目的 了解北京市社区糖尿病患者自我管理的现状.方法 采取定量和定性相结合的方法,在北京3个社区(街道)对240名糖尿病患者进行问卷调查,另对其中18名糖尿病患者进行个人深入访谈.结果 在过去7 d内,71人(占29.6%)没有经常按糖尿病饮食要求合理安排饮食;67人(占27.9%)没有经常进行持续时间＞30 min的运动;101人(占42.1%)没有经常完成适合自身情况的血糖监测;159人(占66.3%)没有经常认真完成足部观察和护理;54人(占22.5%)心理状况因患糖尿病而受到中重度影响.影响糖尿病控制效果因素有:缺乏专业人员帮助制定方案和监督(177人,73.8%)、嫌麻烦不能遵守各种注意事项(131人,54.6%)、经济因素(115人,47.9%)、对糖尿病自我保健知识了解较少(117人,48.8%)、对糖尿病控制缺乏信心(87人,36.3%)、时间因素(84人,35.0%).结论 社区糖尿病患者的疾病控制情况较差,心脑血管疾病、眼病、酮症酸中毒等并发症的控制情况也较差.在自我管理行为方面,社区糖尿病患者都基本能做到规律服药,控烟情况也较好,但在饮食、运动、血糖监测、足部护理等方面却表现较差.因此,社区医务人员应重视对患者在饮食、运动、血糖监测、足部护理、心理指导等方面的个性化指导和定期随访;此外,社区糖尿病管理不仅仅是一项单纯的医疗行为甚或健康管理行为,除了恰当的医疗或健康管理措施之外,社区医务人员还应该注重培养自己并帮助患者建立人文执业或就医能力.%Objective To know the status of self - management among diabetes patients in Beijing communities. Methods The quantitative and qualitative methods were used in combination to do questionnaire survey among 240 patients with diabetes mellitus and in - depth interviews 18 patients with diabetes mellitus in three communities of Beijing. Results In the past 7 days, 71 ( 29. 6% ) of the patients could not always have their reasonable diet according to requirement of diabetic diet; 67 ( 27. 9% ) did not often do exercises that lasts > 30 min; 101 ( 42. 1% ) did not always get the frequency monitoring blood sugar level that is in line with their own conditions; 159 ( 66. 3% ) did not often conduct careful observation and nursing on their own foot; and 54 ( 22. 5 % ) were psychologically impacted moderately or seriously because of the disease. The factors impacting the controlling effect of diabetes lack of professionals to help formulating plan and monitoring ( 177 , 73. 8% ), failing to observe the attention items because of bothers ( 131 , 54. 6% ), economic issues ( 115 , 47. 9% ), little awareness of self- care knowledge on diabetes mellitus ( 117, 48.8% ), loss of confidence in controlling diabetes ( 87, 36.3% ), and time ( 84, 35. 0% ) . Conclusion The disease control in community diabetes patients is not good, and so is the control of complications such as in the heart - brain, eyes, and ketoacidosis. They can generally take medicine regularly and quit smoking. However, it is unsatisfactory in managing diet, exercise, blood sugar monitoring and foot care. So the community medical professionals need to pay attention to personalized guidance in all these respects and regular follow - up. Besides appropriate medical or health management strategies, the professionals should emphasize to improve humanistic capability for both themselves and their patients.
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