2型糖尿病患者衰弱与自我效能的关系及影响因素分析

张瑛; 郑静; 管玉香; 许娟; 王超

doi:10.16766/j.cnki.issn.1674-4152.003072

2型糖尿病患者衰弱与自我效能的关系及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003072

张瑛¹,
郑静¹,
管玉香^2, ,,
许娟¹,
王超¹

1.
安徽中医药大学护理学院，安徽合肥 230012
2.
安徽中医药大学第一附属医院护理部，安徽合肥 230031

基金项目:

安徽省卫生健康委科研项目 AHWJ2021b068

安徽省护理学会科研课题重点项目 AHHLa202106

详细信息

通讯作者:
管玉香，E-mail: 897213643@qq.com

中图分类号: R587.1
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- 被引次数: 0
出版历程
- 收稿日期: 2022-07-06
- 网络出版日期: 2023-08-28

Correlation between frailty and self-efficacy in patients with type 2 diabetes and its influencing factors

1.
School of Nursing, Anhui University of Traditional Chinese Medicine, Hefei, Anhui 230012, China

摘要

摘要: 目的了解2型糖尿病患者衰弱现况并分析影响衰弱的相关因素，探讨2型糖尿病患者衰弱与自我效能的关系。方法本研究为横断面研究，以2021年3—10月安徽省某三级甲等医院住院的2型糖尿病患者为研究对象，收集患者一般资料、Tilburg衰弱量表及糖尿病管理自我效能量表得分，应用SPSS 26.0统计学软件进行统计分析。结果 (1) 本研究共收集296例2型糖尿病患者，120例患者发生衰弱(衰弱组)，176例未发生衰弱(非衰弱组)，衰弱组患者衰弱得分为(7.00±1.76)分, 非衰弱组得分为(3.16±0.96)分, 2组衰弱得分比较差异有统计学意义(P<0.05)。(2)衰弱组自我效能得分为(124.81±28.42)分, 非衰弱组自我效能得分为(140.71±22.11)分，2组自我效能得分比较差异有统计学意义(P<0.05)。(3)Logistic回归分析结果显示: 女性、受教育程度低、合并慢性病数量多、自我效能得分低为2型糖尿病患者衰弱的独立危险因素(均P<0.05)。(4)Spearman相关分析结果显示: 2型糖尿病患者衰弱与自我效能得分呈负相关关系(r=-0.460，P<0.01)。结论衰弱与自我效能呈负相关关系，临床医护人员需要同时关注自我效能与衰弱状况，尽早进行综合干预，提高自我效能，延缓衰弱的发展。
- 2型糖尿病 /
- 衰弱 /
- 自我效能 /
- 生活质量
Abstract: Objective To investigate the current status of frailty in patients with type 2 diabetes mellitus (T2DM) and analyze the related factors of frailty, and explore the relationship between frailty and self-efficacy in patients with T2DM. Methods This study was a cross-sectional study. Patients with T2DM hospitalized in a tertiary A-level hospital in Anhui Province from March to October 2021 were selected as the research object. General data of patients, scores of Tilburg Weakness Scale and diabetes Management Self efficacy Scale were collected and statistically analyzed with SPSS 26.0. Results (1) A total of 296 hospitalized patients with T2DM were included in the study, including 120 frailty patients (frailty group) and 176 no frailty patients (no-frailty group). The frailty score of the frailty group was (7.00±1.76) points, the score of the no-frailty group was (3.16±0.96) points. There were significant differences between the two groups (P<0.05). (2) The score of Chinese-diabetes management self-efficacy scale (C-DMSES) was (124.81±28.42) points in the frailty group and (140.71±22.11) points in the no-frailty group, the difference between the two groups was statistically significant (P<0.05). (3) Logistic regression analysis showed that women, low education level, more chronic diseases, and low self-efficacy score were independent risk factors for type 2 diabetes patients' weakness (all P<0.05). (4) Spearman correlation analysis showed that the weakness of T2DM patients was negatively correlated with self-efficacy scores (r=-0.460, P<0.01). Conclusion The frailty is negatively significantly associated with self-efficacy. Medical staff needs to pay attention to self-efficacy and frailty of patients with T2DM at the same time, carry out comprehensive intervention, and improve self-efficacy, and delay the development of frailty.
- Type 2 diabetes mellitus /
- Frailty /
- Self-efficacy /
- Quality of life

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表 1 不同衰弱状态2型糖尿病患者衰弱得分比较(分)

Table 1. Comparison of frailty scores in type 2 diabetes patients with different frailty states (points)

