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瑞典北部内陆农村社区2型糖尿病患者的糖尿病自我管理能力及自我管理支持需求

Diabetes empowerment and needs for self-management support among people with type 2 diabetes in a rural inland community in northern Sweden.

作者信息

Isaksson Ulf, Hajdarevic Senada, Abramsson MaiGreth, Stenvall Jessica, Hörnsten Åsa

机构信息

Department of Nursing, Umeå University, Umeå, Sweden.

出版信息

Scand J Caring Sci. 2015 Sep;29(3):521-7. doi: 10.1111/scs.12185. Epub 2014 Nov 7.

Abstract

BACKGROUND

Self-management among people with T2D includes being responsible for attaining a blood sugar level within the normal range, eating healthy food, exercising and following prescriptions for medication, something that may need support. In rural areas, access to health care may be limited, and support from family members becomes important.

AIM

The aim of this study was to describe perceptions and associations of diabetes empowerment, self-management ability and needs of self-management support among people with T2D in a northern rural community of Sweden.

METHOD

People with T2D (n = 159) living a rural municipality in northern Sweden answered the SWE-DES-23 questionnaire and additional questions concerning self-management and needs for self-management support.

RESULTS

A higher diabetes empowerment was associated with longer diabetes duration and support from healthcare professionals and relatives. Women rated a need for self-management support significantly higher than men did. Nonretired persons rated a significantly higher need for self-management support and a lower perception of support from healthcare professionals compared to retired persons. Cohabitant persons had a significantly higher perception of support from relatives and also estimated a higher need for relatives' involvement in clinical visits compared to persons living alone. Both the newly diagnosed and also those people with a diabetes duration of 10-15 years rated a higher need for group support. Higher self-awareness and readiness to change were apparent among people with short and long diabetes duration. Furthermore, self-management ability, support from healthcare professionals and from relatives and lastly diabetes duration was associated with diabetes empowerment.

CONCLUSION

Not only people newly diagnosed with T2D should be offered patient-centred group support, strengthening patient empowerment. For future, family-focused care and education and training in person-centred care among diabetes specialist nurses is recommended.

摘要

背景

2型糖尿病患者的自我管理包括负责将血糖水平控制在正常范围内、食用健康食品、进行锻炼以及遵医嘱服药,而这些可能需要得到支持。在农村地区,获得医疗保健的机会可能有限,家庭成员的支持就变得很重要。

目的

本研究的目的是描述瑞典北部一个农村社区中2型糖尿病患者对糖尿病赋权、自我管理能力以及自我管理支持需求的认知和关联。

方法

居住在瑞典北部一个农村自治市的159名2型糖尿病患者回答了SWE-DES-23问卷以及有关自我管理和自我管理支持需求的其他问题。

结果

更高的糖尿病赋权与更长的糖尿病病程以及来自医疗保健专业人员和亲属的支持相关。女性对自我管理支持的需求评分显著高于男性。与退休人员相比,未退休人员对自我管理支持的需求评分显著更高,而对医疗保健专业人员支持的认知更低。与独居者相比,同居者对亲属支持的认知显著更高,并且估计亲属参与临床就诊的需求也更高。新诊断的患者以及糖尿病病程为10至15年的患者对团体支持的需求评分更高。糖尿病病程短和长的患者中自我意识和改变意愿更高。此外,自我管理能力、来自医疗保健专业人员和亲属的支持以及最后糖尿病病程与糖尿病赋权相关。

结论

不仅应该为新诊断的2型糖尿病患者提供以患者为中心的团体支持,以增强患者赋权。未来,建议开展以家庭为重点的护理以及对糖尿病专科护士进行以患者为中心的护理教育和培训。

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