检索历史 清除

目的 探讨健康教育干预对冠心病(CHD)患者高血糖认知、自我效能及血糖的影响.方法 按WHO诊断标准选取CHD患者200例,再按照1999年WHO糖尿病诊断标准将200例CHD患者进一步分组为:血糖正常(NGT)组60例；糖调节受损(IGR)组50例；2型糖尿病(T2DM)组90例,进行住院健康教育及出院后延续性健康教育.在实施健康教育干预前,干预后6个月,运用高血糖相关知识问卷和自我效能测量表进行测评,并比较教育前、教育后3、6个月三组患者空腹血糖(FPG)、餐后2h血糖(2 h PG)及糖化血红蛋白(HbAlc)的变化情况.以上资料采用自身对照比较,计量资料采用t检验和方差分析,计数资料采用x2检验,以P＜0.05为差异有统计学意义.结果 健康教育后三组CHD患者对高血糖相关知识(1-10题)掌握情况的认知率较教育前显著提高,NGT组(x2=17.207,23.582,37.046,39.046,38.686,46.218,28.643,39.895,37.046,33.333),(均P＜0.05);IGR组(x2=31.723,23.529,23.389,27.542,21.091,27.307,20.219,38.235,24.669,26.475),(均P＜0.05);T2DM组(x2=21.161,20.680,14.612,23.104,22.383,29.436,19.444,32.526,24.671,31.696),(均P＜0.05).健康教育后CHD患者症状自我管理和疾病共性管理的自我效能得分均较教育前增高,(t=12.75,7.21,均P＜0.05).健康教育前、教育后3、6个月NGT组患者FPG、2 hPG、HbAlc未见明显改变(F=2.35,1.97,2.01,均P＞0.05)；IGR组患者FPG、2hPG、HbAlc均有显著下降(F=8.07,8.89,10.23,均P＜0.05)；T2DM组患者FPG、2hPG、HbAlc均有显著下降(F=12.35,11.56,8.99,均P＜0.05).结论 健康教育干预可提高CHD患者对高血糖的认知水平、自我效能及改善糖代谢.

Objective To investigate the impacts of health education on awareness of hyperglycemia,self-efficacy and serum level of blood glucose in patients with coronary heart disease (CHD).Methods Two hundred CHD patients were enrolled in this study and assigned to the normal blood glucose (NGT) group ( n =60),impaired glucose regulation (IGR) group ( n =50),and type 2 diabetes mellitus (T2DM) group (n =90).Health education programme was carried out before and after discharge from the hospital.Fasting plasma glucose (FPG),2 h postprandial blood glucose (2 hPG) and glycosylated hemoglobin ( HbA1c ) of each group were assessed at baseline and 3 or 6 months after the intervention.Chisquare or t test was used for data analysis.Results After the intervention,the awareness of hyperglycemia was significantly improved in each of three groups (NGT group:x2 values were 17.207,23.582,37.046,39.046,38.686,46.218,28.643,39.895,37.046 and 33.333,respectively,all P ＜ 0.05 ; IGR group:x2values were 31.723,23.529,23.389,27.542,21.091,27.307,20.219,38.235,24.669 and 26.475,respectively,all P ＜0.05; T2DM group:x2 values were 21.161,20.680,14.612,23.104,22.383,29.436,19.444,32.526,24.671 and 31.696,respectively,all P ＜ 0.05 ).Self-efficacy scores of symptom selfmanagement and common disease management were increased after the health education intervention (t values were 12.75 and 7.21,respectively,both P ＜ 0.05 ).At 3 or 6 months,the NGT group showed on significant change in FPG,2 h PG and HbAlc (F values were 2.35,1.97 and 2.01,respectively,all P ＞0.05) ; however,FPG,2 h PG and HbAlc of the IGR and T2DM group were significantly decreased ( IGRgroup:F values were 8.07,8.89,and 10.23,respectively,all P ＜ 0.05 ; T2DM group:F values were 12.35,11.56 and 8.99,respectively,all P ＜ 0.05 ).Conclusion Health education could improve the awareness of hyperglycemia,self-efficacy and glucose metabolism in patients with CHD.