Chin J Nurs, March 2011, Vol 46, No.3 260, 29~82, , 39, (n=260), Cronbach's α0.76 (%)

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1 Chin J Nurs, March 2011, Vol 46, No Toobert, 260 : (4.65±2.90), (5.10±2.55), (1.15±1.79), (3.05±2.58), (6.83±1.72) 18.2%; 20.4%; 13.3%; 10.4%; 7.0%,,4 29.7%, ; ; The current status and influential factors of selfmanagement in diabetic patients/sun Shengnan,ZHAO Weigang, DONG Yingyue,LI Zheng Abstract Objective To invesigtate the current status of selfmanagement in diabetic patients,and analyze its influential factors. Methods A total of 260 diabetic patients in outpatient department were recruited from two general hospitals in Beijing and were investigated with the Summary of Diabetes SelfCare Activities and a series of influential factors questionnaires. Results The scores were 4.65±2.90 for diet,5.10±2.55 for exercise,1.15±1.79 for glucose monitoring,3.05±2.58 for foot care, 6.83±1.72 for medication compliance (range=0~7). There were 49(18.85 percent) smokers in the sample,who smoked cigarettes on average every day. Multiple linear regression indicated that selfefficacy,gender,types of medical insurance and diabetes knowledge were the influential factors of diet selfmanagement and explained 18.2 percent of the variance ; For exercise selfmanagement,selfefficacy,age,and average annual income were the main influential factors and explained 20.4 percent of the variance; For glucose selfmonitoring,depression,social support,educational level and hospitalization experience for diabetes were the main influential factors and explained 13.3 percent of the variance ; For foot care,selfefficacy,gender and illness duration were the main influential factors and explained 10.4 percent of the variance; For medication compliance, selfefficacy and working status were the main influential factors and explained 7.0 percent of the variance. Logistic regression indicated that age,gender and diabetes knowledge were the protective factors for patients' smoking behavior,while patients' illness perception was the risk factor. Conclusion The current status of self management in diabetic patients is not ideal, a mong which,medication compliance is the best,while glucose monitoring is the worst. Patients' age,gender,selfefficacy and diabetes knowledge are factors influencing selfmanagement. Key words Diabetes Mellitus; Outpatients; Self Care [1] 2010,, 9.7%, 9240,,,, 1 [2] 1.1 [3], , : WHO 1999 [4] ; 18 ; 1 ; DOI: /jssn ;, : : ( ); ; ; (, ); ( ) ; :, zhengli_2004@126.com :,,, sunshengnan850910@126.com 文章来源 : 中华护理杂志 1.2

2 Chin J Nurs, March 2011, Vol 46, No.3 260, 29~82, , 39, (n=260), Cronbach's α0.76 (%) () ~30000 > ) SPSS x±s ;,,,23, ~14,15~23 :Broadbent [8],9, 8 0~10, 3 4 7,, 9,,CVI=1.00;, Cronbach's α0.65 : (Dia [9] betes Care Profile,DCP) 5,, 19, 3( 6)1, 1~5, 18~90,, Cronbach's α0.73 : 14 2, 7, [10] 0~7,8~10,11~21 [11] 1993, Cronbach's α0.92, Cronbach's α , 270, 100%, 260, 96.3% EpiData 3.1,, Logistic Toobert [5],6,13, d,, (4.65±2.90),, (5.10±2.55), (1.15±1.79),,, (3.05±2.58),, (CVI)=1.00, (6.38±1.72) 49,18.9%, Cronbach's α 0.62~ : :Lorig [6],8, (7.82±1.56), (57.18±20.16),, (61.03±10.80), (37.65±9.79) 49 1~10,, (18.9%) ( ),36(13.8%) ( ),,CVI= 1.00,, Cronbach's α 文章来源 : 中华护理杂志 Logistic :Fitzgerald [7],, 22

3 Chin J Nurs, March 2011, Vol 46, No.3 231,α =0.05,α =0.10, Logistic,OR,, 2,,OR<1,,4,,OR>1, 18.2%, 4,,3 29.7% 20.4%, 4, 13.3% 4.1,,, 3, [1214] 10.4%;,,, 7.0% Logistic (3),4, :1,, 2 2, (n=260),, t P B Beta ) ) ) ) ;2)>30000;3) 3 Logistic (n=260) B SE :R 2 =0.297,P=0.000 Wald P OR ,,, 3 :,,, ,,, [1519] Bandura, [20],, [20],,,,,, 4.2.2, Corbett [21],, [2223], 文章来源 : 中华护理杂志,,

