糖尿病患者拒治行为及相关因素的临床调查

摘要

目的：探讨糖尿病患者拒治行为的临床表现及相关因素，为临床干预提供依据。方法选择2014年1月至2015年1月在我科住院有拒绝治疗行为的60例糖尿病患者为研究对象，观察拒治行为的临床表现并作分类统计，以自编糖尿病拒治诱因调查表和汉密顿抑郁量表作为工具，探讨患者拒绝治疗的主要因素，并对拒治患者实施个体化干预措施。结果54例糖尿病患者有可查明的拒治行为诱因，占比90.00%。拒治患者的抑郁发生率为71.67%，抑郁症状的严重程度与拒治症状严重程度及多样性呈正相关。经临床干预后患者的抑郁症状消失或明显缓解，拒治行为症状消失。结论对于拒绝治疗的糖尿病患者，医护人员要加强自身的专业知识和业务水平，加强与患者的沟通，与患者及家属共同制定相应的治疗方案，从而改善患者的生活质量。%Objective To explore the clinical manifestations and related factors of therapy-rejection behavior of diabetes mellitus (DM) patients, so as to provide reference for clinical intervention. Methods A total of 60 cases of DM patients with therapy-rejection behavior were selected as research objects. The clinical manifestations were statistically classified. Self-made questionnaire of causes of therapy-rejection and Hamilton depression scale were used to find the main influencing factors of therapy-rejection behavior. All patients were given individualized intervention. Results 54 cases of DM patients had identified causes of therapy-rejection behavior, accounted for 90.00%. The incidence of depression was 71.67%, and the severity of depression was positively related with severity and diversity of symptom of therapy-rejection. After clinical intervention, the symptoms of depression disappeared or relieved obviously, and the symptoms of therapy-rejection behavior disappeared. Conclusions For DM patients with therapy-rejection behavior, medical staff should enhance their professional knowledge and operational level, strengthen communication with patients, and develop therapy programs with patients and their dependents, so as to improve patients' quality of life.