基于结构方程模型的社区糖尿病患者糖尿病认知与自我管理分析
发布时间：2019-01-23 20:07
【摘要】：目的探索社区糖尿病患者对糖尿病认知水平与自我管理行为、自我健康认知间的关系,为糖尿病健康管理工作的改善提供依据。方法采用分层整群抽样的方法,2014年7—12月选取天津市内六区和四郊五县以及滨海新区共16个社区卫生服务中心或卫生院的糖尿病健康管理对象共1 310例,调查社会人口学资料、患者自我管理情况(健康饮食、体育锻炼、自我血糖监测频率、遵医嘱服药)、用药及治疗满意度评分、糖尿病知识知晓得分、自我健康评分、症状评分。采用结构方程模型分析糖尿病患者社会经济水平、疾病认知、日常行为、自我健康评价间的关系。结果剔除调查信息不全者,共1 038例纳入分析。结构方程模型分析结果显示,文化程度(β=0.067,P=0.038)、家庭人均月收入(β=0.083,P=0.012)与糖尿病知识知晓得分存在正向关系;糖尿病知识知晓得分与健康饮食(β=0.079,P=0.011)、自我血糖监测频率(β=0.098,P=0.002)存在正向关系;健康饮食与用药及治疗满意度评分(β=0.187,P0.001)、自我健康评分(β=0.065,P=0.038)存在正向关系,与症状评分(β=-0.099,P=0.001)存在负向关系;自我血糖监测频率与用药及治疗满意度评分(β=-0.144,P0.001)、自我健康评分(β=-0.067,P=0.032)存在负向关系,与症状评分(β=0.143,P0.001)存在正向关系;家庭人均月收入与文化程度存在正向关系(β=0.370,P0.001);症状评分与自我健康评分存在负向关系(β=-0.270,P0.001);用药及治疗满意度评分与自我健康评分存在正向关系(β=0.187,P0.001),与症状评分存在负向关系(β=-0.207,P0.001)。模型拟合优度检验结果提示拟合良好[χ~2=206.419,自由度(df)=38,P0.001;拟合优度指数(GFI)=0.971,调整拟合优度指数(AGFI)=0.921;近似误差均方根(RMSEA)=0.065,90%CI(0.051,0.074)]。结论社区糖尿病患者对糖尿病的认知程度越高,对健康饮食和自我血糖关注度越高;关注日常自我管理行为有助于提高患者的自我健康认知,减轻糖尿病症状;而关注医疗行为可能使患者提升对糖尿病症状的关注,主观满意度下降。
[Abstract]:Objective to explore the relationship between diabetes cognitive level, self-management behavior and self-health cognition in community diabetes patients, and to provide evidence for the improvement of diabetes health management. Methods using stratified cluster sampling, 1 310 diabetic health management subjects were selected from 16 community health service centers or hospitals in Tianjin from July to December 2014 in six districts and five counties in Tianjin and Binhai New District. Social demographic data, self-management (healthy diet, physical exercise, frequency of self-monitoring of blood glucose, taking medicine according to doctor's instructions), scores of satisfaction with medication and treatment, scores of knowledge about diabetes mellitus, self-health score were investigated. Symptom score. The relationship among social and economic level, disease cognition, daily behavior and self-health evaluation of diabetic patients was analyzed by structural equation model. Results 1038 cases were included in the analysis. The results of structural equation model analysis showed that there was a positive relationship between education level (尾 = 0.067 P0. 038) and average monthly income (尾 = 0. 083 P0. 012) of diabetic knowledge. There was a positive relationship between diabetes knowledge awareness score and healthy diet (尾 = 0.079) and self-monitoring frequency (尾 = 0.098). There was a positive relationship between healthy diet and satisfaction score of medication and treatment (尾 = 0.187), self-health score (尾 = 0.065), and a negative relationship with symptom score (尾 = -0.09 9 P ~ (0.001). There was a negative relationship between the frequency of self-blood glucose monitoring and the scores of medication and treatment satisfaction (尾 = -0.144), self-health score (尾 = -0.067) and symptom score (尾 = 0.143 P0.001), while there was a positive correlation between the frequency of self-blood glucose monitoring and the score of medication and treatment satisfaction (尾 = -0.144), the score of self-health (尾 = -0.067). There was a positive correlation between average monthly income and education level (尾 = 0.370, P 0.001), a negative relationship between symptom score and self-health score (尾 = -0.270, P 0.001), and a negative correlation between symptom score and self-health score (尾 = -0.270, P 0.001). There was a positive relationship between medication and treatment satisfaction score and self-health score (尾 = 0.187 P0.001), and a negative relationship between medication satisfaction score and symptom score (尾 = -0.207 P0.001). The results of model goodness of fit test showed good fit [蠂 ~ 2n 206.419, degree of freedom (df) = 38p 0.001, (GFI) = 0.971, adjusted goodness of fit index (AGFI) = 0.921]. The root mean square (RMSEA) of approximate error is 0.065 / 90 CI (0.051 / 0.074). Conclusion the higher the cognition of diabetes in community is, the more attention is paid to healthy diet and self-blood sugar, and the attention to daily self-management behavior is helpful to improve the self-health cognition and alleviate the symptoms of diabetes. Attention to medical behavior may increase the attention of patients to diabetes symptoms, subjective satisfaction decreased.
