分层次阶梯式健康教育对门诊初始使用基础胰岛素患者自我管理行为的影响

Effects of hierarchical stair health education on self-management behavior of outpatients with initial use of basal insulin

目的探讨分层次阶梯式健康教育对门诊初始使用基础胰岛素患者自我管理行为的影响。方法选择内分泌门诊起始使用基础胰岛素患者，按就诊时间分为干预组和对照组各108例。对照组于第1、4、12周进行3次电话随访和传统教育；干预组于第1、4、12周采用不同形式的分阶段教育，提供心理和情感支持。教育前及教育12周后对两组患者进行空腹血糖、糖化血红蛋白（HbA1c）、自我管理能力方面的评价，24周后再次应用糖尿病自护行为量表（SDSCA）进行评估。结果12周后干预组自我管理能力及空腹血糖、HbA1c均优于对照组，差异有统计学意义（P〈0．05）。24周后干预组患者SDSCA量表遵医用药维度得分（6．43±0．70）分，高于对照组（5．48±1．39）分，差异有统计学意义（P〈0．05）。结论分层次阶梯式健康教育管理模式可以提高初始基础胰岛素注射患者的自我管理水平。

Objective To explore the effects of hierarchical stair health education on self-management behavior of outpatients with initial use of basal insulin. Methods The outpatients with initial use of basal insulin in our hospital were selected and were divided into intervention group （108 cases） and control group （108 cases） according to clinical time. Patients in control group received 3 times telephone follow-up and traditional education at 1,4 week and 12 week, while patients in intervention group received different forms of hierarchical stair health education providing psychological and emotional support at the same time. The fasting blood glucose, glycosylated hemoglobin and self-management ability of two groups were evaluated before and 12 weeks after education. The behavior scale （summary of diabetes self care activities,SDSCA） was also evaluated after 24 weeks. Results The fasting blood glucose, glycosylated hemoglobin and self-management ability in intervention group were significantly better th.an those in control group after 12 weeks. The differences between two groups were statistically significant （ P 〈 0.05 ）. After 24 weeks, medical compliance score of SDSCA in intervention group was higher than that in control group [ （ 6.43 ± 0. 70 ） vs. （ 5.48 ±1.39 ） ], and the difference between two groups was statistically significant （ P 〈 0.05 ）. Conclusions The hierarchical stair health education can improve self-management behavior level of outpatients with initial use of basal insulin.