Study On The Health Effects And Influencing Factors Of Self-care Behavior In Elderly Patients With Type 2 Diabetes

Objective:To investigate the influencing factors and health effects of self-care behavior in elderly patients with type 2 diabetes.The purpose is to provide reference for self-care education and intervention of elderly patients with type 2 diabetes.Methods:A cross-sectional study design was employed.355 elderly patients with type 2 diabetes hospitalized in the Department of Endocrinology,a hospital of Class A and III in Nanning,Guangxi from February 2022 to October 2022 were selected as the research objects.The questionnaire method was used to collect data.The researcher asked the patient,filled in the questionnaire,and collected the relevant data of the patient’s disease through the hospital medical record management system.The research tools include the general situation questionnaire,the Summary of Diabetes Self-care Activities,the Chinese Perceived Stress Scale,the Social Support Rating Scale and Self-Efficacy for Diabetes.EPidata3.2 software was used to establish the database,two people entered the data,and SPSS25.0 was used for statistical analysis.The main statistical methods used in the study of self-care behavior influencing factors included independent sample t-test,one-way ANOVA,Pearson correlation analysis,multiple stepwise regression analysis,etc according to Glasgow’s model of influencing factors of self-caret behavior in diabetes.According to the diabetes care health effect measurement indicators provided by Greenhalgh,biomedical indicators were selected as health effect indicators to analyze the health effects of self-care behavior.The main statistical methods used in the study of self-care behavior health effects included chi-square test,gamma test Logistic regression analysis,etc.Results:1.The self-care behavior scores of elderly patients with type 2 diabetes were 41.37±13.01,and there were significant differences in gender,age,marital status,residence,income level,educational level,medical insurance type,and diabetes education(P<0.05).2.There were significant differences in pressure perception,social support,and self-efficacy among the high,middle,and low self-care behavior groups of elderly patients with type 2 diabetes(P<0.05).The self-care behavior of elderly patients with type 2 diabetes was significantly negatively correlated with stress perception(P<0.01,r=-0.72),and significantly positively correlated with social support and diabetes self-efficacy((P<0.01,r=0.75,P<0.01,r=0.81).3.The self-care behavior of elderly patients with type 2 diabetes was affected by gender(β=-0.08,P=0.013),age(β=-0.10,P=0.001),receiving diabetes education number(β=0.08,P=0.008),pressure perception(β=-0.15,P=0.008),social support(β=0.23,P<0.001)and self efficacy(β=0.48,P<0.001).Accounted for 71%of the variation in self-care behavior(R~2=0.71).4.The self-care behavior of elderly patients with type 2 diabetes was significantly negatively correlated with diabetes complications,diabetes comorbidities,urinary microprotein to creatinine ratio,and glycosylated hemoglobin(P<0.05),and Gamma values were at-0.19,-0.30,-0.42,and-0.62,respectively.The control rate of total cholesterol and blood ketone in the self-care group was significantly higher than that in the low group(P<0.05).5.After controlling demographic and course of disease variables,self-care behavior of elderly patients with type 2 diabetes significantly negatively affected the total cholesterol(OR=0.45),blood ketone(OR=0.22),glycosylated hemoglobin(OR=0.17),ratio of urinary microprotein to creatinine(OR=0.46)and diabetes comorbidities(OR=0.58).With other variables unchanged,the risk of total cholesterol,blood ketone,glycosylated blood red egg,urinary microprotein to urinary creatinine ratio,and poor control of diabetes complications decreased by 55%,78%,83%,54%,and42%respectively in patients with high self-care behavior compared with patients with low self-care behavior.Conclusions:1.The self-care behavior in elderly patients with type 2 diabetes was poor.In general,the self-care behavior level of the elderly type 2 diabetes patients who are male,are elderly people,have no spouse,live in rural areas,low income,or low education level is low.The patients who received higher number of diabetes education,or have medical insurance directly under the provincial level have a higher level of self-care behavior.2.The elderly patients with high level of self-care behavior in type 2diabetes have higher social expenditure,higher diabetes self-efficacy and lower stress perception.The self-care behavior of elderly patients with type 2diabetes is negatively correlated with stress perception,and positively correlated with social support and diabetes self-efficacy.3.The self-care behavior of elderly patients with type 2 diabetes is mainly affected by diabetes self-efficacy,social support,pressure perception,number of diabetes education,age and gender.4.The control rate of total cholesterol and blood ketone in the middle group and the high group of elderly patients with type 2 diabetes self-care behavior is higher than that in the low group.The self-care behavior is negatively correlated with diabetes complications,diabetes comorbidities and urinary microprotein to creatinine ratio.5.After the demographic and course variables are controlled,self-care behavior negatively affects total cholesterol,blood ketone,glycosylated blood red egg,urinary microprotein to creatinine ratio,and the comorbidities of diabetes.Under the condition that other variables remain unchanged,compared with patients with low levels of self-care behavior,the risk that the control effect of total cholesterol,blood ketone,glycosylated blood red egg,urinary microprotein to creatinine ratio and diabetes comorbidities in patients with higher levels of self-care behavior is poor are all reduced.