4 Chin J Nurs, March 2011, Vol 46, No.3, 4.2.3,,,,,,, [24],,, R 2, 4.2.4,,!,,!, :1 [1], 2 Yang WY,Lu JM,Weng JP,et al. Prevenlance of diabetes among men and women in China[J]. N Engl J Med,2010,362(12): , [2]. [M]. :, 3,2005:23., [3] Skinner TC,John M,Hampson SE. Social support and personal models of ; diabetes as predictors of selfcare and wellbeing:a longitudinal study of, adolescents with diabetes[j]. J Pediatr Psychol,2004,25(4): , [4],.[M].6. :,2004: [5] Toobert DJ,Hampson SE,Glasgow RE. The summary of diabetes selfcare,, activities measure:results from 7 studies and a revised scale[j]. Diabetes, ; Care,2000,23(7): , [6] Lorig KR,Sobel DS,Stewart AL.Evidence suggesting that a chronic disease selfmanagement program can improve health status while reducing hospitalization:a randomized trial[j]. Medical Care,1999,37(1):514. (1) : [7] Fitzgerald JT,Anderson RM,Funnell MM,et al. The reliability and validity,,of a brief diabetes knowledge test[j]. Diabetes Care,1998,21(5): , [8] [25] Broadbent E,Petrie KJ,Main J,et al. The brief illness perception question[j]. J Psychosom Res,2006,60(6): , (2) :, [9] Fitzgerald JT,Davis WK,Connell CM,et al. Development and validation, of the Diabetes Care Profile[J]. Eval Health Prof,1996,19(2): , [10],,. [M]. :,,1999:229. (3) : [11],. [J].,1993,2(3):1719., [12] Clark DO,Frankel RM,Morgan DL. The meaning and significance of, selfmanagement among socioeconomically vulnerable older adults [J]., J Gerontol,2008,63(5):S312S319. ;,, [13] Marquis KH,Ware JE. Measures of diabetic patient knowledge,attitudes and behavior regarding selfcare:summary report[r]. Santa [26], Monica, 5, California:RAND,1979. (4) :, [14],,,.6052 [27] [28] [29] [J].,2003,11(4): , [15],,.2, [J].,2005,11(19): , [16] JohnsonBrooks CH,Lewis MA,Garg S,et al. Selfefficacy impacts selfcare and HbA1c in Young adults with type 1 diabetes[j]. Psychosom (5) :,, Med,2002,64:4352. 文章来源 : 中华护理杂志 [17] Xu Y,Christine S,Kyra W,et al. Understanding the factors influencing

5 Chin J Nurs, March 2011, Vol 46, No , 862,43 6,, 6, 3 6, 3 6,, (P<0.05);, 3, (P<0.01),2; ; ; The application of empowerment theory in health education of elders with type 2 diabetes mellitus in community/ye Huiling,SUN Qiuhua,SHEN Cuizhen Abstract Objectives To evaluate the effectiveness of the empowerment theorybased education on the level of metabolic control (HbA1c) and selfefficacy in the elders with type 2 diabetes mellitus in community. Methods The study was a randomized clinical trial(rct). Eightysix elders with type 2 diabetes mellitus were randomly divided into the intervention group and the control group. The intervention group(n=43) received empowerment theorybased education consisted of 6 weekly sessions whilst the control group(n=43) received general community management. After 6 weeks of sessions all patients were followed up 6 months by phone call. The scores of selfefficacy was collected before the sessions and 6 weeks,3 months and 6 months after the end of the sessions. The HbA1c were measured before and 3 months, 6 months after. Results The mean scores of diabetes selfefficacy in most domains had increased after the intervention and significantly higher in the intervention group than those in the control group. HbA1c in the intervention group significantly decreased 3 months after the intervention(p<0.01). Conclusion The empowerment theorybased education can significantly improve patients' selfefficacy and decrease the level of HbA1c. Key words Diabetes Mellitus,Type 2; Aged; Health Education; Community Health Nursing DOI: /j.issn ( :Z ) : ( ); (, ) :, sqh807@163.com :,,, lingxiajiudu2007@163.com diabetes selfmanagement in Chinese people with type 2 Diabetes using structural equation modelin [D]. Cincinnati:University of Cincinnati, , 12.6% 15.7% 9.9% 10.8% [14], [5],,!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! of minor depression and major depression in the national comorbidity survey[j]. J Affect Disord,1997,45(1):1930. [25] Keogh KM,White P,Smith SM,et al. Changing illness perceptions in [18],. poorly controlled type 2 diabetes,a randomized controlled trial of a f [J].,2003,38(6): amilybased intervention:protocol and pilot study [J]. BMC Fam Pract, [19],,. 2 [J]. 2007,36(8): ,2007,11(12): [26] Aljasem L,Peyrot M,Wissow L,et al.the impact of barriers and selfefficacy [20] Bandura A.Social learning theory[m]. Englewood Cliffs:Prentice Hall, 1997:7982. on selfcare behaviors in type 2 diabetes[j]. Diabetes Educator, 2001,27(3): [21] Corbett CF.Researchbased practise implications for patients with diabetes. Part :diabetes selfefficacy[j]. Home Healthc Nurse,1999,17 (9): [27] [28],,. [J].,2005,22(7):2123.,. [J]. [22] StockdaleWoolley R. The effects of education on selfcare agency[j]. Public Health Nursing,1984,1: [29],2008,5(4): [J].,1981, [23],,,. 20(9): [J].,2000,16(1):4647. 文章来源 : 中华护理杂志 [24] Kessler RC,Zhao S,Blazer DG,et al. Prevalence,correlates and course ( )