發(fā)布時(shí)間：2018-05-13 12:46

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

【摘要】：目的:分析影響糖尿病患者體力活動(dòng)水平的個(gè)人、社會(huì)及環(huán)境因素,為對(duì)糖尿病患者進(jìn)行體力活動(dòng)干預(yù)提供依據(jù);探討同伴教育對(duì)糖尿病周圍神經(jīng)病變患者運(yùn)動(dòng)自我效能、體力活動(dòng)及神經(jīng)病變嚴(yán)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(jí)甲等�？漆t(yī)院200例住院2型糖尿病患者為研究對(duì)象,采用橫斷面調(diào)查的方法,以社會(huì)生態(tài)模型和運(yùn)動(dòng)自我效能理論為理論依據(jù),分析對(duì)糖尿病患者體力活動(dòng)水平影響的個(gè)人、社會(huì)、環(huán)境因素。2.選取2015年3月至2015年9月天津市某三級(jí)甲等�？漆t(yī)院60例糖尿病周圍神經(jīng)病變患者為研究對(duì)象。采用類試驗(yàn)研究方法,將研究對(duì)象分為干預(yù)組及對(duì)照組,對(duì)照組研究對(duì)象接受常規(guī)健康教育,干預(yù)組研究對(duì)象在常規(guī)健康教育基礎(chǔ)上接受同伴教育,干預(yù)時(shí)間為12周。干預(yù)前后對(duì)兩組研究對(duì)象進(jìn)行問(wèn)卷調(diào)查,評(píng)價(jià)同伴教育對(duì)糖尿病周圍神經(jīng)病變患者體力活動(dòng)、運(yùn)動(dòng)自我效能和神經(jīng)病變情況的影響。結(jié)果:1.影響糖尿病患者體力活動(dòng)的因素包括領(lǐng)悟社會(huì)支持、運(yùn)動(dòng)自我效能、抑郁及美化環(huán)境情況。2.干預(yù)后,兩組患者運(yùn)動(dòng)自我效能均提高(P0.05),干預(yù)組運(yùn)動(dòng)自我效能較對(duì)照組提升明顯,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.干預(yù)后,兩組患者步數(shù)均增加(P0.05),干預(yù)組相較于對(duì)照組步數(shù)增加明顯,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.干預(yù)后,對(duì)照組日常交通、運(yùn)動(dòng)鍛煉、體力活動(dòng)總量均增加(P0.05),干預(yù)組運(yùn)動(dòng)鍛煉及體力活動(dòng)總量增加(P0.05),干預(yù)組相較于對(duì)照組運(yùn)動(dòng)鍛煉、體力活動(dòng)總量增加明顯,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。5.干預(yù)后,兩組患者靜坐時(shí)間均減少(P0.05),干預(yù)組靜坐時(shí)間較對(duì)照組減少明顯,且差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。6.干預(yù)后,兩組患者多倫多臨床評(píng)分均減少(P0.05),干預(yù)組和對(duì)照組患者多倫多臨床評(píng)分變化的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。7.干預(yù)后,兩組患者收縮壓、舒張壓均無(wú)顯著變化(P0.05),干預(yù)組和對(duì)照組患者收縮壓和舒張壓變化的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。8.干預(yù)后,兩組患者FBG、2h PBG、Hb A1c均降低(P0.05),且干預(yù)組FBG、2h PBG、Hb A1c下降較對(duì)照組明顯,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.領(lǐng)悟社會(huì)支持、運(yùn)動(dòng)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(dòng)水平越高。應(yīng)采取措施提高糖尿病患者的運(yùn)動(dòng)自我效能、領(lǐng)悟社會(huì)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(dòng)水平。2.同伴教育可以提高糖尿病周圍神經(jīng)病變患者運(yùn)動(dòng)自我效能、步數(shù)、體力活動(dòng)水平,降低患者的血糖及糖化血紅蛋白水平,但是對(duì)血壓及神經(jīng)功能的影響不明顯,仍需進(jìn)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(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R473.5
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本文編號(hào)：1883205