健康与遗传心理学研究室知识库

目的探索通过家庭干预改善老年2型糖尿病病患者家庭功能及其焦虑、抑郁、遵医行为、空腹血糖CFBG)、餐后2小时血糖(2hBG)、糖化血红蛋白(HbA1c)等身心健康指标。

方法选取纳入社区慢性病管理的老年2型糖尿病患者100例，并随机分成干预组和对照组。对照组采用为期一年的常规指导和药物治疗，干预组在此基础上增加家庭干预。以家庭关怀度指数问卷(APGAR)、焦虑自评量表(SAS)、抑郁自评量表(SDS), 2型糖尿病患者随访服务记录表为评估工具，随访一年后观察患者的家庭功能、焦虑、抑郁、遵医行为、血糖的改变并评价效果。

结果一、家庭干预效果的追踪(自身)观察干预组:家庭干预前后对比，老年2型糖尿病患者的家庭功能显著改善(P<0. 01)，遵医行为显著提高(P<0. 01)，干预后SAS, SDS、空腹血糖值、餐后两小时血糖值、糖化血红蛋白显著低于干预前(ps<0. 01)。对照组:采用常规指导和药物治疗一年后，对照组的家庭功能无显著改善(P >0. 05);遵医行为高于干预前(P<0. 05)，空腹血糖值、餐后两小时血糖值、糖化血红蛋白显著降低(Ps<0. 05)，但焦虑无显著改善、抑郁值高于一年前。

二、家庭干预效果的横断(组间)对照

家庭干预前，两组的家庭功能、遵医行为、焦虑、抑郁和血糖值(FBG,2hBG,HbA1c)无显著差异。家庭干预后，干预组的家庭功能、遵医行为比对照组明显改善(Ps<0. 01)，且焦虑、抑郁、空腹血糖值(FBG ) ,餐后两小时血糖值(2hBG)、糖化血红蛋白(HbA1c)显著低于对照组(Ps<0. 01) 。结论家庭干预可显著改善老年2型糖尿病患者的家庭功能，减轻其焦虑和抑郁情绪，提高其遵医行为、降低血糖水平，有效促进其身心健康;值得在社区卫生老年2型糖尿病患者健康管理中推广。

Objective: Explore the effect of family intervention on family function, anxiety, depression, compliance behavior, FBG, 2hBG, and HbAlc of elderly patients with type 2 diabetes.

Methods: Recruit 100 elderly patients with type 2 diabetes who have been included in the management of chronic disease from a community in Suzhou, Anhui Province. Participants were randomly assigned into two groups. In addition to the normal instruction procedure and medical therapy, the intervention group was applied with family intervention. SAS, SDS, and physical and clinical indexes were measured before and after the follow up in one year.

Results: 1 .Effect of family intervention-Within group comparison: Scores of SAS and SDS, together with FBG, 2hBG, and HbA1c, of patients in intervention group decreased significantly after family intervention. FBG, 2hBG, and HbAlc of control group also decreased significantly compared with that of one year earlier, but scores of SAS no significant change and SDS increased significantly in the mean time. 2. Effect of family intervention Between group comparisons: Scores of SAS and SDS, FBG, 2hBG, and HbA1c of patients in intervention group were significantly lower than that of control group, while the compliance behavior of intervention group participants was significantly higher than that of control group, after one year.

Conclusion: Family inter0vention can alleviate the symptoms of anxiety and depression of the elderly patients with type 2 diabetes and improve their compliance behavior as well as control blood glucose well and thus promote their physical and mental health. Therefore, family intervention is of the great significance in promoting the physical and mental health of the elderly patients with type 2 diabetes. It is worthy of application in the community health service management in elderly patients with type 2 diabetes.