老年2型糖尿病患者老年综合征现状及与生活质量的关系

发布时间：2018-01-02 05:36

本文关键词：老年2型糖尿病患者老年综合征现状及与生活质量的关系　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的以老年2型糖尿病患者为研究对象,描述其多重老年综合征罹患现状和生活质量水平,并进一步分析生活质量影响因素,旨在探求多重老年综合征对患者生活质量的累积作用,促进临床护士以全新的视角关注患者身心健康,从而采取积极措施帮助患者改善生活质量。方法采用横断面调查研究。于2015年9月至2016年3月,通过便利抽样法选取某三级甲等医院符合纳入标准的397例2型糖尿病患者进行老年综合征的评估和生活质量问卷调查,老年综合征涵盖慢性疼痛、慢性便秘、跌倒、多重用药、尿失禁、营养不良、睡眠障碍。慢性疼痛、慢性便秘、跌倒情况通过问诊方式询问患者,用药情况通过查阅其电子病历获取,最后三项老年综合征分别通过国际尿失禁咨询委员会尿失禁问卷表简表、简易营养法简表、匹兹堡睡眠质量指数进行评估。数据统计分析采用SPSS 17.0软件进行,不同患者生活质量水平比较采用独立样本t检验、单因素方差分析;相关性分析采用Spearman秩相关;生活质量的影响因素分析采用多元线性回归分析法。结果1.老年2型糖尿病患者生理健康和心理健康得分分别为277.11±64.30,307.00±60.45;生活质量8个维度中,情感职能得分最高,一般健康状况得分最低。2.研究对象各老年综合征的发生率依次为:多重用药70.5%,睡眠障碍56.4%,慢性疼痛44.1%,慢性便秘31.5%,跌倒31.2%,尿失禁26.4%,营养不良20.9%;平均患有老年综合征数量为2.81±1.38,81.9%的患者所患老年综合征数量为两个或两个以上。3.不同年龄、职业、医疗费用承担方式对患者生理健康存在影响(P0.05),而年龄、职业、文化程度及婚姻状况对患者心理健康产生影响(P0.05);病程、糖化血红蛋白值、合并症与并发症数量均与患者的生理健康、心理健康得分呈负相关(rs=-0.338~-0.132,P0.05)。4.是否患老年综合征以及所患数量都会影响研究对象的生理健康、心理健康(P0.05)。5.分别对患者生理健康与心理健康得分进行多元线性回归分析。患者罹患的老年综合征数量、糖尿病合并症与并发症数量和病程进入患者生理健康回归方程;老年综合征数量、糖尿病合并症与并发症数量进入患者心理健康回归方程。两回归方程分别解释生理健康、心理健康总变异的29.9%、23.0%。结论住院老年2型糖尿病患者老年综合征的发生率较高,大部分患者同时存在多重老年综合征。患者生活质量水平不容乐观,除受人口学特征和病情影响外,多重老年综合征是患者生活质量主要的影响因素,所造成的损伤超过人口学因素以及糖尿病疾病本身对患者产生的影响。
[Abstract]:Objective to describe the current situation and quality of life (QOL) in elderly patients with type 2 diabetes mellitus (T2DM), and to analyze the influencing factors of QOL. The purpose of this study is to explore the cumulative effect of multiple elderly syndrome on patients' quality of life and to promote clinical nurses to pay attention to patients' physical and mental health from a new perspective. Therefore, positive measures were taken to help patients improve their quality of life. Methods Cross-sectional investigation was carried out from September 2015 to March 2016. According to the convenience sampling method, 397 patients with type 2 diabetes mellitus who met the inclusion criteria in a Grade 3A hospital were selected to evaluate the elderly syndrome and the quality of life questionnaire. The elderly syndrome covers chronic pain. Chronic constipation, fall, multiple medication, urinary incontinence, malnutrition, sleep disorder. Chronic pain, chronic constipation, fall through the way of asking the patient, medication through access to their electronic medical records. The last three items of senile syndrome were summarized by the urinary incontinence questionnaire of the International urinary Incontinence Advisory Committee and the summary table of simple nutrition method. Pittsburgh Sleep quality Index (PQI) was evaluated by SPSS 17.0 software. The quality of life (QOL) of different patients was compared by independent sample t-test and univariate analysis of variance (ANOVA). Spearman rank correlation was used in correlation analysis. Multiple linear regression analysis was used to analyze the influencing factors of quality of life. Results 1. The scores of physical health and mental health of elderly patients with type 2 diabetes were 277.11 卤64.30 respectively. 307.00 卤60.45; In the eight dimensions of quality of life, affective function score was the highest, general health score was the lowest. 2. The incidence of elderly syndrome was 70.5 for multiple drug use and 56.4% for sleep disorder. Chronic pain 44.1, chronic constipation 31.5, falling 31.2 measures, urinary incontinence 26.4am, malnutrition 20.9; The average number of senile syndrome patients was 2.81 卤1.38%. The number of senile syndrome was two or more than two. 3. Different age and occupation. However, age, occupation, education and marital status had an effect on patients' mental health. The course of disease, the value of glycosylated hemoglobin, the number of complications and complications were negatively correlated with the patients' physical and mental health scores. P0.05. 4. whether or not the elderly syndrome and the number of diseases will affect the physical health of the study subjects. The scores of physical health and mental health were analyzed by multivariate linear regression analysis. The number of complications, the number of complications and the course of diabetes entered the regression equation of patients' physiological health. The number of senile syndrome, the number of diabetes complications and complications entered the mental health regression equation of patients. The two regression equations explained the total variation of physical health and mental health 29.9% respectively. Conclusion the incidence of senile syndrome in elderly patients with type 2 diabetes mellitus is high, and most of the patients have multiple elderly syndrome at the same time. The quality of life of the patients is not optimistic. In addition to demographic characteristics and disease, multiple elderly syndrome is the main influencing factor of patients' quality of life. The damage caused by multiple senile syndrome is more than that of demographic factors and diabetes disease itself.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

【参考文献】