摘要： 行為與生活方式干預（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包括幫助患者維護健康飲食、堅持體育鍛煉、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、建立良好的社會支持、進行科學的血糖自我監(jiān)測、堅持降糖藥治療等。除了出現(xiàn)嚴重高血糖及糖尿病急性并發(fā)癥需要立即進行藥物治療外，新診斷的2型糖尿病患者應首先進行BLIs。BLIs應遵循有效性、建立互信、問題解決導向、綜合性和個性化原則。常用干預策略包括應用成熟的行為改變理論、使用行為改變技術、有效運用傳播策略、提高患者行為技能、實施以人為本的患者自我管理教育和支持?；静襟E包括行為與生活方式及其影響因素評估、確定行為目標、制定干預實施方案、實施干預和評價效果。BLIs效果評價指標包括過程指標、臨床結局、社會心理、行為結局、患者報告和健康結局。效果評價可采用定性和定量相結合的方法進行，常用的評價工具包括糖尿病自我護理行為評價量表（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）。

關鍵詞: 糖尿病, 高血糖, 高脂血癥, 高血壓, 行為與生活方式干預

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: 

R 587.1

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