本文選題：糖尿病 + 同伴教育�。� 參考：《天津醫(yī)科大學》2016年碩士論文

【摘要】：目的:分析影響糖尿病患者體力活動水平的個人、社會及環(huán)境因素,為對糖尿病患者進行體力活動干預提供依據(jù);探討同伴教育對糖尿病周圍神經(jīng)病變患者運動自我效能、體力活動及神經(jīng)病變嚴重程度影響的有效性。方法:1.選取2015年1月至2015年5月天津市某三級甲等�？漆t(yī)院200例住院2型糖尿病患者為研究對象,采用橫斷面調(diào)查的方法,以社會生態(tài)模型和運動自我效能理論為理論依據(jù),分析對糖尿病患者體力活動水平影響的個人、社會、環(huán)境因素。2.選取2015年3月至2015年9月天津市某三級甲等�？漆t(yī)院60例糖尿病周圍神經(jīng)病變患者為研究對象。采用類試驗研究方法,將研究對象分為干預組及對照組,對照組研究對象接受常規(guī)健康教育,干預組研究對象在常規(guī)健康教育基礎上接受同伴教育,干預時間為12周。干預前后對兩組研究對象進行問卷調(diào)查,評價同伴教育對糖尿病周圍神經(jīng)病變患者體力活動、運動自我效能和神經(jīng)病變情況的影響。結果:1.影響糖尿病患者體力活動的因素包括領悟社會支持、運動自我效能、抑郁及美化環(huán)境情況。2.干預后,兩組患者運動自我效能均提高(P0.05),干預組運動自我效能較對照組提升明顯,且差異具有統(tǒng)計學意義(P0.05)。3.干預后,兩組患者步數(shù)均增加(P0.05),干預組相較于對照組步數(shù)增加明顯,且差異具有統(tǒng)計學意義(P0.05)。4.干預后,對照組日常交通、運動鍛煉、體力活動總量均增加(P0.05),干預組運動鍛煉及體力活動總量增加(P0.05),干預組相較于對照組運動鍛煉、體力活動總量增加明顯,且差異具有統(tǒng)計學意義(P0.05)。5.干預后,兩組患者靜坐時間均減少(P0.05),干預組靜坐時間較對照組減少明顯,且差異具有統(tǒng)計學意義(P0.05)。6.干預后,兩組患者多倫多臨床評分均減少(P0.05),干預組和對照組患者多倫多臨床評分變化的差異無統(tǒng)計學意義(P0.05)。7.干預后,兩組患者收縮壓、舒張壓均無顯著變化(P0.05),干預組和對照組患者收縮壓和舒張壓變化的差異無統(tǒng)計學意義(P0.05)。8.干預后,兩組患者FBG、2h PBG、Hb A1c均降低(P0.05),且干預組FBG、2h PBG、Hb A1c下降較對照組明顯,差異具有統(tǒng)計學意義(P0.05)。結論:1.領悟社會支持、運動自我效能越高,抑郁水平越低,美化環(huán)境越好,糖尿病患者的體力活動水平越高。應采取措施提高糖尿病患者的運動自我效能、領悟社會支持,改善抑郁狀況及美化環(huán)境狀況,從而提高糖尿病患者體力活動水平。2.同伴教育可以提高糖尿病周圍神經(jīng)病變患者運動自我效能、步數(shù)、體力活動水平,降低患者的血糖及糖化血紅蛋白水平,但是對血壓及神經(jīng)功能的影響不明顯,仍需進一步研究。
[Abstract]:Objective: to analyze the individual, social and environmental factors that affect the physical activity of diabetic patients, to provide evidence for the intervention of physical activity in diabetic patients, and to explore the self-efficacy of peer education in patients with diabetic peripheral neuropathy. Effectiveness of physical activity and severity of neuropathy. Method 1: 1. From January 2015 to May 2015, 200 patients with type 2 diabetes mellitus (T2DM) in a Grade 3A hospital in Tianjin were selected as the research objects. The method of cross-sectional investigation was used, and the theoretical basis was based on the social ecological model and the theory of exercise self-efficacy. To analyze the personal, social and environmental factors that affect the physical activity level of diabetic patients. From March 2015 to September 2015, 60 patients with diabetic peripheral neuropathy were selected from a Grade 3A hospital in Tianjin. The subjects were divided into intervention group and control group. The control group received routine health education and the intervention group received peer education on the basis of routine health education. The intervention time was 12 weeks. A questionnaire survey was conducted before and after intervention to evaluate the effects of peer education on physical activity, exercise self-efficacy and neuropathy in patients with diabetic peripheral neuropathy. The result is 1: 1. Factors affecting physical activity in diabetics include perceived social support, exercise self-efficacy, depression and landscaping. After intervention, the exercise self-efficacy of the two groups increased significantly than that of the control group, and the difference was statistically significant. After intervention, the number of steps of the two groups increased significantly compared with the control group, and the difference was statistically significant. After intervention, the total amount of daily traffic, exercise and physical activity increased in the control group, and the total amount of exercise and physical activity increased in the intervention group. Compared with the control group, the total amount of physical activity increased significantly in the intervention group. The difference was statistically significant (P 0.05). After intervention, the sitting time of the two groups decreased significantly than that of the control group (P 0.05), and the difference was statistically significant. After intervention, the Toronto clinical score of the two groups decreased significantly (P 0.05), and there was no significant difference between the intervention group and the control group in the change of Toronto clinical score. After intervention, there was no significant change in systolic and diastolic blood pressure between the two groups (P 0.05), but there was no significant difference in systolic and diastolic blood pressure between the intervention group and the control group. After intervention, the HbA1c of PBGG in the two groups decreased significantly compared with the control group (P 0.05), and the HbA1c of the intervention group was significantly lower than that of the control group (P 0.05) at 2 h after the intervention, and the HbA1c level in the intervention group was significantly lower than that in the control group (P 0.05). Conclusion 1. Perceived social support, the higher exercise self-efficacy, the lower the level of depression, the better the beautification of the environment, the higher the level of physical activity of diabetic patients. Measures should be taken to improve the exercise self-efficacy of diabetic patients, understand social support, improve depression and beautify the environment, so as to improve the physical activity level of diabetic patients. Peer education can improve the motor self-efficacy, the number of steps, the level of physical activity, and reduce the blood sugar and glycosylated hemoglobin level in patients with diabetic peripheral neuropathy, but the effect on blood pressure and neurological function is not obvious. Further study is needed.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R473.5
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本文編號：1883205