References

diaendo

Сахарный диабет

Diabetes mellitus

2072-03512072-0378

Endocrinology research centre

10.14341/DM2014266-75

diaendo-6437

Research Article

Обучение и психосоциальные аспекты

Education and psychosociologycal aspects

Страх гипогликемии у пациентов с сахарным диабетом 1 типа

Fear of hypoglycaemia in patients with type 1 diabetes

Патракеева

Евгения Михайловна

Patrakeeva

Evgenia Mikhailovna

evgenya.patrakeeva@gmail.com

Дуничева

Мария Николаевна

Dunicheva

Mariia Nikolayevna

m.dunicheva@yandex.ru

Залевская

Алсу Гафуровна

Zalevskaya

Alsu Gafurovna

alsu-zalevskaya@mail.ru

ГБОУ ВПО Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова, Санкт-ПетербургРоссияFirst Pavlov State Medical University of St. PetersburgRussian Federation

2014

09052014

1726675

2014

Патракеева Е.М., Дуничева М.Н., Залевская А.Г.

Patrakeeva E.M., Dunicheva M.N., Zalevskaya A.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.dia-endojournals.ru/jour/article/view/6437

Независимо от причин и факторов риска развития гипогликемии, ее проявления всегда неблагоприятны и закономерно вызывают отрицательные эмоции и страх, что приводит к негативным последствиям в отношении контроля сахарного диабета (СД). Боязнь гипогликемии создает внутренний конфликт, снижая мотивацию к использованию интенсивных режимов инсулинотерапии. Кроме выраженности гипогликемии и ее негативных последствий, одним из главных параметров оценки физической, психологической и социальной составляющих жизни пациента в целом является качество жизни, а страх гипогликемии ? это один из самых главных факторов, напрямую или опосредованно влияющий на все аспекты жизни пациента. Страх гипогликемии также является источником тревоги для близких пациента, нанося ущерб семейным и социальным отношениям. Негативные последствия гипогликемий влияют не только на супружеские отношения, но и на взаимоотношения родителей и детей с СД 1 типа (СД1). Качественные и количественные исследования демонстрируют данные о том, что нетяжелые гипогликемии, возникающие в ночные часы, доставляют больше тревожных переживаний и страха пациентам, чем гипогликемии, возникающие днем. Для количественной оценки страха гипогликемии у взрослых пациентов с СД1 разработана шкала страха гипогликемии (hypoglycemia fear scale, HFS), которая до сих пор остается наиболее часто используемым и актуальным инструментом. Для оценки страха гипогликемии у детей и родителей шкала HFS была адаптирована для использования в педиатрической популяции ? HFS для родителей (PHFS) и HFS для детей (CHFS). С клинической точки зрения, подобные шкалы для измерения уровня страха гипогликемии могут быть полезны для мониторинга взрослых пациентов и семей, которым, возможно, требуется дополнительная поддержка, образование или помощь в решении вопросов, касающихся гипогликемии. Методы воздействия на страх гипогликемии варьируют от поведенческих до фармацевтических и хирургических и включают достаточно большой спектр мероприятий. Тем не менее, проблема остается достаточно актуальной, и на сегодняшний день и подход к ее решению, как со стороны доктора, так и со стороны пациента, должен быть комплексным. Правильная оценка уровня тревожности пациента, влияния страха гипогликемии на социальную жизнь, осознание возможных психологических последствий этого вопроса могут позитивно воздействовать как на поведение и настроение пациента, так и на возможность добиться лучшего гликемического контроля.

Independently of causes and risk factors of hypoglycaemia, its manifestations are always unfavourable and evoke fear and other negative emotions that lead to negative consequences connected with quality of diabetes control. The fear of hypoglycaemia creates an internal conflict by diminishing patients? motivation to adhere to intensive treatment regimes. In addition to the severity of hypoglycaemia and its negative consequences, quality of life is one of the main criteria for evaluating the physical, psychological and social components of patient's life as a whole. Fear of hypoglycaemia is one of the most important factors; it either directly or indirectly affects quality of life and influences all aspects of the patient's life. Fear of hypoglycaemia is also a source of anxiety for the patient's relatives, causing damage to their familial and social relations. The negative consequences of hypoglycaemia can affect the relationship between spouses, as well as between parents and children with type 1 diabetes. The qualitative and quantitative data demonstrate that non-severe nocturnal hypoglycaemia causes more anxiety and fear in patients than daytime hypoglycaemia does. To quantify the fear of hypoglycaemia in adults with type 1 diabetes, the hypoglycaemia fear scale (HFS) was developed and still is the most commonly used instrument. To assess the fear of hypoglycaemia in children and their parents, the HFS scale was adapted to be used in the paediatric population: HFS for parents (PHFS) and HFS for children (CHFS). From a clinical point of view, these scales for measuring the level of fear of hypoglycaemia may be useful for monitoring adult patients and families who may need additional support, training or assistance in dealing with issues related to hypoglycaemia. The methods for regulating the fear of hypoglycaemia range from behavioural to pharmaceutical and surgical ones, and include a broad range of activities. Nevertheless, the problem remains quite relevant today and an integral approach for solving this problem, both by the physician and by the patient, should be used. Proper assessment of the patient's level of anxiety, impact of the fear of hypoglycaemia on his or her social life, awareness of the possible psychological consequences of this problem may positively affect both the behaviour and mood of the patient, and the opportunity to achieve better glycaemic control.

гипогликемияпоследствия гипогликемиистрах гипогликемиишкалы оценки страха гипогликемиитерапевтическое обучение пациентов

hypoglycaemiaconsequences of hypoglycaemiafear of hypoglycaemiahypoglycaemia fear scalestherapeutic patient education

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The authors declare that there are no conflicts of interest present.