonstrated that two years after receiving the diabetes self-management intervention, the patients suffering from diabetes 5 years or more and smoking were less likely to have an increased physical health score, while those with an improved self-efficacy were more likely to have an increased physical health score; the patients with following characteristics were less likely to have an increased mental health score: female, with medication reimbursement by medical insurance for urban workers, having complication of other chronic disease, smoking, and being capable of self-injection of insulin or not needing insulin injection.
      Conclusion  The quality of life was improved to a certain extent among a group of community diabetic patients in China two years after a self-management intervention and the improvement was influenced by the patients′ gender, major payer of the medication cost, disease course, comorbidity of other chronic diseases, self-efficacy, smoking, and self-injection of insulin.

     

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