摘要： 行為與生活方式干預(yù)（behavior and lifestyle interventions，BLIs）可以降低血糖和血壓，調(diào)節(jié)血脂，控制肥胖，減少心血管事件，是糖尿病等慢性病的一線治療措施。BLIs包括幫助患者維護(hù)健康飲食、堅(jiān)持體育鍛煉、保持正常體重、保證良好睡眠、避免吸煙和酗酒、做好心理調(diào)適、建立良好的社會(huì)支持、進(jìn)行科學(xué)的血糖自我監(jiān)測、堅(jiān)持降糖藥治療等。除了出現(xiàn)嚴(yán)重高血糖及糖尿病急性并發(fā)癥需要立即進(jìn)行藥物治療外，新診斷的2型糖尿病患者應(yīng)首先進(jìn)行BLIs。BLIs應(yīng)遵循有效性、建立互信、問題解決導(dǎo)向、綜合性和個(gè)性化原則。常用干預(yù)策略包括應(yīng)用成熟的行為改變理論、使用行為改變技術(shù)、有效運(yùn)用傳播策略、提高患者行為技能、實(shí)施以人為本的患者自我管理教育和支持。基本步驟包括行為與生活方式及其影響因素評估、確定行為目標(biāo)、制定干預(yù)實(shí)施方案、實(shí)施干預(yù)和評價(jià)效果。BLIs效果評價(jià)指標(biāo)包括過程指標(biāo)、臨床結(jié)局、社會(huì)心理、行為結(jié)局、患者報(bào)告和健康結(jié)局。效果評價(jià)可采用定性和定量相結(jié)合的方法進(jìn)行，常用的評價(jià)工具包括糖尿病自我護(hù)理行為評價(jià)量表（summary of diabetes self-care activities，SDSCA）、患者行為量表（patient activation measurement，PAM）和糖尿病管理自我效能量表（diabetes management self-efficacy scale，DMSES）。

關(guān)鍵詞: 糖尿病, 高血糖, 高脂血癥, 高血壓, 行為與生活方式干預(yù)

Abstract:

Behavior and lifestyle interventions (BLIs) can reduce blood glucose and blood pressure, regulate blood lipids, control obesity, reduce cardiovas cular events and are a first-line treatment for chronic diseases such as diabetes mellitus. BLIs include helping patients maintain a healthy diet, adhere to physical exercise, maintain a normal weight, ensure good sleep, avoid smoking and alcohol abuse, make good psychological adjustments, establish good social support, as well as scientific self-monitoring of blood glucose and adherence to drug therapy. Except for the severe hyperglycemia and acute complications requiring medication, patients with newly diagnosed diabetes mellitus should first undergo BLIs. BLIs should follow the principles of effectiveness-centered, mutual trust establishment, problem-solving orientation, integration, and individulization. Common strategies for BLIs include applying behavior change theories, utilizing behavior change technologies, effectively emlpoying communication strategies, improving patient behavior skills, and implementing patient-centered self-management education and support (DSMES). The steps of BLIs include evaluating behavior, lifestyle and their influencing factors, setting behavioral goals, developing intervention plans, and conducting interventions and effectiveness evaluation. The evaluation measures for the effectiveness of BLIs include process indicators, clinical outcomes, socio-psychological and behavioral outcomes, patient reports, and health outcomes. Evaluation can be performed using a combination of qualitative and quantitative methods. Common evaluation tools include the SDSCA, PAM, and DMSES.

Key words: Diabetes mellitus, Hyperglycemia, Hyperlipidemia, Hypertension, Behavior and lifestyle interventions

中圖分類號(hào): 

R 587.1

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