探讨健康信念与家庭功能对老年糖尿病视网膜病变患者血糖控制的影响。

以2019年1月至2020年12月四川省南充市中心医院收治的144例老年糖尿病视网膜病变患者为研究对象，根据患者入院时的血清糖化血红蛋白（HbA1C）水平分为A组（HbA1C≤7.0%，45例）、B组（7.0%<HbA1C≤9.0%，56例）和C组（HbA1C>9.0%，43例）。采用Champion健康信念（CHBM）和家庭功能评定（FAD）量表分别评估患者的健康信念和家庭功能。采用方差分析比较3组患者的CHBM、FAD量表评分，采用Spearman相关性分析法分析各量表评分与血清HbA1C水平的相关性。

3组患者CHBM量表的6个维度评分的差异均有统计学意义（F=58.644、111.271、50.539、54.831、35.638、97.718，P<0.01），其中A组6个维度的评分均明显高于B组和C组（P<0.05），B组6个维度的评分均明显高于C组（P<0.05）。3组患者FAD量表的7个维度评分的差异均有统计学意义（F=315.779、80.880、58.189、51.044、59.501、77.473、46.086，P<0.01），其中A组7个维度的评分均明显低于B组和C组（P<0.05），B组除情感反应外其他6个维度的评分均明显高于C组（P<0.05）。CHBM量表中严重性、益处、健康动力、自我效能的评分均与HbA1C水平呈正相关（r=0.393、0.684、0.463、0.725，P<0.05）；FAD量表中解决、沟通、情感介入、行为控制、总的功能的评分均与HbA1C水平呈负相关（r=-0.453、-0.548、-0.784、-0.774、-0.658，P<0.05）。

老年糖尿病视网膜病变患者的病情控制与患者的健康信念和家庭功能相关，临床对患者及其家属进行针对性的健康教育，提高患者及家属的健康信念，可能有助于改善患者的病情。

To explore the influence of health belief and family function on blood sugar control in elderly patients with diabetic retinopathy.

A total of 144 elderly patients with diabetic retinopathy who were admitted to Nanchong Central Hospital in Sichuan Province from January 2019 to December 2020 were included in the study. According to level of serum glycosylated hemoglobin at admission. The patients were divided into group A (HbA1C≤7.0%, 45 cases), group B (7.0% < HbA1c≤ 9.0%, 56 cases) and group C (HbA1c > 9.0%, 43 cases). The Champion health beliefs modle (CHBM) and the Family assessment device (FAD) were used to assess the health beliefs and family function of patients, respectively. The CHBM and FAD scale scores of the three groups were compared by analysis of variance, and the correlation with level of serum HbA1C was analyzed by Spearman correlation analysis.

The differences of scores in six dimensions of CHBM scale among the three groups were statistically significant (F=58.644, 111.271, 50.539, 54.831, 35.638, 97.718, P < 0.01). The scores in six dimensions in group A were significantly higher than those in group B and group C (P < 0.05), and the scores in six dimensions in group B were significantly higher than those in group C (P < 0.05). The differences in scores of seven dimensions of FAD scale among the three groups were statistically significant (F=315.779, 80.880, 58.189, 51.044, 59.501, 77.473, 46.086, P < 0.01). The scores of seven dimensions in group A were significantly lower than those in group B and group C (P < 0.05). The scores of six dimensions except for emotional response in group B were significantly higher than those in group C (P < 0.05). The scores of severity, benefit, health motivation and self-efficacy in the CHBM were positively correlated with the level of HbA1C (r=0.393, 0.684, 0.463, 0.725, P < 0.05). The scores of resolution, communication, emotional intervention, behavior control, and total function in FAD scale were negatively correlated with level of HbA1C (r=-0.453, -0.548, -0.784, -0.774, -0.658, P < 0.05).

The blood glucose control of elderly patients with diabetic retinopathy is related to their health beliefs and family functions. Clinical targeted health education for patients and their families to improve their health beliefs may help to improve the patients condition.