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目的探讨健康自我管理对糖尿病足患者自我效能及心理状态的影响,为促进糖尿病足患者的健康提供科学依据。方法根据入院顺序将144例2型糖尿病足患者分为观察组和对照组,每组各72例。对照组患者采取常规糖尿病足治疗。观察组在对照组常规糖尿病足治疗的基础上实施健康自我管理措施。采用糖尿病自我效能量表(DEES)、症状自评量表(SQL-90)比较两组自我效能和心理状态。记录两组足部症状改善情况。结果干预后,观察组的饮食控制、药物治疗、血糖监测、自我护理、预防及处理高低血糖的水平均较干预前明显提高(P<0.05),且显著高于对照组,差异有统计学意义(P<0.05);SQL-90评价心理状况显示,观察组除偏执因子,其余各因子(躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐惧、精神病性及其他)水平较干预前明显降低,差异均有统计学意义(P<0.05);观察组的足部发凉、足部干燥、足麻木感发生率较干预前明显降低(P<0.05),且发生率显著低于对照组,差异有统计学意义(P<0.05)。结论健康自我管理模式可通过发挥患者的主观能动性提高其自我管理能力,进而改善糖尿病足患者的自我效能和心理状态,值得广泛应用。
Objective To investigate the effect of health self-management on self-efficacy and psychological status of patients with diabetic foot and to provide a scientific basis for promoting the health of patients with diabetic foot. Methods According to the order of admission, 144 patients with type 2 diabetic foot were divided into observation group and control group, 72 cases in each group. The control group of patients with conventional diabetic foot treatment. Observation group in the control group on the basis of conventional diabetic foot treatment of health self-management measures. The self-efficacy and psychological status of the two groups were compared using the Diabetes Self-Efficacy Scale (DEES) and Symptom Checklist 90 (SELF). Record two groups of symptoms of foot improvement. Results After intervention, the levels of diet control, medication, blood glucose monitoring, self-care, prevention and treatment of hyperglycemia in the observation group were significantly higher than those before intervention (P <0.05), and were significantly higher than those in the control group (P <0.05). The evaluation of psychological status by SQL-90 showed that in addition to the paranoid factors, the other factors (somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, fear, psychosis and others) (P <0.05). In the observation group, the feet were cold and the feet were dry. The incidence of numbness in the foot was significantly lower than that before the intervention (P <0.05), and the incidence was significantly lower than that of the control Group, the difference was statistically significant (P <0.05). Conclusion The model of health self-management can improve the self-management ability of patients by giving play to their subjective initiative, so as to improve the self-efficacy and psychological status of patients with diabetic foot. It is worth to be widely used.