·糖尿病临床流行病学·

　　【摘要】 目的 评价社区糖尿病患者自我管理活动的实施情况和干预效果。 方法 采用患者自我管理小组活动的干预方式对社区糖尿病患者进行管理。小组活动开始前和结束时分别采用问卷调查的方法收集研究对象的一般情况、患病情况、自我管理行为及自我效能信息，收集患者参加小组活动的情况和对活动的评价信息。 结果 共调查糖尿病患者1397例。通过开展自我管理小组活动，掌握了血糖自测方法者51.7%(722/1397)、掌握了足部检查方法者57.2%(799/1397)、主动与医生交流和沟通病情者90.3%(1261/1397)，与活动前比较，差异均有统计学意义(P<0.05)。活动后，糖尿病患者自我效能总分较活动前升高[(79.21±13.21) vs (69.27±16.29)，t=18.15,P<0.05]。年龄、居住地和文化程度是影响糖尿病患者自我效能总分干预效果的因素(F年龄组=4.68，F居住地=33.54，F文化=9.13，P<0.05)。 结论 社区糖尿病患者自我管理可提升患者自我效能、培养患者自我管理意识和行为，社区患者对这种行为干预模式的认可程度较好。

　　【关键词】 糖尿病;患者自我管理;社区;自我效能;干预;评价

　　【Abstract】 Objective To evaluate the process and efficacy of community based diabetic patients’self-management group intervention in six provinces in China. Methods Diabetic patients’self management group interventions were provided in communities. Questionnaire survey was used before and after the intervention. Data including patients’general information, disease history, self-management behavior, self-efficacy, and patients’opinion on group intervention were collected. Results A total of 1397 patients were enrolled. After the intervention, 51.7%(722/1397) patients learned self monitoring skills of blood glucose, 57.2%(799/1397) patients learned foot check skills, and 90.3%(1261/1397) patients were willingly to discuss their diseases with physician. All of the above were significantly improved after group intervention(P<0.05). Patients’overall self-efficacy improved from (69.27±16.29)(hundred-mark system) pre-intervention to (79.21±13.21)post intervention (t=18.15, P<0.05). Age, residence, and education degree were factors influencing the score of self-efficacy evaluation(Fage=4.68, Fresidence=33.54, Feducation=9.13，P<0.05). Conclusion Community based diabetic patients’self-management group intervention could increase patient’s self-efficacy, awareness of self management and behavior. It is well accepted by diabetic patients in community.

　　【Key words】 Diabetes mellitus; Patient self-management; Community; Self-efficacy; Intervention; evaluation.