以PBL、APIE为中心的授权教育在社区2型糖尿病运动疗法中的应用效果研究

Application Effect of Empowerment Centered on PBL and APIE to Exercise Therapy for Type 2 Diabetes in Community

目的探讨以PBL、APIE为中心的授权教育对社区2型糖尿病患者实施运动疗法的影响。方法采取干预前后自身对照设计及随机抽样的方法,将社区82例2型糖尿病患者随机分为干预组41例和对照组41例,均给予饮食、药物治疗,干预组对患者存在的有关运动处方的疑问、误区、知识需求及时进行评估-计划-实施-评价。结果干预6个月后,干预组患者的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)均低于干预前和对照组同期水平,差异有统计学意义(P<0.05);三酰甘油(TG)、总胆固醇(TC)较干预前下降,差异有统计学意义(P<0.05);体质指数(BMI)较干预前和对照组同期水平下降,差异亦有统计学意义(P<0.05)。结论长期规律运动能有效改善2型糖尿病患者的血糖、血脂、BMI、提高生存质量,循序渐进的以PBL、APIE为中心的授权教育是运动疗法发挥作用的重要保证。

Objective To investigate the efficacy of empowerment centered on problem-based learning（PBL） and assessment/planning/ implementation/evaluation（APIE） in performance of exercise therapy for patients with type 2 diabetes mellitus in community.Methods The self-control design before and after intervention,and randomly sampling were used to divide 82 patients type 2 diabetes mellitus in community into trial group and control group,with 41 in each.The patients were all given dietary and medicinal therapies,and the patients in the trial group were given additional timely APIE for their questions,misunderstanding,and demand for knowledge in individual exercise regimen.Results After 6 months intervention in the trial group,the levels of fasting blood glucose,2-h postprandial blood glucose,and glycosylated hemoglobin were significantly lower than those in the trial group before the intervention and those in the control group concurrently（P0.05）;and the levels of triglyceride and total cholesterol were lower than those in the trial group before the intervention（P0.05）;and the body mass index was also significantly decreased as compared with those in the trial group before the intervention and those in the control group concurrently（P0.05）.Conclusion The long-term exercise can effectively improve the type 2 diabetic blood glucose,blood fats,and body mass index,as well as raise the quality of life.And PBL and APIE centered empowerment education is the key of the exercise therapy.