糖尿病足患者自行注射胰岛素行为现状及影响因素的研究

发布时间：2018-01-05 12:35

本文关键词：糖尿病足患者自行注射胰岛素行为现状及影响因素的研究　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的研究糖尿病足患者自行注射胰岛素行为现状;发现注射过程中存在的问题,分析其主要影响因素;为医护工作者进行相关教育及实施预防措施提供参考,促进和规范糖尿病足患者自行注射胰岛素行为,提高糖尿病足的治疗效果。研究方法1.研究者查阅文献,制定问卷,经预实验和专家咨询后最终形成糖尿病足患者自行注射胰岛素行为的调查问卷。《我对胰岛素的看法》量表为国内外正在使用的成熟量表,分为主表和副表两部分。2.采用便利抽样法,选择2015年9月至2016年6月在大连市某三级甲等医院糖尿病足治疗中心,符合纳入、排除标准的糖尿病足患者236人。3.患者自愿参与本研究,研究者通过查阅病历、询问患者填写自然信息和临床信息调查表,患者自行填写糖尿病足患者自行注射胰岛素行为的调查问卷和《我对胰岛素的看法》量表,对于不能自行填写的患者研究者根据患者的回答代为填写问卷。4.采用Epidate3.0软件录入原始数据,SPSS 19.0软件进行统计学分析。计量资料用均数±标准差((?)±s)的形式表示,计数资料按照率和百分比表示,相关分析采用Spearman相关,不同人群特征的自行注射胰岛素行为分析采用两独立样本t检验和单因素方差分析,多因素分析采用多重逐步回归分析。研究结果1.236例糖尿病足患者自行注射胰岛素问卷总分为44~110(79.41±13.387)分,糖尿病足患者在注射胰岛素技术维度得分最低,为(3.00±0.659)分。25个条目中有5个条目的得分均分≤3分,是糖尿病足患者自行注射胰岛素问题最多的条目,即注射前用酒精消毒皮肤(2.92±0.871)分、更换笔芯前检查胰岛素液体(2.56±0.726)分、如何处理废弃针头(1.91±0.639)分、在不同部位之间轮换注射(1.67±0.156)分、规律轮换注射部位(1.58±0.099)分,这其中有4个条目属于注射胰岛素技术维度。2.236例糖尿病足患者中,88.6%的患者存在心理性胰岛素抵抗,糖尿病足患者自行注射胰岛素问卷得分与心理性胰岛素抵抗得分呈正相关(r=0.133,P0.05)。3.不同人群特征分析中,不同性别的糖尿病足患者自行注射胰岛素行为差异有统计学意义(P0.05);不同糖尿病类型的糖尿病足患者自行注射胰岛素行为差异有统计学意义(P0.05);每天注射胰岛素的次数不同的糖尿病足患者自行注射胰岛素行为差异有统计学意义(P0.05);是否定期监测血糖的糖尿病足患者自行注射胰岛素行为差异有统计学意义(P0.05);是否按糖尿病饮食进食的糖尿病足患者自行注射胰岛素行为差异有统计学意义(P0.05);是否遵医嘱运动的患者自行注射胰岛素行为差异有统计学意义(P0.05)。4.糖尿病足患者的多重逐步回归分析,性别、医疗费用支出方式、注射胰岛素时间、糖尿病足等级、是否定期监测血糖、是否按糖尿病饮食进食、心理性胰岛素抵抗得分进入回归方程,是糖尿病足患者自行注射胰岛素行为的主要影响因素。研究结论1.236例糖尿病足患者注射胰岛素技术方面最薄弱,在注射前用酒精消毒皮肤、更换笔芯前检查胰岛素液体、如何处理废弃针头、不同部位之间轮换注射、规律轮换注射部位方面存在问题较多。2.糖尿病足患者胰岛素使用心理状况不佳,糖尿病足患者自行注射胰岛素行为与心理性胰岛素抵抗水平具有相关性。3.性别、医疗费用支出方式、注射胰岛素时间、糖尿病足等级、是否定期监测血糖、是否按糖尿病饮食、心理性胰岛素抵抗是糖尿病足患者自行注射胰岛素行为的主要影响因素。
[Abstract]:To study the status of patients with diabetic foot by injecting insulin injection behavior; found problems in the process of analysis, the main influencing factors for medical workers; and provide reference for prevention measures related to education, to promote and regulate the self injection of insulin in patients with diabetic foot, improve the treatment of diabetic foot. Methods 1. researchers access the literature, questionnaire, expert consultation and pre experimental diabetic foot patients self injection of insulin behavior to form the final questionnaire. My views on insulin > scale at home and abroad are using the mature scale, the main and secondary tables two part.2. with the convenient sampling method, from September 2015 to June 2016 in Dalian City diabetic foot is a three level of first-class hospital treatment center, in accordance with the inclusion and exclusion criteria, 236 patients with diabetic foot.3. patients volunteered to participate in this research The researchers from the medical records, asking patients to fill out the natural information and clinical information questionnaire, patients with diabetic foot patients to fill out self injection of insulin behavior questionnaire and I view on insulin > scale for patients unable to fill in according to the patient's answer to fill in the questionnaire by.4. Epidate3.0 software the original data, SPSS 19 software was used for statistical analysis. The mean and standard deviation of measurement data ((?) + s) in the form of count data according to the rate and percentage, correlation analysis using Spearman correlation, self injection of insulin behavior of different population characteristics were analyzed with the analysis of two