健康行为整合理论指导下的护理干预在妊娠期糖尿病患者中的应用观察

Observing the application of nursing intervention guided by health behavior integration theory in patients with gestational diabetes mellitus

目的探讨健康行为整合理论指导下护理干预在妊娠期糖尿病(GDM)患者中的应用效果。方法选取河南省某医院收治的80例GDM患者为研究对象,采用随机数字表法,将患者分成观察组和对照组,每组40例。对照组患者予以常规护理,观察组患者在对照组基础上进行健康行为整合理论指导下的护理干预。比较干预前及干预12周时2组患者糖尿病自我管理行为量表(DSCS)、2型糖尿病患者饮食行为依从性测评量表评分及空腹血糖(FPG)、餐后2h血糖(2h PBG)水平;干预12周时,比较2组患者不良妊娠结局发生情况。结果干预12周时,观察组患者DSCS中饮食控制、规律锻炼、遵医嘱服药、血糖监测、足部护理、血糖异常预防及处理维度评分分别为(24.65±2.24)分、(16.54±1.71)分、(13.55±0.81)分、(14.29±0.97)分、(21.58±1.73)分及(14.85±1.14)分,高于对照组的(19.28±1.95)分、(13.75±1.63)分、(12.39±0.76)分、(13.14±0.83)分、(18.29±1.67)分及(13.18±1.07)分,差异均有统计学意义(P<0.05)。干预12周时,观察组患者2型糖尿病患者饮食行为依从性测评量表评分为(98.54±9.69)分,高于对照组的(79.28±8.57)分,差异有统计学意义(P<0.05)。干预12周时,观察组患者FPG及2h PBG分别为(6.29±1.17)mmol/L及(9.17±1.53)mmol/L,低于对照组的(7.56±1.28)mmol/L及(10.89±1.67)mmol/L,差异有统计学意义(P<0.05)。观察组患者剖宫产、早产、新生儿窒息发生率均低于对照组,差异均有统计学意义(P<0.05)。结论健康行为整合理论指导下的护理干预有助于GDM患者自我管理能力及饮食行为依从性的提高,也有利于控制患者血糖水平,改善妊娠结局,值得临床推广应用。

Objective To explore the effect of nursing intervention guided by health behavior integration theory in patients with gestational diabetes mellitus(GDM).Methods Eighty patients with GDM admitted to a hospital in Henan Province were selected for the study,and the patients were divided into an observation group and a control group,40 cases in each group,using a random number table.Patients in the control group were given conven-tional care,and patients in the observation group were given nursing intervention guided by health behavior inte-gration theory on the basis of the control group.The Diabetes Self-Care Scale(DSCS),Dietary Behavior Compli-ance Scale for Patients with Type 2 Diabetes,fasting plasma glucose(FPG)and 2-h postprandial blood glucose(2 h PBG)levels were compared between the two groups before and at 12 weeks of intervention.Results At 12 weeks of intervention,the scores of diet control,regular exercise,medication compliance,blood glucose monito-ring,foot care,and abnormal blood glucose prevention and management dimensions in DSCS in the observation group were(24.65±2.24),(16.54±1.71),(13.55±0.81),(14.29±0.97),(21.58±1.73)and(14.85±1.14),which were higher than those of the control group at(19.28±1.95),(13.75±1.63),(12.39±0.76),(13.14±0.83),(18.29±1.67)and(13.18±1.07),and the differences were statistically significant(P<0.05).At 12 weeks of intervention,the scores for the Dietary Behavior Compliance Scale for Patients with Type 2 Diabetes in the observation group was(98.54±9.69),which were higher than that in the control group at(79.28±8.57),and the difference was statistically significant(P<0.05).At 12 weeks of intervention,the FPG and 2 h PBG of patients in the observation group were(6.29±1.17)mmol/L and(9.17±1.53)mmol/L,respectively,which were lower than those at(7.56±1.28)mmol/L and(10.89±1.67)mmol/L in the control group,with statistically significant differences(P<0.05).The incidence of cesarean section,preterm delivery and neonatal asphyxia were lower in the observation group than in the control group,and all differences were sta-tistically significant(P<0.05).Conclusion The nursing intervention guided by health behavior integration theory can help improve the self-care ability and compliance of dietary behavior of GDM patients,which in turn can help control the patients’blood glucose level and improve pregnancy outcome,and is worthy of clinical application.