压力接种训练在2型糖尿病住院患者中的应用研究

发布时间：2018-10-30 11:19

【摘要】：目的了解和评估2型糖尿病住院患者的焦虑、抑郁及自我管理行为现状,并探讨其相关性,为进行针对性的心理干预提供科学依据;探讨压力接种训练(SIT)对2型糖尿病住院患者的应用价值。方法1.2型糖尿病住院患者焦虑、抑郁及自我管理行为状况的调查:一般资料调查表调查患者的基本情况,焦虑自评量表、抑郁自评量表和自我管理行为量表为研究工具,调查患者的心理及自我管理行为,并分析其相关性。2.SIT对改善患者心理、自我管理行为及血糖控制的效果:将入选的70例2型糖尿病住院患者随机分为对照组和试验组,每组各35例,对照组给予常规教育,试验组在对照组的基础上进行SIT,每周一次,每次60分钟,共8周。两组分别在干预前后评价患者的焦虑、抑郁和自我管理行为,在干预前后监测患者空腹血糖、糖化血红蛋白的指标。统计学方法包括:t检验、χ2检验、Pearson相关性分析。结果1.2型糖尿病住院患者焦虑、抑郁及自我管理行为现状。(1)焦虑、抑郁情绪:本研究210例2型糖尿病住院患者中,患者的焦虑总粗分为(44.28±7.71),抑郁总粗分为(43.34±10.14),均高于国内常模,且差异均有统计学意义(P0.05)。(2)自我管理行为现状:本研究210例2型糖尿病住院患者中,自我管理总分为(80.27±14.98)分,处于中等水平,其中遵医嘱用药得分最高,其次为足部护理、预防及处理高低血糖、饮食控制、规律锻炼、得分最低的是血糖监测。(3)2型糖尿病住院患者自我管理行为与焦虑、抑郁情绪的关系:自我管理行为得分与焦虑、抑郁均呈负相关(r值分别为-0.437和-0.346;P0.05)。2.SIT对患者焦虑、抑郁、自我管理行为及血糖控制的影响。(1)干预前,两组患者焦虑、抑郁和自我管理行为得分差异无统计学意义,P0.05;干预后,试验组SAS得分为(49.59±4.78)、SDS得分为(51.67±5.75),显著低于对照组SAS(55.65±5.84),SDS(56.63±5.34),试验组2-DSCS得分(68.10±8.26)显著高于对照组(62.59±7.68),差异有统计学意义,P0.05。(2)干预前,两组患者在空腹血糖、糖化血红蛋白方面差异无统计学意义,P0.05;干预后,试验组空腹血糖(7.38±1.46)显著低于对照组(8.57±1.45),差异有统计学意义,P0.05;干预后,试验组糖化血红蛋白得分(8.62±0.76)与对照组(8.73±0.54)差异不明显,P0.05。结论1.2型糖尿病住院患者伴有不同程度的焦虑、抑郁情绪,其自我管理行为不容乐观。2.2型糖尿病住院患者的自我管理行为与其焦虑、抑郁情绪均呈负相关。3.SIT能有效改善2型糖尿病住院患者的心理健康状况,提高患者的自我管理水平,改善血糖控制。
[Abstract]:Objective to investigate and evaluate the anxiety, depression and self-management behavior of type 2 diabetes mellitus inpatients, and to explore the correlation between them, and to provide scientific basis for psychological intervention. To explore the application value of stress inoculation training (SIT) in type 2 diabetes mellitus inpatients. Methods A survey of anxiety, depression and self-management behavior in in-patients with type 1.2 diabetes mellitus was conducted. The general information questionnaire was used to investigate the basic situation of the patients, and self-rating anxiety scale, self-rating depression scale and self-management behavior scale were used as the research tools. The effects of 2.SIT on improving patients' psychology, self-management behavior and blood glucose control were investigated. 70 inpatients with type 2 diabetes mellitus were randomly divided into control group and experimental group. 35 cases in each group, the control group was given routine education, and the experimental group was given SIT, once a week for 60 minutes for 8 weeks on the basis of the control group. Anxiety, depression and self-management behavior were evaluated before and after intervention. Fasting blood glucose and glycosylated hemoglobin were monitored before and after intervention. Statistical methods included t test, 蠂 2 test and Pearson correlation analysis. Results the status of anxiety, depression and self-management behavior in type 1.2 diabetes mellitus inpatients were as follows: (1) anxiety and depression: in 210 inpatients with type 2 diabetes mellitus, the total gross anxiety was (44.28 卤7.71). The total gross score of depression (43.34 卤10.14) was higher than that of domestic norm, and the difference was statistically significant (P0.05). (2). The total score of self-management was (80.27 卤14.98), which was in the middle level. The highest score was according to doctor's advice, followed by foot nursing, prevention and treatment of high hypoglycemia, diet control and regular exercise. The lowest score was blood glucose monitoring. (3) the relationship between self-management behavior and anxiety and depression in patients with type 2 diabetes mellitus: the scores of self-management behavior were negatively correlated with anxiety and depression (r = -0.437 and -0.346 respectively); P05). The effect of 2.SIT on anxiety, depression, self-management behavior and blood glucose control. (1) before intervention, there was no significant difference in scores of anxiety, depression and self-management behavior between the two groups (P0.05; After intervention, the SAS score of the trial group was (49.59 卤4.78), SDS (51.67 卤5.75), which was significantly lower than that of the control group (55.65 卤5.84), SDS (, 56.63 卤5.34). The 2-DSCS score of the trial group (68.10 卤8.26) was significantly higher than that of the control group (62.59 卤7.68), the difference was statistically significant. (2) before intervention, there was no significant difference in fasting blood glucose and glycosylated hemoglobin between the two groups. P0.05; After intervention, fasting blood glucose in the trial group (7.38 卤1.46) was significantly lower than that in the control group (8.57 卤1.45), the difference was statistically significant (P 0.05). After intervention, the score of glycosylated hemoglobin in the test group (8.62 卤0.76) was not significantly different from that in the control group (8.73 卤0.54), P 0.05. Conclusion the in-patients with type 1.2 diabetes mellitus have different degree of anxiety and depression, and their self-management behavior is not optimistic. 2.2 the self-management behavior and anxiety of type 2.2 diabetic inpatients are not optimistic. 3.SIT can effectively improve the mental health, self-management and blood glucose control of patients with type 2 diabetes mellitus.
【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

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