Abstract：Objective To investigate the impact of health self-management on different self-efficacies in diabetic patients, and to offer proposals for improving and promoting the health self-management. Methods Two hundred and twenty-one patients with confirmed diabetes mellitus and recruited from 12 communities in Jiulongpo District and Shapingba District, Chongqing were surveyed with the questionnaire before and after they participated in the activity of the health self-management. The contents of the questionnaire included demographic characteristics and diabetes-related prevention and treatment knowledge and behavior. Diabetes Management Self-efficacy Scale (DMSES) was employed to evaluate the scores of self-efficacies. The changes of self-efficacies before and after the health self-management were compared by non-parameter Wilcoxon test. Results Among the recruited 221 diabetes patients with average age of (65.8±7.5) years, 214 attended 6 health self-management activities and took part in the questionnaire survey, with the follow-up rate of 96.8%. After participating in the health self-management, the scores of total self-efficacy, self-efficacy total diet control and physical activity, self-monitoring, self-care and complication management were all significantly improved, with statistically significant differences (Z=-7.72, Z=-4.44, Z=-5.00, Z=-5.89, Z=-7.76, Z=-6.67; all P<0.001). But no statistically significant change was found in the score of self-efficacy about medication after the health self-management (Z=-1.54, P=0.123). The scores of the items such as “I could replace the food in the same kind of food according to the calorie” (2.0(1.0-3.0) vs. 3.0(2.0-4.0)), “I could spare time to do exercise even if I was very busy” (3.0 (2.0-5.0) vs. 4.0(3.0-5.0)), “I could still monitor blood glucose or urine glucose when I went outside” (3.0(2.0-4.0)vs.3.5(3.0-4.0)) and “I could examine and nurse my foot correctly according to the doctor’s advice (2.0(1.0-4.0)vs. 4.0(3.0-5.0)) were all low before and after the health self-management, but the scores of these items after the health self-management were all higher than those of before the health self-management, with statistically significant differences (P<0.05). Conclusions The health self-management can effectively improve the patients’ self-efficacies, but there exists a diversity of different self-efficacies. It is necessary to conduct the targeted health self-management training against poor self-efficacies.
[1] Yan W, Lu J, Weng J,et al. Prevalence of diabetes among men and women in China[J]. N Engl J Med, 2010,362(2):1090-1101. [2] Xu Y, Wang L, He J, et al. 2010 China Noncommunicable Disease Surveillance Group. Prevalence and control of diabetes in Chinese adults[J]. JAMA. 2013,310(9):948-959. [3] 俞莉红,江菲菲,齐惠华,等. 自我管理教育对2型糖尿病患者生活质量的影响[J].中华现代护理杂志, 2010,16(24):2941. [4] 许晔,林蓓琪,何敏敏.社区2型糖尿病患者自我效能与生存质量相关性研究[J].河北医药,2013, 35(14):2202-2203. [5] 高红. 2型糖尿病患者自我效能与自我管理水平的相关性研究[J].吉林医学,2012,33(35):7646-7647. [6] 谢波,鞠昌萍,孙子林,等. 糖尿病自我管理培训指导网络对 2 型糖尿病患者自我效能的影响研究[J].中国全科医学,2012,15(11):3610-3612. [7] 刘小丽,王文绢. 糖尿病患者自我管理的研究进展[J].中国慢性病预防与控制,2008,16(2):212-214. [8] 王凤兰.健康信念模式教育对糖尿病患者自我管理疾病能力的影响[J].实用预防医学,2011,18(8):1591-1592. [9] 董胜莲,吴保平,刘海娟, 等.农村2型糖尿病患者自我管理水平调查与分析[J]. 实用预防医学,2014,21(2):242-245.
2016, Vol. 23 
