同伴教育对糖尿病周围神经病变患者体力活动的影响

发布时间：2018-05-13 12:46

  本文选题：糖尿病 + 同伴教育　； 参考：《天津医科大学》2016年硕士论文

【摘要】：目的:分析影响糖尿病患者体力活动水平的个人、社会及环境因素,为对糖尿病患者进行体力活动干预提供依据;探讨同伴教育对糖尿病周围神经病变患者运动自我效能、体力活动及神经病变严重程度影响的有效性。方法:1.选取2015年1月至2015年5月天津市某三级甲等专科医院200例住院2型糖尿病患者为研究对象,采用横断面调查的方法,以社会生态模型和运动自我效能理论为理论依据,分析对糖尿病患者体力活动水平影响的个人、社会、环境因素。2.选取2015年3月至2015年9月天津市某三级甲等专科医院60例糖尿病周围神经病变患者为研究对象。采用类试验研究方法,将研究对象分为干预组及对照组,对照组研究对象接受常规健康教育,干预组研究对象在常规健康教育基础上接受同伴教育,干预时间为12周。干预前后对两组研究对象进行问卷调查,评价同伴教育对糖尿病周围神经病变患者体力活动、运动自我效能和神经病变情况的影响。结果:1.影响糖尿病患者体力活动的因素包括领悟社会支持、运动自我效能、抑郁及美化环境情况。2.干预后,两组患者运动自我效能均提高(P0.05),干预组运动自我效能较对照组提升明显,且差异具有统计学意义(P0.05)。3.干预后,两组患者步数均增加(P0.05),干预组相较于对照组步数增加明显,且差异具有统计学意义(P0.05)。4.干预后,对照组日常交通、运动锻炼、体力活动总量均增加(P0.05),干预组运动锻炼及体力活动总量增加(P0.05),干预组相较于对照组运动锻炼、体力活动总量增加明显,且差异具有统计学意义(P0.05)。5.干预后,两组患者静坐时间均减少(P0.05),干预组静坐时间较对照组减少明显,且差异具有统计学意义(P0.05)。6.干预后,两组患者多伦多临床评分均减少(P0.05),干预组和对照组患者多伦多临床评分变化的差异无统计学意义(P0.05)。7.干预后,两组患者收缩压、舒张压均无显著变化(P0.05),干预组和对照组患者收缩压和舒张压变化的差异无统计学意义(P0.05)。8.干预后,两组患者FBG、2h PBG、Hb A1c均降低(P0.05),且干预组FBG、2h PBG、Hb A1c下降较对照组明显,差异具有统计学意义(P0.05)。结论:1.领悟社会支持、运动自我效能越高,抑郁水平越低,美化环境越好,糖尿病患者的体力活动水平越高。应采取措施提高糖尿病患者的运动自我效能、领悟社会支持,改善抑郁状况及美化环境状况,从而提高糖尿病患者体力活动水平。2.同伴教育可以提高糖尿病周围神经病变患者运动自我效能、步数、体力活动水平,降低患者的血糖及糖化血红蛋白水平,但是对血压及神经功能的影响不明显,仍需进一步研究。
[Abstract]:Objective: to analyze the individual, social and environmental factors that affect the physical activity of diabetic patients, to provide evidence for the intervention of physical activity in diabetic patients, and to explore the self-efficacy of peer education in patients with diabetic peripheral neuropathy. Effectiveness of physical activity and severity of neuropathy. Method 1: 1. From January 2015 to May 2015, 200 patients with type 2 diabetes mellitus (T2DM) in a Grade 3A hospital in Tianjin were selected as the research objects. The method of cross-sectional investigation was used, and the theoretical basis was based on the social ecological model and the theory of exercise self-efficacy. To analyze the personal, social and environmental factors that affect the physical activity level of diabetic patients. From March 2015 to September 2015, 60 patients with diabetic peripheral neuropathy were selected from a Grade 3A hospital in Tianjin. The subjects were divided into intervention group and control group. The control group received routine health education and the intervention group received peer education on the basis of routine health education. The intervention time was 12 weeks. A questionnaire survey was conducted before and after intervention to evaluate the effects of peer education on physical activity, exercise self-efficacy and neuropathy in patients with diabetic peripheral neuropathy. The result is 1: 1. Factors affecting physical activity in diabetics include perceived social support, exercise self-efficacy, depression and landscaping. After intervention, the exercise self-efficacy of the two groups increased significantly than that of the control group, and the difference was statistically significant. After intervention, the number of steps of the two groups increased significantly compared with the control group, and the difference was statistically significant. After intervention, the total amount of daily traffic, exercise and physical activity increased in the control group, and the total amount of exercise and physical activity increased in the intervention group. Compared with the control group, the total amount of physical activity increased significantly in the intervention group. The difference was statistically significant (P 0.05). After intervention, the sitting time of the two groups decreased significantly than that of the control group (P 0.05), and the difference was statistically significant. After intervention, the Toronto clinical score of the two groups decreased significantly (P 0.05), and there was no significant difference between the intervention group and the control group in the change of Toronto clinical score. After intervention, there was no significant change in systolic and diastolic blood pressure between the two groups (P 0.05), but there was no significant difference in systolic and diastolic blood pressure between the intervention group and the control group. After intervention, the HbA1c of PBGG in the two groups decreased significantly compared with the control group (P 0.05), and the HbA1c of the intervention group was significantly lower than that of the control group (P 0.05) at 2 h after the intervention, and the HbA1c level in the intervention group was significantly lower than that in the control group (P 0.05). Conclusion 1. Perceived social support, the higher exercise self-efficacy, the lower the level of depression, the better the beautification of the environment, the higher the level of physical activity of diabetic patients. Measures should be taken to improve the exercise self-efficacy of diabetic patients, understand social support, improve depression and beautify the environment, so as to improve the physical activity level of diabetic patients. Peer education can improve the motor self-efficacy, the number of steps, the level of physical activity, and reduce the blood sugar and glycosylated hemoglobin level in patients with diabetic peripheral neuropathy, but the effect on blood pressure and neurological function is not obvious. Further study is needed.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.5
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本文编号：1883205