independent samples t test and ANOVA. Multivariate analysis using multiple stepwise regression analysis. Results: 1.236 cases of patients with diabetic foot self injection of insulin for 44~110 scores (79.41 + 13.387), sugar Diabetes foot patients on insulin injection technology for the lowest score, (3 + 0.659).25 entries in 5 items were scored less than 3 points, is the most entries in patients with diabetic foot self injection of insulin, namely before injection with alcohol disinfection of the skin (2.92 + 0.871) points, refillable check insulin liquid (2.56 + 0.726) points, how to deal with discarded needles (1.91 + 0.639) points, rotation injection in different parts between the (1.67 + 0.156), regular rotation injection site (1.58 + 0.099) points, of which 4 items belong to the insulin injection technology dimension.2.236 cases in patients with diabetic foot, 88.6% patients have psychological insulin resistance in patients with diabetic foot, self injection of insulin and insulin resistance questionnaire scores of psychological scores were positively correlated (r=0.133, P0.05) of.3. in different populations of patients with diabetic foot with different gender self injection of pancreas There were statistically significant differences in insulin behavior (P0.05); there were statistically significant differences in different types of diabetic patients with diabetic foot self injection of insulin (P0.05); differences in behavior of patients with diabetic foot times daily insulin injections of different self injection of insulin behavior was statistically significant (P0.05); whether the diabetic foot patients regularly monitor blood glucose by difference insulin injection behavior was statistically significant (P0.05); the difference was statistically significant in patients with diabetic foot according to whether diabetes diet eating behavior of self injection of insulin (P0.05); difference is not exercise compliance with acts of self injection of insulin was statistically significant (P0.05) in patients with diabetic foot multiple.4. stepwise regression analysis, gender, medical expenses time, insulin, diabetic foot level, whether the regular monitoring of blood glucose, whether by diabetes diet, psychological Enter the regression equation of scores of insulin resistance are the main influencing factors of patients with diabetic foot self injection of insulin action. The conclusion of the study of 1.236 cases of diabetic foot in patients with insulin injection technology is the use of alcohol disinfection of the skin before injection, refillable check before insulin liquid, how to deal with discarded needles in different parts of rotation between the injection of insulin with more.2. diabetic foot using the psychological status of poor law of rotation of the injection site, self injection of insulin in patients with diabetic foot behavior and psychological level of insulin resistance associated with.3. sex, medical expenses, insulin injection time, diabetic foot level, whether the regular monitoring of blood glucose, whether the diabetic diet, psychological insulin resistance is the main factor effect of diabetic foot patients self injection of insulin action.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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