Influence of health management based on dual-frame design of framing effect on self-care ability of type 2 diabetes patients
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摘要:
目的 探讨基于信息框架效应双框架设计的健康管理对2型糖尿病患者自我护理能力的影响，为优化临床糖尿病健康管理方案提供依据。 方法 便利抽样法选取2024年8月—2025年7月在玉环市人民医院收治的164例2型糖尿病患者作为研究对象，采用随机数字表法将患者分为对照组（82例）和观察组（82例）。对照组应用常规健康管理，观察组实施基于信息框架效应双框架设计的健康管理。2组患者均持续干预6个月。比较2组患者血糖水平、自我护理能力、决策准备及决策自我效能情况。 结果 干预后，观察组空腹血糖、餐后2 h血糖及糖化血红蛋白(HbA1c）水平均低于对照组[（6.51±0.83）mmol/L vs. (7.33±1.16）mmol/L、（8.85±1.19）mmol/L vs. (10.03±1.47）mmol/L、（6.90±0.87）% vs. (7.85±1.02）%，P < 0.05]；观察组糖尿病自我管理行为量表(SDSCA)总分及各维度得分均高于对照组（P < 0.05）；观察组决策准备量表（PrepDMS）及中文版决策自我效能量表得分均高于对照组（P < 0.05）。 结论 基于信息框架效应双框架设计的健康管理能够增强2型糖尿病患者自我护理能力、控制血糖水平，增强患者决策自我效能，值得临床推广应用。但本研究样本来源单一、干预周期较短，结论的外推性有待多中心、长周期的研究进一步验证。 Abstract:Objective To explore the influence of health management based on the dual-frame design of framing effect on the self-care ability of type 2 diabetes patients, and to provide a basis for optimizing clinical diabetes health management strategies. Methods A total of 164 patients with type 2 diabetes who were admitted to Yuhuan People's Hospital from August 2024 to July 2025 were selected by a convenience sampling method as the research objects. They were divided into a control group and an observation group with 82 cases each by a random number table. The control group applied conventional health management, while the observation group implemented health management based on the dual-frame design of the framing effect. Both groups received continuous intervention for 6 months. The blood glucose levels, self-care ability, decision preparation, and decision self-efficacy were compared between the two groups of patients. Results After intervention, the levels of FPG, 2hPG, and HbA1c in the observation group were significantly lower than those in the control group [(6.51±0.83) mmol/L vs. (7.33±1.16) mmol/L, (8.85±1.19) mmol/L vs. (10.03± 1.47) mmol/L, (6.90±0.87)% vs. (7.85±1.02)%], and the differences between groups were statistically significant (P < 0.05). The total score and all dimension scores of the summary of diabetes self-care activities (SDSCA) in the observation group were significantly higher than those in the control group (P < 0.05); The scores of the preparation decision making scale (PrepDMS) and the Chinese version of decision self-efficacy scale (DSES) were also significantly higher than those in the control group (P < 0.05). Conclusion Health management based on a dual-frame design of framing effect can enhance the self-care ability of type 2 diabetes patients, control blood glucose level, and enhance patients' decision self-efficacy, which is worthy of clinical application. However, due to the single source of sample and short intervention period in this study, the extrapolation of the conclusions needs to be further verified by multi-center, long-term studies. -
Key words:
- Type 2 diabetes /
- Framing effect /
- Dual-frame design /
- Health management /
- Self-care ability /
- Decision self- efficacy
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表 1 2组T2DM患者一般资料比较
Table 1. Comparison of general data between the two groups of T2DM patients
项目 对照组(n=80) 观察组(n=79) 统计量 P值 性别[例(%)] 0.172a 0.679 男性 45(56.25) 47(59.49) 女性 35(43.75) 32(40.51) 年龄(x±s，岁) 58.26±7.84 57.93±8.12 0.261b 0.795 文化程度[例(%)] 0.638a 0.727 小学及以下 14(17.50) 16(20.25) 中学 40(50.00) 36(45.57) 大专及以上 26(32.50) 27(34.18) 糖尿病病程(x±s，年) 7.62±3.47 7.85±3.26 0.413b 0.680 降糖方案[例(%)] 0.070a 0.791 胰岛素治疗 49(61.25) 50(63.29) 非胰岛素治疗 31(38.75) 29(36.71) 合并其他慢性病[例(%)] 0.408a 0.523 有 54(67.50) 57(72.15) 无 26(32.50) 22(27.85) 注：a为χ2值，b为t值。 
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表 2 2组T2DM患者干预前后血糖指标比较(x±s)
Table 2. Comparison of blood glucose indicators between the two groups of T2DM patients before and after intervention (x±s)
组别 例数 空腹血糖(mmol/L) 餐后2 h血糖(mmol/L) HbA1c(%) 干预前 干预后 干预前 干预后 干预前 干预后 对照组 80 9.85±1.36 7.33±1.16b 13.13±2.17 10.03±1.47b 8.45±1.24 7.85±1.02b 观察组 79 9.90±1.42 6.51±0.83b 13.07±2.25 8.85±1.19b 8.52±1.16 6.90±0.87b 统计量 0.227a 4.831c 0.171a 5.106c 0.367a 5.753c P值 0.821 ＜0.001 0.864 ＜0.001 0.714 ＜0.001 注：a为t值，c为F值；与同组干预前比较，bP＜0.05。
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表 3 2组T2DM患者干预前后自我护理能力比较(x±s，分)
Table 3. Comparison of self-care ability between the two groups of T2DM patients before and after intervention (x±s, points)
组别 例数 饮食 运动 血糖监测 干预前 干预后 干预前 干预后 干预前 干预后 对照组 80 13.87±1.31 18.73±1.57b 5.06±0.71 8.19±1.62b 6.95±1.17 10.72±1.44b 观察组 79 14.12±1.66 22.15±0.45b 5.13±0.72 11.74±1.33b 6.87±1.20 12.58±1.07b 统计量 1.055a 17.052c 0.617a 14.122c 0.426a 8.413c P值 0.293 ＜0.001 0.538 ＜0.001 0.671 ＜0.001 组别 例数 足部护理 用药 总分 干预前 干预后 干预前 干预后 干预前 干预后 对照组 80 5.71±1.49 6.33±1.76 5.08±1.11 5.76±0.94 36.79±4.51 49.77±5.16b 观察组 79 5.64±1.52 10.28±1.40b 5.13±1.06 6.20±0.33b 37.28±4.37 64.23±4.02b 统计量 0.293a 11.672c 0.290a 3.188c 0.696a 18.705c P值 0.770 ＜0.001 0.772 0.001 0.488 ＜0.001 注：a为t值，c为F值；与同组干预前比较，bP＜0.05。
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表 4 2组T2DM患者干预前后决策准备情况及决策自我效能比较(x±s，分)
Table 4. Comparison of decision readiness and decision-making self-efficacy between the two groups of T2DM patients before and after intervention (x±s, points)
组别 例数 PrepDMS量表 中文版决策自我效能量表 干预前 干预后 干预前 干预后 对照组 80 55.86±10.72 58.92±10.33b 45.71±10.22 48.76±9.73b 观察组 79 56.13±9.76 71.58±8.49b 44.89±10.57 65.44±8.49b 统计量 0.166a 8.437c 0.497a 11.512c P值 0.868 ＜0.001 0.620 ＜0.001 注：a为t值，c为F值；与同组干预前比较，bP＜0.05。
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