对社区糖尿病患者采用“量体裁衣”式护理干预的效果评价

The Evaluation of Effect about the Nursing Intervention According to the Actual Circumtanceto the Community Diabetes Patients.

目的 通过对社区糖尿病患者采取“量体裁衣”式的量化饮食和运动干预，探索社区糖尿病护理干预的有效模式，控制血糖，降低医疗费用。方法 选取社区内2型糖尿病患者169例，随机分为强化干预组（84例）和普通干预组（85例）。强化干预组采用家庭访问和一对一的指导和跟踪，结合家庭结构和家庭功能，制定“量体裁衣”式的量化饮食、运动计划。普通干预组为一般健康教育和门诊咨询。观察两组一年后的生理、生化指标和医疗费用使用情况。结果 强化干预组平均空腹血糖为5.91mmol／L，比普通干预组的7．33mmol／L有明显降低（p〈0．05）：糖化血红蛋白强化干预组平均5．88％，普通干预组为7．12％（p〈0．05）；强化干预组医疗费用平均每人每月下降34．36，下降幅度为21．08％，普通干预组下降13．56，下降幅度为4．77％。结论 应用量化饮食和运动的强化干预，在社区糖尿病管理中优于普通干预组，而且医疗费用明显降低。

Objective To explore the mode of community nursing intervention to the diabetes patients through intervention to the diet and sport of diabetes patients. Moreover, to control the blood sugar and to decrease the medical cost. Methods To survey 169 diabetes patients in community who divided into common intervention group（84 cases） and regular intervention group with random （85 cases）. For the regular interverntion group, we gave them family follow-up and education face to face. At the same time, we designed the plan of diet and sport according to the structure and function of families. As for the common intervention group, we gave them the usual healthy education and clinical consultation. After a year, we observed the change of the physical, biochemical index and the medical cost. Results The average FPG in regular intervention group is 5.9hnmol/L and in common intervention group is 7.33 mmol/L（P 〈 0.05）; HbAlc in regular intervention group is 5.88% and in the common intervention group is 7.12%（P 〈 0.05）.the average medical cost of every person in regular intervention is reduced 34.36（21.08%） every month and in the common intervention group is reduced 13.56（4.77%）. Conclusion The regular intervention of controlling the quantity of diet and sport have better effect than the common intervention. At the same time, the regular intervention can reduce the medical cost.