马龙飞+乐嘉宜+魏魏+郁敏杰+宋锐+沈世蜂

摘 要 目的：探讨同伴支持模式干预对社区2型糖尿病患者自我血糖监测的影响。方法：选取黄浦区瑞金二路街道在册管理的2型糖尿病患者110名，按照随机数字表法分為对照组（54例）和干预组（56例）。对照组采用常规糖尿病健康教育，干预组进行常规糖尿病健康教育和同伴支持干预。比较干预前后两组患者的便携式血糖仪拥有率，自测血糖次数达标率，糖化血红蛋白水平，空腹血糖水平和自我效能得分等情况。结果：干预3个月后，干预组患者的便携式血糖仪拥有率，自测血糖操作技能，监测次数达标率，糖化血红蛋白和空腹血糖的平均水平，自我效能得分均比对照组有改善，差异均有统计学意义（P<0.05）。结论：同伴支持模式有助于改善2型糖尿病患者自我管理能力，血糖监测情况的提高，促进血糖及糖化血红蛋白指标的明显改善，是一种适合在社区开展的2型糖尿病健康教育模式。

关键词 2型糖尿病；同伴支持；自我血糖监测

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2017）24-0047-04

Application of peer support model in self-monitoring of blood glucose in type 2 diabetes mellitus

MA Longfei， LE Jiayi， WEI Wei， YU Minjie， Song Rui， SHEN Shifeng

（Ruijinerlu Community Health Service Center of Huangpu District， Shanghai 200020， China）

ABSTRACT Objective： To explore the influence of peer support model intervention on self-monitoring of blood glucose in the community type 2 diabetes mellitus patients. Methods： One hundred and ten patients with type 2 diabetes mellitus in the registered management in Ruijinerlu Community were enrolled and divided into a control group （54 cases） and an intervention group （56 cases） according to the random number table. The control group received the conventional diabetes health education and the intervention group received the routine diabetes education and peer support intervention. The ownership rate of portable blood glucose meter， the compliance rate of self-testing blood sugar frequency， glycated hemoglobin levels， fasting blood glucose levels and self efficacy scores were compared between the two groups before and after intervention. Results： After 3 months of intervention， self-testing blood sugar operation skills， compliance rate of monitoring times， the average levels of HbA1c and fasting plasma glucose， the owning rate of portable blood glucose meters， and the scores of self-efficacy in the intervention group were better than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion： Peer support model can improve the self-management ability of the patients with type 2 diabetes mellitus， improve blood glucose monitoring， and significantly improve blood glucose and glycosylated hemoglobin indicators， and it is a type of health education model for type 2 diabetes mellitus which is suitable for community development.

KEY WORDS type 2 diabetes mellitus； peer support； self-monitoring of blood glucose

自我血糖监测（self-monitoring of blood glucose，SMBG）作为糖尿病患者自我管理的重要组成部分，对糖尿病的管理具有重要作用。但国内有超过35%的糖尿病患者从未进行过SMBG，仅有19%的糖尿病患者能遵照血糖监测指南[1]推荐频率进行规范的SMBG。目前，国内对如何提高自我血糖规范监测的研究较少。同伴支持是有着相似经历的患者互相交流、学习和沟通的一种教育方式，可以有效地提高患者的自我管理能力[2]，在糖尿病自我管理的应用中已取得较好效果[3]，本研究探讨同伴支持模式对2型糖尿病SMBG的影响，为提高社区2型糖尿病的SMBG水平提供可借鉴的经验。endprint

1 对象与方法

1.1 一般资料