糖尿病教育与管理措施对患者延续性护理失访的影响分析

Analysis on the Influence of Diabetes Education and Management Measures on Lost Follow-up during Continuous Nursing

目的探索糖尿病患者延续性护理失访的影响因素,寻找适宜的患者随访计划及方法,以保证院外随访率及随访质量,为提高患者院外延续性护理质量提供依据。方法由2名专职糖尿病教育护士对2012年9月-2014年4月住院治疗好转出院的600例糖尿病患者进行延续性护理随访并记录随访情况,按照入组先后顺序将患者分为3组,采用不同的护理干预措施进行随访干预。分析对比各组患者失访情况及失访原因,分析护理干预措施对患者失访的影响。结果 3组患者失访率分别为29.4%、20.3%和12.2%,大课堂参与率分别为29.4%、50.5%和57.5%;干预3组采用团队式综合管理模式的患者失访率较低。3组患者失访人群集中在40岁以下以及75岁以上,病程10年以上,较多并发症的患者,对于失访患者给予电话联系并询问发现,失访原因多见于自我感觉良好、认为随访缺乏意义。结论多元化随访方式能互补长短,采取个体化、针对性和系统的团队式综合管理的糖尿病护理干预措施可以有效降低患者失访率。

Objective To explore the influencing factors for lost follow-up of diabetic patients,looking for suitable follow-up methods for patients in the region of Central and Western China,in order to help ensure the quality of follow-up,improve the rate of follow-up and provide a basis for improving the quality of patients＇ continuous nursing outside of the hospital.Methods Continuous nursing was carried out for 600 patients discharged from our department by two full-time diabetes education nurses from September 2012 to April 2014.The data of outside hospital patients who were lost in the follow-up were retrospectively analyzed.According to the sequential order of the patients,they were divided into three groups.The difference among the three groups of patients was analyzed and the effect of nursing intervention on patients＇ follow-up loss was also analyzed.Results The rate of lost follow-up for the three groups were 29.4%,20.3%,and 12.2%.Big classroom participation rate was 29.4%,50.5%,and 57.5%.The lost follow-up rate of group three using team comprehensive management pattern was lower than that in group 1 with traditional supervision intervention.The age of the patients who were lost in the follow-up concentrated under 40 and above 75 years old.The patients with a disease history longer than 10 years with more complications were more likely to be lost in the follow-up.The main reason for lost follow-up was self-conceit and lack of awareness of the follow-up.Conclusion Diversified ways of follow-up can complement each other which can reduce the rate of lost follow-up.