摘要目的 分析参与社区患者自我管理小组干预活动的糖尿病患者生活质量及其影响因素.方法 2014年4至6月,社区卫生服务中心的医生采用电话通知、张贴招募海报、发放宣传单等多种形式,在社区卫生服务中心登记管理的糖尿病患者中招募参与者.共招募自愿参加自我管理的糖尿病患者633例.分别在患者自我管理干预前及6个月干预后,对招募的研究对象进行两次问卷调查、身体测量和实验室检测,采用配对t检验、卡方检验比较生活质量前后变化,运用二元Logistic回归分析影响因素.结果 完成6次小组活动的患者为603例,应答率95.2%.患者自我管理干预前后生活质量8个维度均有所提高,差异有统计学意义(P均<0.05).单因素分析结果显示:月收入(χ2=6.72, P=0.035)、蔬菜水果摄入改善组(χ2=5.11,P=0.024)、中等强度体力活动改善组(χ2=16.29,P=0.000)、饮食习惯改善组(χ2=7.34,P=0.007)、自信可以管理糖尿病改善组(χ2=20.48,P=0.000)、血糖控制改善组(χ2=5.10,P=0.024)、体质指数改善组(χ2=4.80,P=0.028)的生活质量总得分改善情况较好,差异有统计学意义.多因素分析结果显示:中等强度体力活动改善组(OR=1.711,P=0.020)、自信可以管理糖尿病改善组(OR=2.935,P=0.000)生活质量改善情况较好.结论 患者自我管理干预活动可以从生理和心理层面改善患者生活质量.

abstractsObjective To analyze changes in quality of life(QOL)of diabetic patients before and after self-management group activities and potential factors influencing the changes.Methods From April to June 2014, volunteer patients with medical records confirming diagnosis of diabetes were recruited through telephone notification,poster announcements,and letter invitation.At baseline and six months later, interviews were conducted to analyze changes in QOL.A total of 633 participants were recruited who agreed to enter aself-management group. Paired t-tests were used to compare QOL before and after the self-management group activities, andbinary logistic regression analysis was used to analyze the potential influencing factors. Results Six hundred and three participants completed the 6-session activities with a response rate of 95.2%. Compared to baseline, the QOL scores in eight domains were all higher after six months.Single factor analysis showed that QOL of those with high income(χ2=6.72,P=0.035),the fruit and vegetable intake improvement group (χ2=5.11, P=0.024), the moderate-intensity physical activity improvement group (χ2=16.29, P=0.000), the eating habits improvement group (χ2=7.34, P=0.007), the self-confidence to manage diabetes improvement group(χ2=20.48,P=0.000),the glycemic control group(χ2=5.10,P=0.024),and the body-mass index improvement group(χ2=4.80,P=0.028)were higher than for other groups. Multi-factor analysis results showed that moderate physical activity improvement (OR=1.711, P=0.020) and self-confidence to manage diabetes improvement (OR=2.935, P=0.000) were factors related to improvement of QOL.Conclusion Self-management group activities were important ways to improve QOL.