Research And Application On Self-management Behavior Changing Method Of Type2DM In Community

Objective：①To understand the condition of self-management behavior with type2diabetes in communities and to explore the influential factors that affect theirself-management;②To determine the effects of Transtheoretical ModeIntervention(TTMI) and Motivational Interviewing(MI) on self management behaviorwith type2diabetes in communities;③To evaluate the effects of TTMI and MI onself-efficacy,coPing style, quality of life.Method：This was an experimental study. In the investigation stage,a cross-sectionstudy by stratified cluster sampling on418individual with diabetes were investigatedin the three communities. Based on the investigation result,the182diabetic patients inprecontemplation and contemplation in the first part were incorporated into the nursingintervention study.They were randomly divided into two groups,90in the control groupand92in the intervention group. Control grouponly received knowledge education ofdiabetic，Subjects in the intervention group were given the Ml and TTMI．In theresearch process, according to the changes in behavior at the stage, patients were givenappropriate interview skills and the matching intervention based on TTM．The time offollow-up was6months after intervention in the two groups. Before and after theintervention of two time points, The outcome of self management behavior,self-efficacy, coping style, quality of life were evaluated to analyze the effects of TTMIand Ml.Result:①the score of self-management behaviors in patients with type2Diabeteswas82.30±17.79and the score index was63.31%. Different self-management activities had different levels，medication compliance got the highest score and itsaverage indicator was76.47%.In contrast， the lowest score was from glucoseself-monitoring,whose indicator was54.85%.The self-management behavior amongdiabetic patients was affected by many factors, The stage of patients’ behaviorchange and patients’ disease course、complication、previous hospitalization、livingcondition were the main influential factors.②ComPared to baseline, the ability ofself-management had significant improvement after the intervention（P＜0.05）.Inaddition, compared to that of control group, the HbA1c has decreased significantlyafter intervention（P＜0.05）.③As to self-management stages of those who in theexperimental group，The number of subjects decreased in the precontemplation andcontemplation stage and increased in the preparation and the action stage，the resultwas significant（P＜0.05）,④The scores of A-DQOL were increased in experimentalgroup after interventions（P＜0.05），while there were no significance in scores ofphysiological and therapeutic dimension between pre and post interventions（P﹥0.05）;⑤The scores of confrontation in experimental group after intervention were increasedsignificantly, the scores of Resignation and avoidance decreased significantly, and bothchanged more than control group.⑥The scores of self-efficacy were significant Preand post interventions in the experimental group and scores more than control group（P＜0.05）.Conclusion:①The current status of self management in diabetic patients was not ideal,the self-management behavior among diabetic patients was affected by many factors.The stage of patients’ behavior change and patients’ disease course、complication、previous hospitalization、living condition were the main influential factors. nursesshould improve the level of self-management,delay and control their complication bytailored behavior intervention.②Most of the patients were in the decisional balance ofbehavior change, did not enter behavior level.③TTMI and MI have positive effects on self management behavioral change of patients with type2diabetes.④TTMI andMI can improve coping style、self-efficacy，then the fav ourable behavior of self-management was established;⑤TTMI and MI can improve most aspects of quality oflife of patients with type2diabetes.