赵伟萍 奚紫薇 张渊蓓

【摘要】  目的  探討基于保护动机理论（PMT）干预方案的构建及其在社区老年2型糖尿病患者的应用效果。方法  选取2021年3-10月在社区卫生服务中心全科门诊就诊的糖尿病患者122例为研究对象，根据组间性别、年龄、病程、文化程度等基线资料均衡可比的原则分为对照组与观察组，每组61例。对照组接受社区常规管理，观察组接受基于PMT构建的干预方案，为期3个月。比较两组患者干预前后血糖指标、自我管理行为与自护能力得分差异。结果  干预前，两组患者血糖指标比较，差异无统计学意义（P>0.05）；干预3个月后，两组患者血糖指标均改善，但观察组低于对照组，差异有统计学意义（P<0.05）。干预前，两组自我概念、自护责任感、自我护理技能、健康知识水平各项自护能力得分及总分比较，差异无统计学意义（P>0.05）；干预3个月后，观察组自我概念、自护责任感、自我护理技能、健康知识水平各项自护能力得分均高于对照组，差异有统计学意义（P<0.05）；观察组自护能力总分高于对照组，差异有统计学意义（P<0.05）。结论  基于PMT构建的干预方案可有效提高社区老年2型糖尿病患者的自我管理和自护能力，对血糖控制有改善。

【关键词】  2型糖尿病；社区老年人；保护动机理论；血糖控制；自我管理；自护能力

中图分类号  R587.1    文献标识码  A    文章编号  1671-0223（2023）09--04

Application of intervention based on protective motivation theory in community elderly patients with type 2 diabetes mellitus  Zhao Weiping， Xi Ziwei， Zhang Yuanbei. Lianyang Community Health Service Center， Pudong New Area， Shanghai 200135， China

【Abstract】  Objective  To explore the application of the construction of an intervention program based on protective motivation theory （PMT） in elderly patients with type 2 diabetes in the community， and to evaluate the application effect. Methods  From March to October 2021， 122 diabetic patients who were treated in general outpatient clinics of community health service centers were selected as the research objects. According to the principle of balanced and comparable baseline data such as sex， age， course of disease and education level among the groups， they were divided into control group and observation group， with 61 cases in each group. The control group received routine community management， and the observation group received an intervention program based on PMT for a period of 3 months. The differences in blood glucose indexes， self-management behavior and self-care ability scores were compared between the two groups before and after the intervention. Results  Before intervention， there was no statistically significant difference in blood glucose between the two groups （P>0.05）. After 3 months of intervention， the blood glucose indexes of the two groups were improved， but the observation group was lower than the control group， the difference was statistically significant （P<0.05）. Before intervention， there was no statistically significant difference in the scores and total scores of self-care ability in self-concept， self-care responsibility， self-care skills and health knowledge level （P>0.05）. After 3 months of intervention， the scores of self-concept， self-care responsibility， self-care skills and health knowledge of  the observation group was significantly higher than the control group （P<0.05）. The total score of self-care ability in the observation group was significantly higher than that in the control group （P<0.05）. Conclusion  The intervention plan based on PMT can effectively improve the self-management and self-care ability of elderly patients with type 2 diabetes in the community， and improve blood sugar control.

【Key words】   Type 2 diabetes; Community elderly; Protective motivation theory; Blood sugar control; Self-management; Self-care ability

目前我国老年2型糖尿病防治现状欠佳，且存在弱化和消极趋势[1]。相比年轻人，老年人受生理机能下降等因素影响，对血糖暴露的耐受性更差，组织器官储备能力更弱，药物治疗风险更大，因此需要更为全面、综合、个体化的管理。……