护理干预对糖尿病病人健康行为的影响

Impact of Nursing Intervention on Diabetic's Health Behavior

目的:减少和延缓糖尿病并发症的发生,提高生存质量;降低个体医疗费用;降低社会负担。方法:对病人进行糖尿病有关监测项目的检查,了解患病情况;收集被调查者糖尿病相关知识掌握信息;按照护理程序的方法,遵循WHO倡导的"饮食、运动、能量平衡促健康"的理念,建立对糖尿病病人健康行为的护理干预模式;以Orem"自我照顾"的理论为指导,将其应用于对糖尿病病人的健康行为指导之中,实施护理干预措施,提高病人的自护能力。结果:对94例糖尿病病人实施12个月的健康行为管理结果是:①糖化血红蛋白百分比均数由8.64下降为7.76,空腹血糖均数值(mmol/L)由8.94下降为6.68,提高了糖尿病的治疗有效率;②病人的自护能力由干预前的33.16%,提高到83.33%,自护缺陷明显改善;③病人遵医行为平均率由干预前的51.83%,提高到82.14%,使血糖平均降低了2.26mmol/L。结论:病人对饮食、运动指导、合理用药等知识有教育需求,表明医院内的健康教育对糖尿病病人是不够的,社区护理干预是护理工作的延续,对病人的支持更有针对性。接受个性化护理干预的病人对疾病防治知识认识较前提高,纠正了不良生活习惯,自我监测能力和自我护理能力提高,生理指标、并发症指标、生活质量较前改善,住院率下降,表明护理干预对病人具有支持作用,可以提醒和帮助病人遵从医嘱,达到很好控制疾病,重塑健康生活方式的目的。

Objective： To reduce and postpone diabetes complication, improve survival quality, depress individual hospitalization costs and society burden. Methods： 188 patients with diabetes were selected and divided into experimental group and control group. Patients were taken nursing intervention measures to make an impact on their health behavior according to the idea of diet, exercise and energy balance promoting health proposed by WHO. Results： Through 12 months of health behavior administration of 94 diabetes patients, the results were as follows： ①The mean value of glycosylated hemoglobin decreased from 8.64% to 7.76%, and that of the fasting blood-glucose decreased from 8.94mmol/L to 6.68mmol/L, thus the therapeutic effective rate of diabetic was increased; ②Patient＇s self-nursing ability increased from 33.16% to 83.33%; ③The mean rate of patient＇s following the advice of the doctor increased from 51.83% to 82.14%, which made blood sugar fall 2.26mmol/L on average. Conelusions： Patients have demands for education on diet, exercise instruction, rational administration. It has been showed that the health education for diabetes patients in the hospital is not enough and that community nurse intervention should be continued. Patients having individual nursing intervention have much more knowledge on diabetes prevention and treatment than before. Nursing intervention can be helpful in reminding patients to follow the advice of the doctor, controlling the disease and remodeling the healthy life style.