MUST教育模式对2型糖尿病患者依从性的影响

Affect of the MUST education mode on compliance of patients with type 2 diabetes mellitus

目的建立患者家属参与的糖尿病教育管理新模式,观察其对2型糖尿病患者依从性的影响。方法建立以医生为总管理者(Manager,M)、患者家属为督促者(Urger,U)、患者本人为自我管理者(Self-manager,S)以及护士为施教者(Teacher,T)的MUST糖尿病管理模式。180名2型糖尿病患者被分为干预组和对照组,其中干预组90例患者进入MUST管理模式进行1年的观察,采用改良的Deborah糖尿病自我管理评价表进行依从性判定,分析新模式对糖尿病患者依从性的影响。结果至观察结束,干预组患者完全从医行为提高近1倍(P<0.01),而且从进入MUST模式的第3个月依从性改善就有明显提高(P<0.01),半年后依从性改善维持高水平,但不再进一步提高(P>0.05)。结论 MUST模式强调了家属以监督者的身份参与到糖尿病教育管理,提高了患者的依从性,保证了糖尿病教育的效果。

Objective To set up a new education mode MUST,in which patient′s family members must be involved,and to observe its effect on compliance of patients with type 2 diabetes mellitus（T2DM）,and to require the compliance of patients with type 2 diabetes mellitus（T2DM）.Methods The MUST diabetic education mode was set up,consisting of doctors（acting as managers,M）,patients′ family members（acting as urgers,U）,patients themselves（acting as self-managers,S） and nurses（acting as teachers,T）.180 T2DM patients were randomly divided into the interventional group and the control group so as to analyze the change of compliance in 90 patients（the interventional group） educated by the MUST mode for 1 year and evaluate the effect with the modified Deborah′s Diabetes Knowledge and Self-management Skills Self-evaluate Table.Results The compliance in the interventional group nearly doubled after 1 year（P0.01）.The peak point of improved compliance was observed at the 6th month from the beginning and this high level lasted till the end of observation.Conclusion The MUST mode emphasizes that family members of patients with T2DM should be involved in the DM educational system,which could improve patients′ compliance and the effect of diabetic education.