| Backgrounds: With the increasing level of economy, the change of life style and the aging of the population, diabetes prevalence shows a trend of rapid rise that is seriously harmful to human health.Updated datas of the International Diabetes Federation(IDF)in 2012 showed that: the total number of diabetes patients over the age of 20 in China was 9.2 million; the prevalence rate was 9.7%. Along with the rapid increase of medical expenses, economic burden induced by diabetes will continue to increase, so the prevention and control of diabetes become a urgent task to be completed around the world.Due to the transformation of medical model, it can not guarantee satisfactory work effect and improving the health level of the diabetes population just relying on biomedical achievements and advanced technology and treatment.It was comparatively late to take up research into the relations between the social capital theory and the diabetes mellitus prevention and cure in our country. Social capital is one of the important factors affecting population health. As a kind of intangible resources on social aspect, it has important practical significance to make up for the deficiency of the existing tangible resources in prevention and treatment of diabetes.Objectives: To understand the stock, the component characteristics and the influencing factors of social capital among diabetic patients; To master the self-management behavior status and its influencing factors among diabetic patients; To explore the relationships between social capital and the self-management behavior of diabetes; To effectively mobilize all resources of diabetes patients and promote practice in diabetes prevention and treatment.Methods: This research adopted the multistage sampling method. We performed the scene investigation in Hefei, Fuyang and Tongling from August, 2014 to October, 2014.Our ways to collect data were the one-to-one questionnaire or self-administered questionnaire. Data were cross-checked in computer by Epi-Data 3.1 and analyzed by SPSS 18.0. Measurement data were shown by means ± SD and analysis methods were ANOVA or non parametric test. Enumeration data were shown by rate or constituent radio and analysis methods were Chi-square test and Fisher’s exact test. The model to analyze the influence factors was Logistic regression model. α= 0.05.Results:(1) 392 effective questionnaires were taken back from the investigated 400 diabetes patients, and the effective response rate was 98%.(2) The number of men(31.9%) was less than the number of women(68.1%) in the total surveyed respondents; The age of respondents was mainly concentrated in 60-80 years old(68.4%); More than half(52.0%) of their occupations were farmers; Education level basically was the junior middle school or below(86.7%), and they generally did not have a high level of education.(3) 58.7% of the respondents did not attend any social organization, 71.7% of respondents did not participated in the elections of village committee or community residents committee in the past year; 66.8% of the respondents knew all the surrounding neighbors, and 2.0% basicly didn’t know; 27.0% of respondents often drop around to the neighbors if free, and 13.0% don’t drop around at all; 50.8% of respondents thought most people would provide spiritual support for themselves, and26.8% of respondents thought some else would provide spiritual support for themselves completely; 48.5% of respondents thought most people would provide economic support for themselves, and 26.8% of respondents thought some else would provide economic support for themselves completely; 18.6% of respondents completely trust most people; 25.3% of respondents showed fully trust on the village committee or community residents committee; 25.3% of respondents would completely help familyrelatives when they were in trouble; 21.9% of respondents would completely help neighbors when they were in trouble; 22.4% of respondents would completely help their friends when they were in trouble; 28.1% of respondents thought the interpersonal relationship in their own region was harmonious; 26.5% of respondents felt that they cared about their community or village very much; 18.6% of respondents felt that others concerned about their community or village very much; 18.6% of respondents would feel very loathe to leave the recent community or village.(4) About social capital questionnaire reliability, the whole internal consistency coefficient of the questionnaire(Cronbach’s α coefficient) was 0.879; About validity, six extraction common factors could explain 74.714% of the total variance.(5) For respondents, the average number of days in accordance with the requirements for diabetes diet in the past 7 days were 5.94 days. In the past one month, respondents were completely in accordance with the requirements for diabetes diet with average5.85 days a week; In the past seven days, respondents ate some fruit or vegetable besides the dinner with the average number of days to 5.09 days; In the past seven days,respondents ate some foods high in fat, such as fatty meat, animal offal, full-fat dairy products with the average number of days to 1.43 days; Diet score was 22.45±5.164. In the past 7 days, respondents only exercised at least 30 minutes in 4.00 days averagely;In addition to live and work, respondents participated in moderate intensity aerobic exercise, such as swimming, jogging, biking with the average number of days to 1.97days; Exercise score was 5.98±5.272. In the past 7 days, respondents were completely in accordance with the doctor to self-monitor blood glucose only in 1.04 days; Blood glucose monitoring score was 1.90±3.511. In the past 7 days, the average number of days for patients to check their feet(with or without damage, fester, black) were only1.72 days; In the past 7 days, the average number of days for patients to check with shoes(such as foreign matte, comfort level) were only 1.65 days; Foot care score was3.37±4.946. In the past 7 days, respondents were completely in accordance with thedoctor to take medicine or inject insulin properly were 4.62 days; Medication score was4.62±3.114.(6) The single factor logistic regression analysis showed that the impact of social participation and social trust on self-management behaviors were both statistically significant(OR=1.76;OR=2.66). Logistic regression analysis of this study found that the influence of social participation on diet behavior, exercise behavior and blood sugar monitoring behavior among patients had statistical significance(OR=1.73;OR=1.91;OR=1.74). The impact of neighborhood relationship on foot care behavior medication treatment behavior had statistical significance(OR=1.54; OR=1.62); Social trust impacted on exercise behavior and blood sugar monitoring behavior with statistical significance(OR=2.68;OR=2.08); Mutual reciprocity and mutual benefit impacted on blood sugar monitoring behavior and foot care behavior with statistical significance(OR=1.61;OR=1.70); Cohesion and belonging impacted on blood sugar monitoring behavior, foot care behavior and medication treatment behavior with statistical significance(OR=1.64;OR=2.22;OR=1.73).Conclusions:(1) The social capital questionnaire of diabetes patients in this study had good reliability and validity.(2) The social capital of diabetic patients remained to be further improved. In addition to relatively high social support, social participation, neighborhood relations, social trust,reciprocity and mutual benefit, cohesion and sense of belonging needed to be strengthened.(3) The self-management behaviors of diabetes were relatively poor. Diet score was highest but still not ideal. Blood sugar monitoring score was lowest.(4) The higher social capital diabetic patients had, the better self-management behavior;Social participation was proportional to diet behavior, exercise behavior and blood sugar monitoring behavior in patients; Better neighborhood relationships, better foot care behavior and medication treatment in patients; Social trust was proportional toexercise behavior and blood sugar monitoring behavior; Mutual reciprocity and mutual benefit was proportional to blood sugar monitoring behavior and foot care behavior;Cohesion and sense of belonging was proportional to blood sugar monitoring behavior,foot care behavior and medication.(5) Negative effects of social capital and its components on diabetes patients had not yet been found in this study. |
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