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目的 :探讨糖尿病社区干预措施对Ⅱ型糖尿病患者心理卫生状况干预的有效性及其影响因素 ,为适宜的社区干预对策与措施的制定提供科学依据。方法 :按群体实验流行病学方法 ,选取山东省两城市社区分别作为干预社区与对照社区。 1997年 ,收集基线资料 ,同时开始在干预社区实施糖尿病综合干预措施。2 0 0 1年 ,再次以相同的方法收集两社区相关资料 ,通过两社区基线与 4年后资料的比较 ,分析社区干预对Ⅱ型糖尿病患者焦虑总标准分、抑郁指数和社会支持分的影响。并通过对干预社区干预后的病例对照分析 ,探讨上述心理卫生指标与Ⅱ型糖尿病的关系及其影响因素。结果 :4年后 ,干预社区患者的焦虑总标准分、抑郁严重度指数和社会支持总分及主、客观支持分各指标均有显著性改善 ,而对照社区患者各项指标的改变无统计学意义。干预后干预社区患者各心理卫生指标仍与一般健康人群有显著性差异。排除了年龄、性别、职业等因素的潜在混杂作用后 ,焦虑总标准分、抑郁严重度指数及客观支持总分仍与Ⅱ型糖尿病有显著关联 ,OR值分别为 1 41,1 79,0 69。多元逐步回归分析显示 ,文化程度越高患者的心理卫生健康状况越好 ,而同时患其它慢性病则为影响患者心理卫生健康的危险因素。结论 :该社区水平的糖尿病干预项目对Ⅱ型糖尿
Objective: To investigate the effectiveness and influential factors of community interventions on the mental health of patients with type 2 diabetes, and provide a scientific basis for making appropriate community interventions and measures. Methods: According to the population experimental epidemiological method, two communities in Shandong Province were selected as the intervention community and the control community respectively. In 1997, baseline data were collected and com- prehensive diabetes interventions were started in intervention communities. In 2001, the data of two communities were collected again in the same way, and the influence of community intervention on the total anxiety score, depression index and social support score of type 2 diabetes patients were analyzed based on the baseline of two communities and the data after 4 years . And through the intervention of community intervention after the case-control analysis to explore the relationship between mental health indicators and type 2 diabetes and its influencing factors. Results: After 4 years, the total anxiety score, the severity of depression index, the total social support score, the main objective support score and the subjective support score of all interventions in community intervention group were significantly improved, while those in control community group had no statistical significance significance. Intervention in community patients after intervention of mental health indicators are still significantly different from the general health population. After excluding the potential confounding factors such as age, gender, occupation and other factors, the total anxiety score, the severity of depression index and the objective support score were still significantly associated with type II diabetes, with OR values of 1 41,1 79,0 69 . Multivariate stepwise regression analysis showed that the higher the level of education, the better the mental health status of patients, while other chronic diseases at the same time affect the mental health of patients with risk factors. CONCLUSIONS: The level of diabetes intervention in this community is associated with type II diabetes