广西医学

目的探讨青少年1型糖尿病（T1DM）患儿的授权能力及其影响因素。方法采用一般资料调查表、糖尿病授权量表（DES⁃SF）中文简化版、慢性病儿童应对方式（CODI）量表和父母教养方式（EMBU）量表对131例青少年T1DM患儿进行调查。比较不同特征患儿的授权能力。分析患儿授权能力与应对方式、父母教养方式的相关性，以及授权能力的影响因素。结果患儿的DES⁃SF总分为（4.09±0.83）分，授权能力水平低、中等及高的患儿比例分别为13.74%、72.52%和13.74%。不同病程、是否独立注射胰岛素、是否独立测血糖和不同父母婚姻状态的患儿DES⁃SF总分差异有统计学意义（P<0.05）。DES⁃SF总分与自我安慰、接受及远离应对方式均分和自我评价均分，以及父母情感温暖、理解因子均分呈正相关（P<0.05），与父亲惩罚、严厉及父母拒绝否认因子均分呈负相关（P<0.05）。多元线性回归分析结果显示，病程为6~12个月可降低患儿授权能力，不独立注射胰岛素、接受应对方式均分增加、自我评价均分增加可提高患儿授权能力（P<0.05）。结论青少年T1DM患儿授权能力较好，接受应对方式和正向的自我评价可以提高患儿授权能力，病程为6~12个月可降低患儿授权能力，但尚不能认为独立注射胰岛素可以提高患儿的授权能力。

Objective To investigate the empowerment ability in children with juvenile type 1 diabetes mellitus (T1DM) and its influencing factors. Methods The general data inventory, Diabetes Empowerment Scale⁃Short Form (DES⁃SF) in simplified Chinese version, Coping with a Disease (CODI) scale, and Egna Minnen av Barndoms Uppfostran (EMBU) scale were employed to perform investigation on 131 children with juvenile T1DM. Empowerment ability was compared between children with different characteristics. The correlation of children's empowerment ability with coping style and parents' parenting style, as well as the influencing factors for empowerment ability were analyzed. Results Children's DES⁃SF total score was 4.09±0.83, and the proportions of low, medium, and high⁃level empowerment ability of children were 13.74%, 72.52%, and 13.74%, respectively. There was a statistically significant difference in DES⁃SF total score between children with different disease courses, whether to inject insulin independently or not, whether to measure blood glucose independently or not, and different martial statuses of parents (P<0.05). DES⁃SF total score positively correlated with average scores of self⁃consolation, acceptance, and distance from coping style, and self⁃evaluation, as well as average scores of parents' emotional warmth and understanding factors (P<0.05), whereas negatively correlated with average scores of paternal punishment and stringency, and parental rejecting and denial factors (P<0.05). The results of multiple linear regression analysis indicated that disease course of 6⁃12 months could decrease children's empowerment ability, and no independent insulin injection, increased average score of acceptance coping style, and increased average score of self⁃evaluation could elevate children's empowerment ability (P<0.05). Conclusion Empowerment ability of children with juvenile T1DM is favorable, acceptance coping style and positive self⁃evaluation can improve children's empowerment ability, while disease courses of 6-12 months can decrease empowerment ability of children, but independent insulin injection can not be regarded as empowerment ability improvement of children yet.

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