老年糖尿病合并肌少症患者运动自我效能相关因素调查及干预策略^*

Investigation on factors associated with exercise self-efficacy and proposed intervention strategies in patients with diabetes mellitus and sarcopenia

摘要

目的 调查影响老年糖尿病(DM)合并肌少症患者运动自我效能的相关因素,并提出针对性干预策略,为改善患者运动依从性、延缓肌少症进展提供参考。方法 回顾性选取江苏省人民医院2022年10月—2024年10月收治的老年DM合并肌少症患者共120例,应用运动自我效能量表(ESES)评估分析老年DM患者现状,并通过单因素和多元线性回归分析筛选相关影响因素。结果 120例患者ESES总分为(24.93±4.26)分,其中低水平32例(26.67%),中水平65例(54.17%)、高水平23例(19.17%),整体处于中等偏低水平。单因素分析显示,文化水平、四肢骨骼肌质量指数(ASMI)、握力、步速、平均血糖波动幅度、合并糖尿病足/心血管并发症、肌少症严重程度、衰弱状态、营养状况、肌肉活动功能、自理能力、合并焦虑/抑郁、认知功能、社会支持水平与老年DM合并肌少症患者运动自我效能相关,差异均有统计学意义(P<0.05);多元线性回归分析显示,ASMI、衰弱状态、肌肉活动功能、合并焦虑/抑郁、社会支持水平是老年DM合并肌少症患者运动自我效能的影响因素(P<0.05)。结论 老年DM合并肌少症患者运动自我效能处于中等偏低水平,且受ASMI、衰弱状态、肌肉活动功能、合并焦虑/抑郁、社会支持水平影响,医护人员应据此制定个体化干预策略,提高运动自我效能。

Abstract

Objective To investigate factors associated with exercise self-efficacy and propose targeted intervention strategies in elderly patients with diabetes mellitus (DM) and sarcopenia so as to provide reference for improving exercise compliance and delaying the progression of sarcopenia. Methods A total of 120 elderly patients with DM and sarcopenia admitted to Jiangsu Provincial Hospital were retrospectively enrolled between October 2022 and October 2024. The current situation of elderly patients with DM was evaluated and analyzed by exercise self-efficacy scale (ESES), and the relevant influencing factors were screened by univariate and multiple linear regression analysis. Results The total score of ESES in the 120 patients was (24.93±4.26) points, including 32 cases (26.67%) at a low level, 65 cases (54.17%) at a medium level and 23 cases (19.17%) at a high level. Overall, exercise self-efficacy was at a moderate to low level. Univariate analysis showed that education level, appendicular skeletal muscle mass index (ASMI), grip strength, walking speed, mean amplitude of glycemic excursions, diabetic foot/cardiovascular complications, severity of sarcopenia, frailty status, nutritional status, muscle activity function, self-care ability, anxiety/depression, cognitive function and social support level were correlated with exercise self-efficacy in elderly patients with DM and sarcopenia (all P<0.05). Multiple linear regression analysis showed that ASMI, frailty status, muscle activity function, anxiety/depression and social support level were influencing factors of exercise self-efficacy (all P<0.05). Conclusion The exercise self-efficacy is at a moderate to low level in elderly patients with DM and sarcopenia, and its influencing factors include ASMI, frailty status, muscle activity function, anxiety/depression and social support level. Medical staffs should formulate individualized intervention strategies based on these factors to improve exercise self-efficacy.

关键词

糖尿病 / 肌少症 / 运动自我效能

Key words

Diabetes mellitus / Sarcopenia / Exercise self-efficacy

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基金资助

^*中国老年学和老年医学学会2025年第1批立项项目(CAGG2025104)