综合心理行为干预对社区Ⅱ型糖尿病患者焦虑情绪改善的效果研究

摘要

Objective:To evaluate the efficacy of comprehensive psychological and behavioral intervention to type lⅡ diabetes mellitus (DM) patients in the community.Method:The screening procedure firstly was conducted using Zung anxiety self-assessment scale (SAS) in order to select the eligible DM patients who concomitant with anxiety.According to the inclusion and exclusion criteria of the study,all 66 subjects were entered the study and then randomized into intervention group and control group,each with 33 cases.The comprehensive psychological and behavioral intervention was then carried out during the intervention period for intervention group.Follow-up assessment were continued after 5 months to analyze and compare the efficacy of the intervention between two groups finally.Result:In this study,there was no statistically significance in aspects of demographic information,medical history and baseline laboratory tests between two groups.After the intervention procedure,the score of SAS for patients with anxiety,compared to that of the control group,was significantly decreased in the intervention group.The decrease levels of intervention and control group were 10.7 and 5.6,respectively.Additionally,the improvement rate of intervention group (81.8％) was higher than that in the control group (66.7％).Logistic regression were conducted and found that regression coefficient of comprehensive psychological and behavioral intervention was 1.190 (P＜0.05),with odds ratio (OR) value of 0.304 (95％ CI 0.093 to 0.991).Conclusion:The comprehensive psychological and behavioral intervention,which would be beneficial to the community-based care and health management,has a significantly well efficacy for type 1Ⅱ diabetes subjects with anxiety.%目的:评价综合心理行为干预对社区Ⅱ型糖尿病患者焦虑情绪改善的效果.方法:对社区内Ⅱ型糖尿病患者进行Zung焦虑自评量表(SAS)筛查,依据入选排除标准确定研究对象,并随机化分为干预组和对照组,各33例,干预组研究期限内给予综合心理行为干预,5个月后随访,评价综合心理行为干预对患者焦虑情绪改善的效果.结果:干预组和对照组组间性别、年龄等人口学信息,既往疾病及心血管病危险因素情况,基线实验室检查水平均无统计学差异.干预前后两组SAS评分水平比较,干预组评分降低10.7,对照组评分降低5.6,差异有统计学意义(P＜0.05).比较两组SAS评分改善率,干预组(81.8％)高于对照组(66.7％).Logistic回归分析发现,综合心理行为干预因素回归系数为-1.190,有统计学意义(P＜0.05),OR值为0.304(95％ CI 0.093-0.991).结论:综合心理行为干预对改善Ⅱ型糖尿病患者焦虑情绪具有良好效果,利于社区Ⅱ型糖尿病患者的治疗和健康管理.