背景：中青年患者已经成为2型糖尿病患病率增长最快的人群。糖尿病痛苦是糖尿病患者常见的情绪困扰，中青年2型糖尿病患者的糖尿病痛苦水平更高。糖尿病痛苦会对患者自我管理行为造成影响，从而导致血糖控制不佳，降低患者生活质量。目前针对于中青年2型糖尿病患者糖尿病痛苦的干预相对较少，本研究基于认知行为理论构建糖尿病痛苦干预方案，采用类实验研究方法评价干预方案对中青年2型糖尿病患者糖尿病痛苦水平、疾病感知、糖尿病自我管理行为和糖化血红蛋白值的改善效果。

目的：比较经糖尿病痛苦干预方案干预前后，干预组和对照组糖尿病痛苦、疾病感知和自我管理行为和糖化血红蛋白的差异；以及干预组自身糖尿病痛苦、疾病感知和自我管理行为和糖化血红蛋白的差异。

方法：本研究为类实验研究。采用便利抽样法，于2024年6月至2024年12月，在中日友好医院内分泌病房抽取82名糖尿病痛苦得分≥2分的2型中青年糖尿病患者，为避免沾染，将2024年6月至8月收取的患者作为对照组，将2024年9月至2024年12月收取的患者作为干预组。干预组采用糖尿病痛苦干预方案进行干预，对照组接受病房糖尿病常规护理。分别与干预前、干预后和干预后3个月，采用糖尿病痛苦量表、简易疾病感知问卷和糖尿病自我管理行为量表，评估患者糖尿病痛苦水平、疾病感知水平以及自我管理行为，并收集患者干预后3个月的糖化血红蛋白值。

结果：本研究共有72名研究对象完成了全部的资料收集（对照组和干预组分别为36例）。研究结果为：（1）两组研究对象各测量指标组间比较结果：干预组研究对象的糖尿病痛苦水平、疾病感知水平在干预后和干预后3个月均显著低于对照组（P < 0.05），干预组研究对象的糖化血红蛋白值在干预后3个月显著低于对照组（P < 0.05），干预组研究对象的自我管理水平在干预后和干预后3个月均高于对照组（P < 0.05）。（2）干预组研究对象各测量指标组内比较结果：干预组研究对象干预后和干预后3个月的糖尿病痛苦、疾病感知显著低于干预前（P < 0.05），干预组研究对象干预后3个月的糖化血红蛋白值显著低于干预前（P < 0.05），干预组研究对象在干预后和干预后3个月的自我管理行为水平显著高于干预前（P < 0.05）。干预措施和时间因素对糖尿病痛苦、疾病感知和自我管理行为得分均存在交互作用（P < 0.05）。（3）干预方案满意度：97%的干预组对象对干预内容和干预方式表达了满意的态度，全部研究对象对干预时长及干预频率表示满意。

结论：糖尿病痛苦干预方案能够降低中青年2型糖尿病患者的糖尿病痛苦，改善患者的疾病感知，促进自我管理行为，降低糖化蛋白血红值，对中青年2型糖尿病患者的疾病管理有积极作用，值得在临床开展。糖尿病痛苦干预方案的干预内容、干预方式、干预时长和干预频率得到了大部分研究对象的认可。

Background:Young and middle-aged adults have become the fastest-growing population affected by type 2 diabetes mellitus (T2DM). Diabetes distress is a common emotional challenge among patients with diabetes. Moderate to severe diabetes distress was more common in young and middle-aged individuals with T2DM. Diabetes distress negatively impacts patients’ self-management behaviors, resulting in poor glycemic control and an increased risk of diabetes-related complications. However, there is a scarcity of targeted interventions specifically designed to address diabetes distress in young and middle-aged patients with T2DM. Therefore, it is necessary to develop an intervention program to explore the effect of intervention program on reducing diabetes distress among young and middle-aged patients with T2DM.

Objective:To compare the differences of diabetes distress, illness perception, self-management behaviors, and glycated hemoglobin (HbA1c) between the intervention and control groups before and after the implementation of the diabetes distress intervention program. To compare the pre- and post-intervention differences in these outcomes within the intervention group.

Methods: This quasi-experimental study employed convenience sampling. From June 2024 to December 2024, a total of 82 young and middle-aged patients with T2DM and diabetes distress score ≥2 were recruited from the Department of Endocrinology at China-Japan Friendship Hospital. To avoid contamination between groups, patients recruited from June to August 2024 were assigned to the control group, and those recruited from September 2024 to February 2025 were assigned to the intervention group. The intervention group received a structured diabetes distress intervention program, while the control group received usual nursing care. Assessments were conducted at baseline, post-intervention, and three months post-intervention. Evaluation tools included the Diabetes Distress Scale (DDS), the Brief Illness Perception Questionnaire (BIPQ), and Summary of Diabetes Self-Care Activities (SDSCA). HbA1c was collected at three months after the intervention.

Results: A total of 72 participants were enrolled, with 36 in the intervention group and 36 in the control group. The main findings were as follows: (1) the intervention group showed significantly lower levels of diabetes distress and illness perception immediately after the intervention and at the 3-month follow-up (P < 0.05). HbA1c levels were also significantly lower in the intervention group at 3 months post-intervention (P < 0.05), and self-management behavior scores were significantly higher at both post-intervention time points (P < 0.05). (2) Within the intervention group, diabetes distress and illness perception scores significantly decreased, and self-management behaviors significantly improved after the intervention and at the 3-month follow-up compared to baseline (P < 0.05). HbA1c levels were significantly lower at the 3-month follow-up than at baseline (P < 0.05). There were interaction effects between the intervention and time factors on diabetes distress, illness perception, and self-management behaviors in both groups (P < 0.05).(3) Regarding intervention satisfaction, approximately 97% of participants in the intervention group reported satisfaction with the content and format of the diabetes distress intervention, and all participants expressed positive feedback regarding the duration and frequency of the intervention.

Conclusion:The diabetes distress intervention program effectively reduced diabetes distress, improved illness perception, enhanced self-management behaviors, and lowered HbA1c levels in young and middle-aged patients with T2DM. The intervention demonstrated a positive impact on diabetes management and is suitable for clinical application. The majority of participants expressed recognition and approval of the intervention’s format, content, and timing.