认知行为干预模式对孕妇妊娠糖尿病负性情绪和血糖的效果评价

摘要

目的：探讨认知行为干预模式在妊娠糖尿病患者中的应用并评价其效果。方法运用便利抽样方法选取240例妊娠糖尿病患者，按照随机数法将患者随机分为对照组和干预组，每组120例，对照组开展常规健康教育，干预组在常规健康教育基础上开展认知行为干预，并运用焦虑自评量表（SAS）、抑郁自评量表（SDS）、一般自我效能量表（GSES）、妊娠压力量表（PPS）进行评价。结果干预后，干预组 SAS （52.43±3.91）、SDS （47.55±5.23）、PPS （45.89±6.23）得分均低于干预前，GSES 得分（2.89±0.33）高于干预前（P ＜0.05）；除PPS 因子3外，干预组 SAS、SDS、PPS 得分均低于对照组、GSES 得分高于对照组（P ＜0.05）；干预组中度（4.17％）和重度（2.50％）焦虑发生率较干预前明显下降，且干预后的中度和重度焦虑发生率低于对照组（P＜0.05）；干预组中度和重度抑郁发生率较干预前明显下降（P ＜0.05），但干预组中度和重度抑郁发生率与对照组比较差异无统计学意义（P ＞0.05）；干预组空腹血糖、餐后2 h 血糖均低于干预前，同时低于对照组（P ＜0.05）。结论对妊娠糖尿病患者应用认知行为干预模式，能够有效减轻孕妇负性情绪，提高自我效能水平，减轻妊娠压力，改善血糖水平。%Objective To investigate the cognitive behavioral intervention model applying to negative emotion and glucose levels of pregnant women with gestational diabetes.Methods Byconvenience sampling method,the selected patients with gestational diabetes were randomly included in control group and intervention group with each of 120 cases.Cases in con-trol group were carried out routine health education,while cases in intervention group were carried out cognitive behavioral intervention together with conventional health education.Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS),General Self-Efficacy Scale (GSES),and Pregnancy Stress Scale (PPS)were used.Results After the inter-vention,SAS (52.43 ±3.91 ),SDS (47.55 ±5.23),PPS (45.89 ±6.23) scores in intervention group were lower compared to before the intervention,GSES (2.89 ±0.33)score was higher than before the intervention with significant difference (P <0.05);except for factor 3 of PPS,SAS,SDS,PPS scores in intervention group were lower and GSES score were higher than that in the control group with statistically significant difference (P <0.05);after the intervention, the occurrence of moderate (4.17%)and severe anxiety (2.50%) in the intervention group was decreased and signifi-cantly lower compared to the control group (P <0.05);the occurrence of moderate and severe depression in intervention group were decreased with significant difference (P <0.05).Fasting glucose and after 2 h postprandial blood glucose in in-tervention group were significantly lower than before the intervention,and significantly lower than the control group (P <0.05).Conclusion Applied Cognitive behavioral intervention model diabetics to pregnant women with GDMs can effectively reduce negative emotions,improve self-efficacy,reduce pregnancy stress,and improve blood glucose levels.