作者：李玉梅1 ，郑梅邦2 ，何芳3 ，高梅鸿2 ，李萍1 ，黄弋潇4 ，陆秋梅2 ，刘怡2 ，黄虹2

单位：

1.535000广西壮族自治区钦州市第二人民医院护理部　2.535000广西壮族自治区钦州市第二人民医院内分 泌科　3.535000广西壮族自治区钦州市第二人民医院重症医学科　4.535000广西壮族自治区钦州市第二人民医院心血 管内科

Units：

1.Nursing Department, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 2.Department of Endocrinology, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 3.Critical Care Department, the Second People's Hospital of Qinzhou, Qinzhou 535000, China 4.Department of Cardiovascular Medicine, the Second People's Hospital of Qinzhou, Qinzhou 535000, China

关键词：

糖尿病，2型；中年人；青年人；接纳与承诺疗法；恐惧疾病进展

Keywords：

Diabetes mellitus, type 2; Middle aged; Young adult; Acceptance and commitment therapy; Fear of progression

CLC：

R 587.1

DOI：

10.12114/j.issn.1008-5971.2024.00.108

Funds：

广西壮族自治区卫生健康委员会自筹经费科研课题（Z-N20221904）

摘要：

　目的　探讨接纳与承诺疗法（ACT）对中青年2型糖尿病（T2DM）患者恐惧疾病进展（FoP）心理的 干预效果。方法　选取2022年7月—2023年3月钦州市第二人民医院收治的中青年T2DM患者120例为研究对象。采用 随机数字表法将患者分为对照组和ACT组，各60例。对照组进行常规护理干预，ACT组在对照组基础上进行ACT，两 组均干预1个月。比较两组干预前、干预后1个月、干预后3个月恐惧疾病进展简化量表（FoP-Q-SF）、糖尿病接纳与 行动问卷（AADQ）、医院焦虑抑郁量表（HAD）、中国糖尿病患者生存质量特异性量表（DSQL）评分。结果　干 预方法与时间在FoP-Q-SF、AADQ、HAD、DSQL评分上存在交互作用（P＜0.05）；干预方法、时间在FoP-Q-SF、 AADQ、HAD、DSQL评分上主效应显著（P＜0.05）。干预后1、3个月，ACT组FoP-Q-SF、AADQ、HAD、DSQL评分 低于对照组（P＜0.05）；两组干预后1、3个月FoP-Q-SF、AADQ、HAD、DSQL评分分别低于本组干预前，干预后3个 月FoP-Q-SF、AADQ、HAD、DSQL评分分别低于本组干预后1个月（P＜0.05）。结论　ACT能有效减轻中青年T2DM 患者FoP程度，提升其对疾病的接纳程度及管理和应对疾病的能力，减轻焦虑、抑郁情绪，提高生活质量。

Abstract：

Objective To explore the intervention effect of acceptance and commitment therapy (ACT) on the fear of progression (FoP) in young and middle-aged patients with type 2 diabetes (T2DM) . Methods A total of 120 young and middle aged T2DM patients admitted to the Second People's Hospital of Qinzhou from July 2022 to March 2023 were selected as the study objects. The patients were divided into control group and ACT group using random number table method, with 60 cases in each group. The control group received routine nursing intervention, and the ACT group received ACT on the basis of the control group. Both groups received intervention for 1 month. The scores of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) , Acceptance and Action Diabetes Questionnaire (AADQ) , Hospital Anxiety and Depression Scale (HAD) and Diabetes Specific Quality of Life (DSQL) before intervention, at 1 and 3 months after intervention were compared between the two groups. Results There was interaction between intervention method and time on FoP-Q-SF, AADQ, HAD and DSQL scores (P < 0.05) . The main effect of intervention method and time was significant in FoP-Q-SF, AADQ, HAD and DSQL scores (P < 0.05) . At 1 and 3 months after intervention, the scores of FoP-Q-SF, AADQ, HAD and DSQL in the ACT group were lower than those in the control group (P < 0.05) . The scores of FoP-Q-SF, AADQ, HAD and DSQL in the two groups at 1 and 3 months after intervention were lower than those before intervention, and the scores of FoP-Q-SF, AADQ, HAD and DSQL at 3 months after intervention were lower than those at 1 month after intervention, respectively (P < 0.05) . Conclusion ACT can effectively reduce the degree of FoP in young and middle-aged T2DM patients, improve their acceptance of the disease and their ability to manage and cope with the disease, reduce anxiety and depression, and improve the quality of life.

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