叙事医学教育模式对中高危糖尿病足患者足部知识水平及代谢指标的影响

Effects of narrative medicine on diabetic foot knowledge level and metabolic parameters of patients with middle or high risks for diabetic foot

目的：探讨叙事医学教育模式对中、高危糖尿病足患者足部知识水平及代谢指标控制效果的影响。方法选择2012年10月—2013年5月符合纳入标准的90例中、高危糖尿病足患者作为研究对象。对患者进行足部知识问卷调查，对患者存在的问题进行常规指导后运用随机数字表将其分为对照组和观察组，每组各45例。对照组采用常规教育模式，观察组采用叙事医学教育模式。干预6个月后比较两组患者足部知识得分及代谢指标结果。结果共87例患者完成整个干预过程，其中对照组43例，观察组44例。干预后两组收缩压、舒张压及餐后2 h血糖、糖化血红蛋白比较差异有统计学意义（P〈0.05）。干预后观察组患者糖尿病基本知识、对糖尿病足部的认识、足部保健知识、正确的穿鞋袜知识、避免足部损伤的知识得分及足部知识问卷总分与对照组比较，差异有统计学意义（ P P〈00.05）。结论叙事医学教育模式能提高中、高危糖尿病患者的足部知识水平及改善患者代谢指标。

Objective To discuss the effects of narrative medicine on diabetic foot knowledge level and metabolic parameters of patients with middle or high risks for diabetic foot. Methods We selected 90 patients with mid-and-high risks for diabetic foot who accorded with the inclusion criteria from October 2012 to May 2013. All patients were given a questionnaire about knowledge of diabetic foot to evaluate the degree of patients′mastery level of diabetic foot knowledge and after routine education, patients were randomly divided into experimental group and control group by random number table. The patients of control group received conventional education, while the patients of experimental group were intervened with narrative medicine education. We compared patient′s foot related knowledge level and metabolic parameters after 6 months. Results A total of 87 patients completed the whole study. Forty-three patients were in the control group, and forty-four patients were in the experimental group. After interventions, patient′s systolic pressure, diastolic pressure, 2 h postprandial blood sugar, and glycosylated hemoglobin in the experimental group were lower than that of the control group （P〈0. 05）. After interventions, the scores of the questionnaire were higher than that of the control group （P P〈00. 05）. After interventions, the basic information of diabetes knowledge, recognition of diabetic food, food nursing, correct knowledge of wearing shoes and socks, knowledge of avoiding food injuries, total score of food knowledge questionnaire in the experimental group were compared with those of control group with statistical significance （P〈0. 05）. Conclusions Narrative medicine can improve middle or high risks diabetic foot patient′s foot related knowledge level and metabolic parameters.