循证沟通技巧在老年2型糖尿病患者健康教育中的应用

Application of the evidence-based communication skills in health education of elderly patients with type 2 diabetes

目的 探讨循证沟通技巧在老年2型糖尿病患者健康教育中的应用效果.方法 将98例老年2型糖尿病患者按入院时间分为两组,对照组（48例）为开展循证护理前住院患者,接受一般健康教育；观察组（50例）患者接受护士循证沟通技巧培训后的健康教育.比较两组患者健康教育前后健康相关知识得分、糖代谢指标的改善情况.结果 接受循证沟通技巧后6个月后,观察组患者健康相关知识得分为（94.14±1.96）,对照组为（71.25±2.07）分,两组比较差异有统计学意义（t=31.24,P＜0.01）；观察组患者空腹血糖为（5.83±1.45） mmol/L,餐后2h血糖为（10.29±4.42） mmol/L,尿糖为（5.06 ±0.89） mmol/L,糖化血红蛋白为（6.27±1.44）％,均优于对照组[分别为（7.63±1.64） mmol/L,（12.95±4.78） mmol/L,（6.92 ±0.88） mmol/L,（7.46±1.07）％],两组比较差异有统计学意义（t值分别为1.972,2.036,1.363,2.451；P均＜0.05）.干预后观察组饮食控制、规律运动、遵医嘱服药、血糖监测、足部护理、预防及处理高/低血糖六个维度的自护行为得分均高于对照组[（21.85±4.07）/（16.60±3.91）分,（17.25±2.32）/（13.05±3.01）分,（13.55±1.39）/（10.10±2.05）分,（16.85±2.34）/（11.50±3.22）分,（20.55±3.66）/（11.70±3.48）分,（16.20±2.58）/（13.35±2.08）分],两组比较,差异有统计学意义（t值分别为5.48,5.86,5.89,4.30,3.79,3.91;P ＜0.05）.结论 在糖尿病教育中应用循证沟通技巧能改善老年2型糖尿病患者糖代谢指标,提高自护能力.

Objective To explore the effect of the evidence-based communication skills on health education of elderly patients with type 2 diabetes.Methods Totals of 98 cases of elderly patients with type 2 diabetes were divided into control group （n =48） which received the general health education,and observation group （n =50） which received the communication skills of health education.Then,the scores of patient＇s health knowledge,and related control condition of metabolic indexes were observed and compared before and after the intervention.Results After the intervention,in observation group,the indexes such as FBG [（5.83 ±1.45）mmol/L],P2hBG [（10.29 ± 4.42） mmol/L],Glu [（5.06 ± 0.89） mmol/L],HbAlc [（6.27 ±1.44） ％] were better than those in the control group [（7.63 ± 1.64） mmol/L,（12.95 ± 4.78） mmol/L,（6.92 ± 0.88） mmol/L,（7.46 ± 1.07） ％],and differences were statistically significant （t =1.972,2.036,1.363,1.451 ;P ＜ 0.05）,as well as the scores of patient＇s health knowledge [（94.14 ± 1.96） vs （71.25 ±2.07）,t=31.24,P＜0.01）].The scores of diet control [（21.85 ±4.07） vs （16.60 ±3.91）],regular exercise [（17.25 ± 2.32） vs （13.05 ± 3.01）],take medicine by doctor [（13.55 ± 1.39） vs （10.10 ±2.05）],blood sugar monitoring [（16.85 ± 2.34） vs （11.50 ± 3.22）],foot nursing [（20.55 ± 3.66） vs （11.70 ± 3.48）],prevention and management of high/low blood sugar [（16.20 ± 2.58） vs （13.35 ± 2.08）]in observation group were higher than those in control group （t =5.48,5.86,5.89,4.30,3.79,3.91 ; P ＜0.05）.Conclusions Evidence-based communication skills can help the elderly patients with type 2 diabetes to establish and maintain healthy behavior habits,and thereby to achieve better control of plasma metabolic indices.