社区护理干预对2型糖尿病患者自我管理行为的影响

Effect of Community Nursing on the Self-management Behaviors of the Patients with Type 2 Diabetes Mellitus

目的:探讨社区护理干预对2型糖尿病(T2DM)患者自我管理行为的影响。方法:选取2013年3月-2014年3月在笔者所在社区中心建立糖尿病健康档案的T2DM患者93例,将其随机分为干预组(n=47)和对照组(n=46)。两组均接受社区糖尿病相关知识健康教育,干预组在此基础上给予社区护理干预。采用糖尿病自护行为量表(SDSCA)对两组患者自我管理行为进行评定,生命质量评价量表SF-36对生命质量进行评估。比较两组干预前后空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)等糖尿病生化指标、血压、体质量指数(BMI)及SDSCA评分,并观察生命质量的改善情况。结果:干预组干预后药物依从性、饮食控制、血糖监测、运动锻炼、足部护理及自我管理总得分均显著高于对照组,差异均有统计学意义(P<0.01)。干预后,两组FBG、2 h PG、Hb A1c、BMI、收缩压(SBP)及舒张压(DBP)均较干预前明显降低(P<0.05或P<0.01),且干预组降低幅度显著大于对照组(P<0.05或P<0.01)。干预后,两组SF-36量表各维度得分均较干预前明显升高(P<0.01),且干预组升高幅度显著大于对照组(P<0.01)。结论:社区护理干预能有效控制T2DM患者的血糖水平,改善自我管理行为,提高患者生存质量。

Objective： To explore the effect of community nursing on the self-management behaviors of the patients with type 2 diabetes mellitus （T2DM）.Method： 93 patients with T2DM at the community center established diabetes health records from March 2013 to March 2014 were selected, they were randomly divided into the intervention group（n=47） and the control group（n=46）.Both groups were given the health education related to community diabetes.Based on this, the intervention group was added community nursing.Self-management behaviors and quality of llfe（QOL） of patients of the two groups were evaluated respectively using SDSCA and SF-36 scale.Diabetes-related biochemical indexes including fasting blood glucose（FBG）, 2 h postprandial glucose（2 h PC,）, glycosylated hemoglobin（HbAlc）, blood pressures, body mass index（BMI） and SDSCA scores of the two groups before and after intervention were compared, and the improved condition of QOL was observed.Result： The drug compliance, dietary control, glucose monitoring, exercises training, foot nu^ing and total score of self-management behaviors in the intervention group after intervention were all higher than those of the control group, the differences were statistically significant（P〈0.01）. After intervention, FBG, 2 h PG, HbAlc, BMI, systolic blood pressure（SBP） and diastolic blood pressure（DBP） of the two groups went down dramatically compared with intervention before（P〈0.05 or P〈0.01）, and the decreased range of intervention group was larger（P〈0.05 or P〈0.01）.Additionally, each dimensionality score of SF-36 scale went up conspicuously compared with intervention before, and the increased range of the intervention group was more significant（P〈0.O1）.Conclusion： Community nursing can effectively control the blood glucose level of patients with T2DM, ameliorate self-management behaviors and improve QOL.