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130例糖尿病患者对糖尿病及胰岛素相关知识的认知调查
陈晶波1,2,林红梅1,胡禅珊1,宋敬云1,霍翠兰1,施文君1,黄勤1*
0
(1. 第二军医大学长海医院内分泌科, 上海 200433;
2. 武警福建总队医院内三科, 福州 350003
*通信作者)
摘要:
目的 探讨2型糖尿病(T2DM)患者对糖尿病及胰岛素的认知情况。方法 对130例行胰岛素治疗的T2DM患者在住院当天针对糖尿病及胰岛素相关知识进行问卷调查,给予针对性健康教育1周再行问卷调查。结果 (1)130例患者入院时糖化血红蛋白(HbA1c)、空腹血糖(FBG)和餐后2 h血糖(2-hPBG)平均水平分别为(9.82±2.37)%、(7.39 ±2.07)mmol/L和(10.29±3.22)mmol/L,达标率分别为10.00%、53.85%和55.38%。(2)糖尿病基础知识缺乏:患者入院时对血糖控制标准和监测频率知晓率低,入院后知晓率呈增高趋势(P <0.05,P <0.01)。(3)胰岛素认知存在误区:与入院时已用胰岛素者比较,拟用胰岛素患者对使用胰岛素表现出更多担忧(部分P <0.05);入院后两者对使用胰岛素的担忧程度均呈降低趋势(部分P <0.05)。(4)病情监测意识不强:与拟用胰岛素患者入院时比较,已用胰岛素患者具有更好的病情监测意识(P <0.05,P <0.01);入院后两者对病情监测的认同率均呈升高趋势(部分P <0.01)。(5)使用胰岛素顾虑多:主要表现在"担心成瘾""怕注射错误"等方面。结论 已用或拟行胰岛素治疗的T2DM患者的血糖控制情况不容乐观,患者对糖尿病和胰岛素的认知缺乏或误区是影响起始胰岛素治疗及血糖达标的重要因素,个体化教育能有效改善此现象。
关键词:  2型糖尿病  胰岛素  认知  问卷调查  健康教育
DOI:10.16781/j.0258-879x.2017.03.0383
投稿时间:2016-08-06修订日期:2016-10-28
基金项目:国家自然科学基金面上项目(81471038).
Cognition on diabetes and insulin in 130 diabetic patients
CHEN Jing-bo1,2,LIN Hong-mei1,HU Chan-shan1,SONG Jing-yun1,HUO Cui-lan1,SHI Wen-jun1,HUANG Qin1*
(1. Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Third Department of Internal Medicine, Hospital of Fujian Armed Police Forces, Fuzhou 350003, Fujian, China
*Corresponding author)
Abstract:
Objective To explore the cognition on diabetes and insulin of the patients with type 2 diabetes mellitus (T2DM). Methods We recruited 130 T2DM inpatients on insulin therapy who met our inclusion criteria. All patients finished the questionnaire surveys for related knowledge of diabetes and insulin upon admission and after receiving one-week targeted health education in hospital. Results (1) The average levels of hemoglobin A1c (HbA1c), fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2-hPBG) were (9.82±2.37)%, (7.39±2.07) mmol/L and (10.29±3.22) mmol/L, respectively, and the standard-reaching rates were 10.00%, 53.85% and 55.38%, respectively. (2) Lack of basic knowledge of diabetes. Patients' cognition rates of target glycemic levels and frequency of glucose monitoring were low. For blood glucose control standards and monitoring frequency, the cognition rate of the patients after admission was higher than that of the patients on admission (P <0.05, P <0.01). (3) Cognitive misunderstanding on insulin. Compared to those with insulin therapy at admission, the patients who were about to receive insulin showed more anxiety about insulin usage (some P <0.05). The concerns about the use of insulin were decreased in both groups after admission (some P <0.05). (4) Awareness of disease monitoring was to be emphasized. Compared with those were to use insulin on admission, the patients with insulin therapy had better awareness of disease monitoring (P <0.05, P <0.01). The cognitive rates on disease monitoring were significantly increased in both groups after admission (some P <0.01). (5) There were great concerns about insulin therapy. They were afraid of many things including "addicted to insulin" and "fault in injecting insulin". Conclusion The blood glucose control status of T2DM patients with insulin therapy or being about to insulin therapy is poor. T2DM patients lack the related knowledge on diabetes and insulin, which is an important factor affecting insulin therapy and glucose management. Individualized T2DM education is needed to improve the situation.
Key words:  type 2 diabetes mellitus  insulin  cognition  questionnaires  health education