老年2型糖尿病住院患者健康促进行为现状及其影响因素分析-现代医学

老年2型糖尿病住院患者健康促进行为现状及其影响因素分析

单位：1. 贵州医科大学护理学院, 贵州贵阳 550001;
2. 贵州医科大学附属医院精神科, 贵州贵阳 550004;
3. 贵州医科大学附属医院护理部, 贵州贵阳 550004;
4. 贵州医科大学附属医院综合病房, 贵州贵阳 550004;
5. 贵州医科大学附属医院内分泌科, 贵州贵阳 550

关键词：老年人 2型糖尿病健康促进行为影响因素中介效应分析

分类号：R587.1;R473.5

出版年·卷·期（页码）：2026·54·第六期（976-985）

摘要：

目的：调查老年2型糖尿病(T2DM)住院患者健康促进行为(HPB)现状并分析其影响因素。方法：采用便利抽样法选取2024年12月至2025年5月在贵州医科大学附属医院内分泌科住院的老年T2DM患者为研究对象，采用一般资料调查表、多维度健康心理控制源C版量表(MHLC-C)、老年慢性病患者健康赋权量表和糖尿病患者健康促进行为量表(T2DHPS)进行调查。单因素分析采用独立样本t检验或单因素方差分析，相关性分析采用Pearson相关分析，以HPB得分为因变量，单因素分析和相关性分析中有统计学意义的变量为自变量进行多元线性回归分析，中介效应检验采用Bootstrap法进行。结果：老年T2DM住院患者HPB得分为(89.08±9.29)分。多元线性回归分析显示，高健康内部控制(β=2.074，P＜0.001)、健康医生控制(β=1.603，P=0.017)和健康赋权水平(β=0.554，P＜0.001)是老年T2DM住院患者HPB的保护因素；高健康机遇控制水平(β=-1.523，P=0.004)是老年T2DM住院患者HPB的危险因素。中介效应分析显示，健康赋权分别在健康内部控制和健康机遇控制与HPB之间起部分中介作用；健康赋权在健康医生控制与HPB之间不存在中介效应。结论：老年T2DM住院患者的HPB处于中等水平，且受文化程度、是否接受过糖尿病健康教育、健康心理控制源(HLC)和健康赋权等多种因素共同影响。医护人员须帮助低文化程度患者获取健康知识、优化健康教育质量、引导患者树立对疾病的积极认知、合理利用医疗和社会资源，提升HPB水平，改善预后、提高生活质量。

Objective: To investigate the current status of health-promoting behavior(HPB) in hospitalized elderlypatients with type 2 diabetes mellitus(T2DM) and analyze its influencing factors. Methods: A convenience sampling method was used to select elderly patients with T2DM hospitalized in theEndocrinology Department,Guizhou Medical University Affiliated Hospital from December 2024 to May 2025. Data were collected using a general information questionnaire, the Multidimensional Health Locus of Control Scale(Form C), the Health Empowerment Scale for Elderly Patients with Chronic Diseases, and the Type 2 Diabetes and Health-Promoting Scale. Univariate analysis was performed using independent sample t-tests orone-way ANOVA, and correlation analysis using Pearson correlation. Multiple linear regression analysis was conducted with HPB score as the dependent variable, and variables that were statistically significant in univariate analysis and correlation analysis as independent variables. The Bootstrap method was used for mediation effect analysis.Results: The HPB score of elderly hospitalized patients with T2DM was(89.08±9.29) points. Multiple linear regression analysis showed that high internal health locus of control(β=2.074, P<0.001), health-related doctor control(β=1.603, P=0.017), and high health empowerment level(β=0.554, P<0.001) were protective factors for HPB in elderly T2DM inpatients, while high chance health locus of control(β=-1.523, P=0.004) was a risk factor. Mediation effect analysis showed that health empowerment partially mediated the relationships between internal health locus of control and HPB, and between chance health locus of control and HPB; no mediation effect of health empowerment was found between health-related doctor control and HPB. Conclusion:The HPB level of elderly hospitalized patients with T2DM is moderate, and is influenced by multiple factors including education level, receipt of diabetes education, health locus of control, and health empowerment. Medical staff should help patients with low education levels acquire health knowledge, optimize the quality of diabetes education, guide patients to develop positive perceptions of their disease, and make reasonable use of medical and social resources, so as to improve HPB level, enhance prognosis, and increase quality of life.

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