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目的了解乌鲁木齐市社区居民2型糖尿病(T2DM)患者与高危及健康人群间的生活、睡眠及心理行为差异,为社区T2DM患者行为及心理干预指导提供理论依据。方法于2016年3-7月按照整群随机抽样方法调查新疆乌鲁木齐市3个社区卫生服务中心在档的35~75岁T2DM患者、高危及健康人群,采用自制行为调查问卷、生活行为量表、康奈尔医学指数(CMI)量表的M-R精神部分R51量表和匹茨堡睡眠质量指数量表(PSQI)调查T2DM患者、糖尿病高危以及健康人群的一般资料、生活行为、心理和睡眠情况。用SPSS 16.0软件对数据进行方差分析和χ~2检验,应用多因素logistic回归模型分析影响因素。结果糖尿病组、高危组、健康组间年龄、性别、民族等基本信息差异均无统计学意义(P>0.05)。T2DM组饮食、生活行为合计得分高于健康组,高危组生活行为合计得分高于健康组,差异均有统计学意义(P<0.05)。T2DM组和高危组睡眠7个因子得分及总得分均高于健康组,差异均有统计学意义(P<0.05)。T2DM组与健康组6个心理因子得分差异均有统计学意义(P<0.05),高危组与健康组在不适应、抑郁、愤怒、紧张方面差异均有统计学意义(P<0.05),T2DM组与高危组的焦虑、敏感及紧张方面差异有统计学意义(P<0.05)。对3个量表的18个因子做主成分分析提取3个主成分,依次分别为心理因素、睡眠因素、行为因素,与3个量表所代表因素相吻合。多因素logistic回归分析显示,以健康组为对照,心理、睡眠和生活行为均是健康人群发展为糖尿病高危及T2DM患者的危险因素(P<0.05);以高危组为对照,心理问题是高危人群发展为T2DM的危险因素(P<0.05)。心理异常的健康人发展为T2DM的风险是心理健康的4.076倍,心理异常的健康人群发展为糖尿病高危的风险是心理健康的2.682倍,心理异常的高危人群发展为T2DM的风险是心理健康的1.520倍。结论应加强对糖尿病高危人群生活行为的健康教育和心理异常的干预,降低其发展为T2DM的可能性,同时重视对T2DM患者进行睡眠及心理的干预。
Objective To understand the differences in life, sleep and psychological behaviors between community-based T2DM patients and high-risk and healthy subjects in community in Urumqi, and to provide theoretical basis for behavioral and psychological intervention guidance in community-based T2DM patients. METHODS: From March to July 2016, randomized sampling methods were used to investigate the prevalence of T2DM among 35-75 year-old T2DM patients, high-risk and healthy population in Urumchi, Xinjiang. Three questionnaires of self-made behavior, life behavior scale, The MR spirit R51 scale and the Pittsburgh Sleep Quality Index Scale (PSQI) of the Cornell Medical Index (CMI) scale were used to investigate general information, lifestyle behavior, psychology and sleep status in T2DM patients, at high risk of diabetes and in healthy people. Data were analyzed by ANOVA and χ ~ 2 using SPSS 16.0 software, and multivariate logistic regression model was used to analyze the influential factors. Results There were no significant differences in age, sex, ethnicity and other basic information between diabetic group, high risk group and healthy group (P> 0.05). The total score of diet and life behavior of T2DM group was higher than that of healthy group, while the total score of living behavior of high risk group was higher than that of healthy group (P <0.05). The score of 7 factors and total score of sleep in T2DM group and high-risk group were higher than those in healthy group, the difference was statistically significant (P <0.05). There were significant differences in scores of 6 psychological factors between T2DM group and healthy group (P <0.05). There was significant difference between high risk group and healthy group in unmatchedness, depression, anger and tension (P <0.05) There were significant differences in anxiety, sensitivity and stress between high risk group and high risk group (P <0.05). The principal component analysis of 18 factors of three scales was performed to extract three principal components, which were psychological factors, sleep factors and behavioral factors, respectively, which were consistent with those represented by the three scales. Multivariate logistic regression analysis showed that mental health, sleep quality and life behavior were the risk factors for the development of diabetes mellitus and T2DM in healthy people (P <0.05). The high risk group was the control group, and the psychological problems were high risk group Development of T2DM risk factors (P <0.05). The risk of developing T2DM is 4.076 times that of healthy people with abnormal psychology, and 2.682 times that of healthy people with abnormal psychology is 2.482 times higher than that of healthy people. The risk of developing T2DM is 1.520 Times Conclusions Health education and psychological abnormalities should be strengthened for the life behaviors of high risk population of diabetic patients to reduce their possibility of developing T2DM. At the same time, attention should be paid to sleep and psychological intervention in T2DM patients.