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目的 探讨实施同伴支持教育对农村城市化2型糖尿病患者自我管理能力和生命质量的影响.方法 选取2015年1-9月上海市奉贤区下属3个镇大型居住社区2型糖尿病患者117例,采用随机数字法分为观察组58和对照组59例.2组患者健康教育内容相同.对照组由糖尿病教育护士课堂教育;观察组在此基础上实施为期6个月同伴支持教育.干预前、干预6个月后采用糖尿病患者自我管理行为量表、简明健康状况量表对患者进行测评,并采用全自动生化分析仪测定糖化血红蛋白水平,评定患者自我管理能力、生命质量和糖代谢水平.结果 干预6个月后观察组生命质量得分,生理功能(73.6 ± 11.5)分,生理职能(86.7 ± 14.5)分,躯体疼痛(76.3 ± 12.3)分,总体健康(64.5 ± 13.6)分,活力(67.5 ± 12.3)分,社会功能(87.1 ± 16.2)分,情感职能(81.1 ± 14.2)分,精神健康(68.9 ± 12.6)分,对照组为生理功能(51.3 ± 10.6)分,生理职能(62.1 ± 12.1)分,躯体疼痛(51.3 ± 10.8)分,总体健康(51.1 ± 11.6)分,活力(56.4 ± 12.1)分,社会功能(70.1 ± 14.1)分,情感职能(71.2 ± 13.9)分,精神健康(56.1 ± 10.8)分,(t=2.316~6.365,P<0.05).自我管理得分分别为观察组饮食管理(5.79 ± 0.98)分,运动管理(5.41 ± 0.57)分,血糖监测(4.01 ± 0.90)分,足部护理(5.26 ± 0.89)分,药物管理(4.47 ± 0.90)分,吸烟(0.86 ± 0.34)分,对照组为饮食管理(3.62 ± 0.99)分、运动管理(3.66 ± 0.94)分、血糖监测(1.90 ± 0.84)分、足部护理(2.54 ± 0.62)分、药物管理(3.73 ± 0.80)分,吸烟(0.76 ± 0.42)分(除吸烟t=1.375,P=0.172,其余各项t=4.659~19.137,P<0.01).结论 同伴支持教育能改善患者的生命质量,增强自我管理能力,控制糖代谢水平,可操作性强,值得推广.

Objective To explore the effect of peer support education on self-management ability and survival quality of urbanized type 2 diabetes patients in rural areas. Methods From January to September 2015, a total of 117 patients with type 2 diabetes were selected from three large-scale living communities of Fengxian District.Then,they were randomly divided into observation group(58 cases)and control group (59 cases) using random number method, respectively. And the same health education contents were conducted for the patients in both two groups.The patients in control group were educated by the diabetic nurse in classroom. Additionally, the peer support education was conducted for these patients in observation group for 6 months on this basis.The diabetes patient's self-management behavior scale and 36-item Short-Form Health Survey Questionnaire(SF-36)were used to assess the patients before intervention and 6 months later,respectively.Besides,the level of glycosylated hemoglobin was measured by the automatic biochemical analyzer. The self- management ability and survival quality and glycometabolism level were assessed as well. Results 6 months later after intervention, the survival quality score in observation group was as following:physical function(PF) 73.6±11.5,role physical(RP) 86.7 ± 14.5, body pain (BP) 76.3 ± 12.3, general health (GH) 64.5 ± 13.6, vitality (VT) 67.5 ± 12.3, social function (SF) 87.1 ± 16.2, role emotional (RE) 81.1 ± 14.2, mental health (MH) 68.9 ± 12.6, while that in control group was as following:physical function(PF)51.3±10.6,role physical(RP)62.1±12.1,body pain (BP)51.3±10.8,general health(GH)51.1±11.6,vitality(VT)56.4±12.1,social function(SF)70.1±14.1, role emotional (RE) 71.2 ± 13.9, mental health (MH) 56.1 ± 10.8 (t=2.316-6.365, P<0.05). The self-management score in observation group was following:diet management 5.79±0.98,exercise management 5.41 ± 0.57, blood glucose monitoring 4.01 ± 0.90, foot care 5.26 ± 0.89, drug administration 4.47 ± 0.90, smoking 0.86 ± 0.34, while that in control group was following: diet management 3.62 ± 0.99, exercise management 3.66 ± 0.94, blood glucose monitoring 1.90 ± 0.84, foot care 2.54 ± 0.62, drug administration 3.73 ± 0.80, smoking 0.76 ± 0.42 (t=4.659-19.137, P of rest was less than 0.01 except that of smoking equaled to 0.172 and t=1.375). Conclusions Peer support education can improve the quality of life, enhance self-management ability, control the level of glucose metabolism and has a strong operability. Therefore,it is worthy of promotion.