糖尿病患者家族式护理干预模式的建立与实施

Establishment and application of family nursing intervention model to the patients with diabetes

目的:探讨糖尿病(DM)患者家族式护理干预模式的建立与实施方法。方法:将2型DM一级亲属非DM患者180例随机分为强化组、一般指导组和对照组各60例,对照组不给予健康指导;一般指导组给予常规健康教育指导;强化组在一般指导组基础上按DM患者的标准制定饮食和运动处方,定期监测体重、血压、血脂、血糖、空腹血浆胰岛素(F ins)等指标,计算体重指数(BM I)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI),并且对其进行多时间段的比较。结果:强化组、一般指导组与对照组比较,血糖、血压、WHR、HOMA-IR、F ins、TG、TC、LDL-C值显著降低,ISI及高密度脂蛋白显著升高(P<0.05,P<0.01),DM患者院外遵医自觉性明显提高。结论:DM患者家族式护理干预模式的建立与实施,可提高DM高危人群治病、防病的自觉性,降低DM的发病率,强化DM患者的遵医行为。

Objective ： To explore the establishment and application of family nursing intervention model to the patients with diabetes. Methods： One hundred and eighty patients with diabetes Ⅱ were randomly divided into intensive nursing care group （ n = 60） , instruction group （ n = 60） and control group （ n = 60 ）. The patients in control group were not given any instruction on health, the patients in instruction group were given common health education and the patients in intensive nursing care group were additionally given special instruction on diet and exercise according to the standard for diabetic based on basic intervention. The indexes of body weight, blood pressure, blood lipid, blood glucose and fasting insulin were detected periodically; BMI, WHR, HOMA - IR and ISI were calculated, analyzed and compared in different period of time. Results： Compared with that in control group, the plasma glucose, blood pressure, WHR, HOMA - IR, fasting insu- lin, TG, TC, LDL - C decreased significantly ; ISI and HDL - C increased obviously （ P 〈 0. 05, P 〈 0. 01 ）. The compliance of discharged patients with doctor＇ s prescription was improved markedly. Conclusions： The establishment and application of family nursing intervention model can intensify the awareness of individual of high risk group in prevention and treatment of diabetes, reduce the incidence of diabetes and enhance the patients＇ compliance.