吴冰+王丹

[摘要] 目的 探讨社区空巢老年糖尿病患者心理特点及对策。 方法 2009年9月—2012年9月期间对该社区确诊的空巢老年糖尿病患者进行为期3年的医护干预，心理疏导前后对患者进行问卷调查和医学体检，评价其效果。 结果292人参与，男性131人，女性161人，在糖尿病诊断标准、服降糖药感觉良好后仍需保持良好的心态等方面，除遗传是危险因素知晓率无差别外，其余知识的知晓率在心理疏导前后差异有高度统计学意义（P<0.01）；对控制体重、有氧运动，戒烟、限酒和保持心理平衡等非药物疗法的使用率均上升，除戒烟外，其余差异有统计学意义（P<0.05）。心理疏导后患者总复查率、总药物治疗率和总控制率较心理疏导前分别提高了12.81%，7.41%和23.62%，其中心理疏导前后总控制率差别有统计学意义（χ2=10.84，P

[关键词] 社区；空巢老人；糖尿病；心理疏导

[中图分类号] R473.2 [文献标识码] A [文章编号] 1674-0742（2015）02（b）-0022-03

Investigation of the Psychological Characteristics of Community Empty Nesters with Diabetes and the Countermeasures

WU Bing WANG Dan

Changchun Medical College， Changchun， Jilin Province， 130013 China

[Abstract] Objective To explore the psychological characteristics of community empty nesters with diabetes and the countermeasures. Methods The empty nesters confirmed with diabetes in the community were given a 3-year medical and nursing intervention from September 2009 to September 2012. And they underwent the questionnaire survey and medical examination before and after psychological counseling. And the effect was evaluated. Results 292 people were enrolled in this study， including 131 males and 161 females. There were statistically significant differences in the awareness rate of rest knowledge about diagnostic criteria for diabetes， patients need to keep good state of mind even if they feel good after taking hypoglycemic drugs and so on except the awareness rate of risk factor heredity before and after psychological counseling（P<0.01）. In the patients， the unilization ratio of non-drug treatment， such as weight control， aerobic exercise， quitting smoking， alcohol limitation and keeping psychologic equilibrium， increased after psychological counseling， the differences in the above non-drug treatment factors except quitting smoking before and after psychological counseling were statistically significant （P<0.05）. After psychological counseling， the overall review rate， total drug treatment rate and total control rate increased by 12.81%， 7.41% and 23.62%， respectively， as compared with that before psychological counseling， and significant difference was found in the total control rate before and after psychological counseling（χ2=10.84， P<0.01）. Compared with before psychological counseling， after psychological counseling， the fasting blood glucose of the patients decreased by 8.07 mmol/L， with statistically significant difference（t=13.73， P<0.05）， blood pressure decreased by 5.47 mmHg， with statistically significant difference （t=1.74， P<0.05）. Conclusion For the empty nesters with diabetes， formulating individualized health guidance scheme mainly including regular psychological counseling， is of great significance in improving the awareness rate of diabetic knowledge， drug and non-drug treatment compliance and blood glucose control rate.

[Key words] Community； Empty nesters； Diabetes； Psychological counseling

糖尿病是一种终身性疾病易并发心、脑血管疾病，死亡率高，由于其病程长，治疗效果慢，且易反复，患者容易出现各种各样复杂的心理变化，又属于身心疾病不仅心理因素影响糖尿病，而且糖尿病本身往往影响患者的性格、精神状态，引起继发性心理障碍如抑郁、孤独、恐惧等，心理应激反应和性格特征的相互作用，被认为在疾病发生上是重要环节[1]。心理因素在疾病发生、发展、治疗及预后起着决定性作用，因此在药物治疗的同时，进行心理治疗可起到很好的效果，为此该社区从2009年9月—2012年9月调查随访了292例空巢老年糖尿病患者心理特点，现报道如下。

1 资料与方法

1.1 一般资料

将该管辖社区2009年9月—2012年9月的空巢老年糖尿病患者292人作为研究对象，（均符合WHO关于糖尿病的诊断标准）其中男性131人，占44.86%，女性161人，占55.14%；年龄55～82岁，平均（55.81±10.86）岁，其中男性平均（56.90±12.27）岁，女性平均（54.95±9.60）岁。职业分布情况见表1。……