张卫 顾昊 赵芳 阮敏 沈晓梅 王雯婕 王璐彬

摘 要 目的：探討全科医生团队基于阶段变化理论对社区老年2型糖尿病的健康教育效果。方法：选取148例上海市闵行区老年2型糖尿病患者为研究对象，采用随机分为对照组74例，研究组74例。对照组平均年龄为（68.10±9.36）岁，其中男性39例，女性35例；研究组平均年龄（69.97±9.10）岁，其中男性42例，女性32例。对对照组患者开展常规的健康教育，研究组则由全科医生团队根据阶段变化理论为不同行为阶段患者制定健康教育计划，干预时间为1年。评估两组患者干预前后行为转变阶段、自我管理行为和血糖相关指标。结果：基于阶段变化理论的全科医生团队干预健康教育4个月后，患者的行为改变阶段跨度明显增加，自我行为管理评分明显增加，空腹血糖，餐后2 h血糖和糖化血红蛋白水平均明显下降。结论：全科医生团队根据阶段变化理论的健康教育效果良好，可以显著改善患者自我管理行为和血糖水平。

关键词 老年2型糖尿病，全科医生团队，阶段变化理论，健康教育

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2021）24-0040-04

The effect of health education based on the theory of stage change on the elderly patients with type 2 diabetes in the community

ZHANG Wei1， GU Hao1， ZHAO Fang2， RUAN Min1， SHEN Xiaomei1， WANG Wenjie1， WANG Lubin1（1. General Practice Department of Xinzhuang Community Health Service Center of Minhang District， Shanghai 201199， China； 2. School of

Nursing and Health Management of Shanghai University of Health and Medicine， Shanghai 201318， China）

ABSTRACT Objective： To explore the effect of the general practitioner team based on the theory of stage change on the health education of the elderly patients with type 2 diabetes in the community. Methods： One hundred and forty-eight elderly patients with type 2 diabetes in Minhang District， Shanghai were selected as the research objects， and divided into a control group with 74 cases and a study group with 74 cases by random method. The average age of the control group was（68.10±9.36） years， including 39 males and 35 females； the average age of the study group was （69.97±9.10） years， including 42 males and 32 females. Routine health education was carried out for patients in the control group， and for the study group， the general practitioner team formulated health education plans for patients at different behavior stages according to the theory of stage change， and the intervention time was one year. The behavior transition stage， the self management behavior and blood glucose related indicators of the two groups before and after the intervention were evaluated. Results： After 4 months of intervention in health education by the general practitioner team based on the theory of stage change， the patient’s behavioral change phase span increased significantly， self-behavior management score increased significantly， fasting blood glucose， blood glucose and glycosylated hemoglobin level 2 hours after a meal decreased significantly. Conclusion： The health education of the general practitioner team based on the theory of stage change has a good effect， which can significantly improve patients’ selfmanagement behavior and blood glucose level.

KEY WORDS elderly type 2 diabetes； general practitioner team； theory of stage change， health education

糖尿病是一组以高血糖为特征的代谢性疾病。上海作为中国人口密度较大的城市，糖尿病患病率更是迅猛增加[1]，60岁以上的老年糖尿病患者成为社区卫生服务中心的主要慢性病群体之一[2]，也是全科医生签约管理的主要群体。通过糖尿病健康教育可以有效地促进糖尿病患者控制血糖[3-4]。但是现阶段许多老年糖尿病患者的自我管理行为还存在许多问题[5-7]。……