Intervention Effect Of Self-management Behavior On Different Personality Traits In Patients With Type 2 Diabetes Mellitus

Objective:The purpose of this study was to investigate the current status and influencing factors of self-management behaviors in patients with type 2 diabetes mellitus,understand the differences of self-management behavior and its influencing factors in different personality dimensions on the basis of the theory of differential susceptibility model.To explore the intervention effect of self management behavior on different personality traits in patients with type 2 diabetes mellitus,and provide new theoretical guidance for clinical intervention.Methods:From June 2016 to July 2017,a total of 191 T2 DM patients from a hospital in Shanxi province were investigated by the general situation questionnaire,type 2diabetes self-management behavior scale,diabetes self-efficacy scale,Eysenck personality questionnaire China version,social support rating scale,simple coping style questionnaire,meanwhile,their fasting blood glucose and 2 hours postprandial blood glucose were collected.According to the voluntary principle,90 T2 DM patients were selected to attend the psychological intervention,and because of the fall off,42 patients in the intervention group and 43 patients in the control group completed the study finally.Both groups received drug treatment and routine nursing intervention,meanwhile,the intervention group was given positive psychological intervention.After the psychological intervention,both groups were assessed by those questionnairesagain except Eysenck personality questionnaire.Results:1.Survey results(1)The total score of self-management behavior of patients with type 2 diabetes was76.10 + 11.83,the compliance behavior of patients with medication is best,followed by the treatment of the level of blood glucose,foot care,diet control,blood glucose monitoring behavior,and the management of exercise behavior is the worst.59.7% of patients had poor self-management behavior,patients in the middle level accounted for39.3%,and only 1% of patients had better self-management behavior.(2)The self-management behavior of T2 DM patients has no significant differences in gender,education level,other diseases,complications,and family history(p<0.05);but it differences in the place of residence,age,marital status,occupation type,disease duration,smoking,drinking,family income and medical insurance type significantly(p<0.05).(3)On the total score of self-management behavior,self-efficacy and some dimensions,high neurotic patients scored lower than the middle group and low neuroticism group patients,the difference was statistically significant(p<0.05);and compared with the middle group and high extraversion group of patients,patients with low extraversion group scored the lowest in the compliance in medication behavior,with significant difference(p<0.05).On the total score of self-management behavior,self-efficacy and some dimensions,high psychoticism group scored significantly lower than the low psychoticism group(p<0.01).(4)There was a significant positive correlation between social support,positive coping,self-efficacy and self-management behavior(p<0.05);only medication compliance behavior and extraversion showed significant positive correlation(p<0.05);negative coping,psychoticism,neuroticism,fasting blood glucose,2 hours postprandial blood glucose and self management behavior was negatively correlated(p<0.05).(5)Regression analysis showed that the self-efficacy,negative coping,neuroticismand support utilization were the main factors influencing self-management behavior of patients with type 2 diabetes mellitus.2.Intervention study results:(1)Before and after psychological intervention,the intervention group has a significant improvement in support utilization,self-management behavior,self-efficacy,coping style and their dimensions(p<0.01);the control group has a significant improvement in the total score of self-management behavior,self-efficacy and their partial dimensions(p<0.01);for the fasting blood glucose and postprandial 2hours blood glucose,both groups have a significant decline after the intervention(p<0.01).(2)After the psychological intervention,the scores of self-management behavior,positive coping style,self-efficacy and its dimensions except blood glucose treatment,medication compliance were significantly higher in the intervention group than in the control group(p<0.01);in coping style,support utilization,self-management behavior,self-efficacy and its dimensions except medication compliance,the difference scores of the intervention group was higher than those of the control group significantly(p<0.01).(3)After the psychological intervention,in the self-management behavior and its diet control dimension,self-efficacy and its diet control,compliance medication dimensions,the difference scores of the patients with high neuroticism were significantly higher than those of the patients with low neuroticism(p<0.05);in the self management behavior and its diet control dimension,self-efficacy and its diet control,regular exercise,medication compliance dimensions,the difference scores of the patients with low extraversion were higher than those of the patients with high extraversion significantly(p<0.05);there were no statistically significant differences in the difference scores of each variable among the patients with different levels of psychoticism.Conclusion:(1)The self-management behavior of patients with type 2 diabetes is not good,mostof them are in the middle or below level.(2)Self-management behaviors of patients with type 2 diabetes are influenced by general demographic characteristics,self-efficacy,coping style,social support,personality traits and blood glucose levels,also,patients with high neuroticism or low extroversion have worse psychological performance.(3)Positive psychological intervention can improve the level of self-management behavior,it also can improve self-efficacy,coping style and social support to a certain degree,and the patients with high neuroticism and low extraversion have a better improvement.