糖尿病风险评分转盘在糖尿病高危人群动机性访谈中的应用

方　英，戴莉敏，倪　雯，侯宝霞



糖尿病风险评分转盘在糖尿病高危人群动机性访谈中的应用

方英，戴莉敏，倪雯，侯宝霞

摘要：[目的]探讨糖尿病风险评分转盘在糖尿病高危人群动机性访谈中的应用效果。[方法]采用方便取样方法选取2014年6月—12月在某三级甲等医院治疗的糖尿病病人家属中的高危人群212人作为研究对象，在动机性访谈中运用糖尿病风险评分转盘对研究对象进行筛查、干预。比较干预前及干预后3个月、6个月自我护理能力测量量表、代谢指标及人体测量指标的变化情况。[结果]干预后3个月、6个月随访时研究对象自护能力总分与干预前比较差异有统计意义(P<0.05或P<0.01)；干预后3个月空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、腰臀比(WHR)等代谢指标及人体测量指标与干预前比较差异有统计学意义(P<0.01)，干预后6个月FBG、2 hPBG、HbA1c有所回升，与干预前比较差异有统计意义(P<0.05)。[结论]动机性访谈中运用糖尿病风险评分转盘对糖尿病高危人群进行筛查，并对筛查出的高危人群进行生活方式、饮食习惯等危险因素干预和指导，在唤起家庭、社会对糖尿病重视的同时，实现早期检查和诊断，减少和预防糖尿病的发生。

关键词：糖尿病风险评分；动机性访谈；糖尿病高危人群；自护能力；血糖；血脂

Application of diabetes risk score turntable in motivational interviewing of high risk group of diabetes

Fang Ying,Dai Limin,Ni Wen,et al

(Affiliated People’s Hospital of Jiangsu University,Jiangsu 212001 China)

AbstractObjective:To probe into the application effect of the diabetes risk score turntable in the motivational interviewing of high-risk patients with diabetes.Methods：A total of 212 high-risk people in diabetic patient’s family in a third grade A hospital for treatment were selected as research objects by using convenient sampling method from 2014 June to December,who were screened and intervened by using diabetes risk score turntable in the motivational interviewing.The change of self nursing ability measurement scale,metabolic index and the index of human body measurement were compared before intervention and 3 and 6 months after intervention. Results:There was statisticaly significant difference in self-care ability score between before intervention and 3 and 6 months after intervention(P<0.05 orP<0.01);3 months after the intervention,the difference has statistically significant in the metabolic parameters of fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),body mass index(BMI),waist hip ratio(WHR) and anthropometric indicators before and after the intervention(P<0.01),There was statisticaly significante difference in increased FBG、2 hPBG,HBA1c compared with before the intervention and 6 months after the intervention(P<0.05).Conclusion：In motivational interviewing by using diabetes risk score turntable the high-risk patients with diabetes were screened.who were intervened and guided in high-risk of lifestyle、 dietary habits and so on,in order to arouse the family and society attention to diabetes，achieve early screening and diagnosis diabetes,reduce and prevent the occurrence of diabetes.

Key wordsdiabetes risk score;motivational interviewing;high risk group of diabetes；self-care ability;blood glucose;blood lipid

2010年中国国家疾病控制中心和中华医学会内分泌学分会调查，我国糖尿病患病率为9.7%，糖尿病病人将近9 240万人[1]。更令人震惊的是，据2013年《美国医学会杂志》研究显示：目前我国已有4.93亿糖尿病高危人群。糖尿病高危人群是2型糖尿病发展前期阶段，不加以控制和管理，就会进展为糖尿病病人。如何筛查糖尿病高危人群，早期预测糖尿病的发生，是当前糖尿病防治的关键问题。动机性访谈 (motivational interviewing，MI)是一种以病人为中心的咨询方式，着眼于改变病人的动机，以达到改变其行为的目的[2]。笔者根据2013年版中国2型糖尿病防治指南中的中国糖尿病风险评分表[3]，设计出“糖尿病风险评分转盘”。在动机性访谈中运用中国糖尿病风险评分转盘对糖尿病高危人群进行筛查，并对筛查出的高危人群开展预防性的糖尿病教育，从而提高自我护理能力，有效减少和阻止糖尿病的发生。……