【作者单位】： 天津医科大学公共卫生学院流行病与卫生统计学系;天津市社区卫生协会;天津医学高等专科学校;
【分类号】：R587.1
本文编号：2414150
[Abstract]:Objective to explore the relationship between diabetes cognitive level, self-management behavior and self-health cognition in community diabetes patients, and to provide evidence for the improvement of diabetes health management. Methods using stratified cluster sampling, 1 310 diabetic health management subjects were selected from 16 community health service centers or hospitals in Tianjin from July to December 2014 in six districts and five counties in Tianjin and Binhai New District. Social demographic data, self-management (healthy diet, physical exercise, frequency of self-monitoring of blood glucose, taking medicine according to doctor's instructions), scores of satisfaction with medication and treatment, scores of knowledge about diabetes mellitus, self-health score were investigated. Symptom score. The relationship among social and economic level, disease cognition, daily behavior and self-health evaluation of diabetic patients was analyzed by structural equation model. Results 1038 cases were included in the analysis. The results of structural equation model analysis showed that there was a positive relationship between education level (尾 = 0.067 P0. 038) and average monthly income (尾 = 0. 083 P0. 012) of diabetic knowledge. There was a positive relationship between diabetes knowledge awareness score and healthy diet (尾 = 0.079) and self-monitoring frequency (尾 = 0.098). There was a positive relationship between healthy diet and satisfaction score of medication and treatment (尾 = 0.187), self-health score (尾 = 0.065), and a negative relationship with symptom score (尾 = -0.09 9 P ~ (0.001). There was a negative relationship between the frequency of self-blood glucose monitoring and the scores of medication and treatment satisfaction (尾 = -0.144), self-health score (尾 = -0.067) and symptom score (尾 = 0.143 P0.001), while there was a positive correlation between the frequency of self-blood glucose monitoring and the score of medication and treatment satisfaction (尾 = -0.144), the score of self-health (尾 = -0.067). There was a positive correlation between average monthly income and education level (尾 = 0.370, P 0.001), a negative relationship between symptom score and self-health score (尾 = -0.270, P 0.001), and a negative correlation between symptom score and self-health score (尾 = -0.270, P 0.001). There was a positive relationship between medication and treatment satisfaction score and self-health score (尾 = 0.187 P0.001), and a negative relationship between medication satisfaction score and symptom score (尾 = -0.207 P0.001). The results of model goodness of fit test showed good fit [蠂 ~ 2n 206.419, degree of freedom (df) = 38p 0.001, (GFI) = 0.971, adjusted goodness of fit index (AGFI) = 0.921]. The root mean square (RMSEA) of approximate error is 0.065 / 90 CI (0.051 / 0.074). Conclusion the higher the cognition of diabetes in community is, the more attention is paid to healthy diet and self-blood sugar, and the attention to daily self-management behavior is helpful to improve the self-health cognition and alleviate the symptoms of diabetes. Attention to medical behavior may increase the attention of patients to diabetes symptoms, subjective satisfaction decreased.
【作者单位】： 天津医科大学公共卫生学院流行病与卫生统计学系;天津市社区卫生协会;天津医学高等专科学校;
【分类号】：R587.1
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1 荆少华;基于结构方程模型的男男性行为接触者焦虑、抑郁症状影响因素研究[D];重庆医科大学;2016年
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