组别	例数	衰弱得分 (x±s)	躯体衰弱 [M(P₂₅, P₇₅)]	躯体衰弱 [M(P₂₅, P₇₅)]	社会衰弱 (x±s)
非衰弱组	176	3.16±0.96	0.74(0.34, 1.34)	1.04(0.48, 1.74)	1.38±0.54
衰弱组	120	7.00±1.76	3.09(1.86, 4.10)	2.08(1.91, 2.73)	1.82±0.62
统计量		-24.161^a	-8.300^b	-4.862^b	-6.478^a
P值		< 0.001	< 0.001	< 0.001	< 0.001
注：^a为t值，^b为Z值。

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表 2 不同衰弱状态2型糖尿病患者一般资料比较(例)

Table 2. Comparison of general data of type 2 diabetic patients with different frailty states(cases)

项目	非衰弱组 (176例)	衰弱组 (120例)	χ²值	P值	项目	非衰弱组 (176例)	衰弱组 (120例)	χ²值	P值
年龄(岁)			3.515	0.172	目前是否工作		0.421	0.516
18~39	21	9			是	93	68
40~59	72	42			退休/无	83	52
≥60	83	69			家庭人均月收入(元)			3.599	0.165
性别			68.644	< 0.001	<2 000	68	34
男	134	33			2 000~5 000	59	50
女	42	87			>5 000	49	36
婚姻状况			0.307	0.580	BMI			35.393	< 0.001
已婚	159	106			＜24	68	14
未婚	17	14			24~27	93	73
受教育程度			19.119	< 0.001	>27	15	33
文盲	6	13			HbA1c(%)			110.831	< 0.001
小学	12	21			＜6.5	38	7
初中及高中	128	77			≥6.5~8.4	107	18
大专及以上	30	9			≥8.5~10.4	23	75
合并慢性病数量(种)			44.629	< 0.001	≥10.5	8	20
0	42	9			FPG(mmol/L)			7.133	0.068
1	96	41			≤6.1	18	10
2	32	63			6.2~7.7	46	18
≥3	6	7			7.8~11.0	47	45
家族史			0.001	0.969	≥11.1	65	47
有	84	57			2hPG(mmol/L)			1.773	0.183
无	92	63			＜11.1	80	64
医保类型			2.323	0.127	≥11.1	96	56
职工医保	78	64
新农合/居民医保	98	56

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表 3 自变量赋值方法

Table 3. Independent variable assignment methods

变量	赋值方法
性别	男性=1，女性=2
受教育程度	文盲=1，小学=2，初中及高中=3，大专及以上=4
合并慢性病种类	≥3种=1, 2种=2, 1种=3，0种=4
BMI	以实际值赋值
HbA1c	以实际值赋值
自我效能得分	以实际值赋值

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表 4 衰弱影响因素的logistic回归分析

Table 4. Logistic regression analysis of frailty influencing factors

项目	B	SE	Waldχ²	P值	OR值	95% CI
女性	0.084	0.038	4.848	0.028	1.088	1.009~1.172
文化程度	-0.291	0.144	4.077	0.043	0.748	0.564~0.992
合并慢性病数量	-0.559	0.148	14.274	< 0.001	0.572	0.428~0.764
自我效能得分	-0.137	0.069	3.924	0.048	1.147	1.001~1.313
BMI	0.070	0.039	3.333	0.068	1.073	0.995~1.157
HbA1c	0.134	0.069	3.793	0.051	1.144	0.999~1.309

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表 5 不同衰弱状态2型糖尿病患者C-DMSES得分比较(x±s，分)

Table 5. Comparison of C-DMSES scores in type 2 diabetic patients with different frailty states (x±s, points)

组别	例数	自我效能	血糖与足部检查	锻炼与体重	健康饮食	遵医服药
非衰弱组	176	140.71±22.11	36.96±11.78	47.76±14.72	34.17±10.27	19.24±7.23
衰弱组	120	124.81±28.42	37.04±11.75	38.74±11.03	29.33±12.33	18.91±6.19
t值		5.401	-0.057	5.707	3.667	0.410
P值		< 0.001	0.954	< 0.001	< 0.001	0.682

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表 6 2型糖尿病患者衰弱与自我效能的相关性(r值)

Table 6. Association between frailty and self-efficacy in patients with type 2 diabetes (r value)

项目	自我效能	血糖与足部检查	健康饮食	锻炼与体重	遵医服药
衰弱	-0.460^a	0.029	-0.187	-0.200^b	-0.110
躯体衰弱	-0.205^b	0.079	0.031	-0.231^b	-0.168
心理衰弱	-0.191	-0.116	-0.206^b	-0.030	0.069
社会衰弱	0.103	0.049	-0.124	-0.181^b	-0.046
注：^aP<0.01，^bP<0.05。

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