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目的 探讨基于跨理论模型的抑郁管理对老年2型糖尿病患者的影响.方法 采用便利抽样方法选取2015年9月至2016年12月江阴市人民医院内分泌科就诊的老年2型糖尿病患者78名,采用随机数字表法分为干预组39名和对照组39名,干预组患者采用基于跨理论模型的抑郁管理,对照组采用常规心理健康教育方法,采用抑郁症状量表、抑郁预防与管理调查问卷以及生化指标比较两组干预效果.主要统计学方法包括χ2检验,独立样本t检验、Mann-Whitney U检验以及重复测量方差分析.结果 干预后3个月,干预组抑郁平均得分50.97分(F=17.814)、知觉利益得分(9.59 ± 2.10)分(t=-6.732)、知觉障碍得分(5.59 ± 1.30)分(t=2.980)、认知层面得分(32.98 ± 4.87)分(t=-10.189)、行为层面得分(34.32 ± 5.02)分(t=-13.745)、自我效能得分(12.11 ± 2.13)分(t=-7.845)与干预前比较有明显改善,并且优于对照组知觉利益得分(8.31 ± 1.12)分(F=32.789)、知觉障碍得分(6.99 ± 2.12)分(F=18.788)、认知层面得分(29.01 ± 3.34)分(F=67.876)、行为层面得分(28.03 ± 4.77)分(F=43.476)、自我效能得分(9.78 ± 2.03)分(F=15.543),组内及组间比较差异均有统计学意义(P<0.01);干预后3个月,干预组空腹血糖(7.24 ± 1.36)mmol/L明显低于对照组(7.41 ± 1.34)mmol/L,差异有统计学意义(t=0.624,P=0.028).结论 基于跨理论模型的抑郁管理对老年2型糖尿病患者抑郁、自我效能等均有明显改善效果,有效缓解患者病情.

Objective To investigate the impact of transtheoretical model-based depression management on senile people with type 2 diabetes. Methods A total of 78 senile patients with type 2 diabetes were recruited from the Affiliated Jiangyin Hospital of Southeast University Medical College and the Nantong Tumor Hospital during the period from September 2015 to December 2016.They were randomly divided into the experimental(n=39)and the control groups(n=39).The patients in the experimental group received transtheoretical model-based depression management while those in the control group received traditional health education. The intervention results were evaluated using Demographic Data Recording Form, Self-Rating Depression Scale, and Depression Prevention & Management Survey Items. The main statistical methods included Chi square test,independent sample t test,Mann-Whitney U test,and repeated measures analysis of variance. Results After the intervention of three months, the mean scores of Self-Rating Depression Scale was 50.97 (F=17.814), perceived benefit score was (9.59 ± 2.10) (t=-6.732), perceived barriers score was (5.59 ± 1.30) (t=2.980), cognitive level score was (32.98 ± 4.87) (t=-10.189), the behavior level score was (34.32 ± 5.02) (t=-13.745), and the self-efficacy score was (12.11 ± 2.13)(t=-7.845),all of which significantly improved in the experimental group,more than the control group with its perceived benefit score of(8.31 ± 1.12)(F=32.789),perceived barriers score of(6.99 ± 2.12)(F=18.788), cognitive level score of (29.01 ± 3.34) (F=67.876), behavior level score of (28.03 ± 4.77) (F=43.476), and self-efficacy score of(9.78 ± 2.03)(F=15.543),and the difference was statistically significant(P<0.01).The level of FPG in experimental group was(7.24 ± 1.36)mmol/L,which was significantly lower than the FPG of (7.41 ± 1.34)mmol/L in the control group(t=0.624,P=0.028).Conclusions Transtheoretical model-based depression management can effectively improve senile type 2 diabetes'management of depression,which is valuable in the clinical context.