协同护理模式在2型糖尿病患者中的应用研究

The application of collaborative care model in patients with type 2 diabetes

目的评价协同护理模式对2型糖尿病患者生活质量、空腹血糖、餐后2 h血糖、糖化血红蛋白、低血糖发生率及胰岛素规范注射技术的影响。方法将240例胰岛素治疗的2型糖尿病患者随机分为观察组和对照组各120例,对照组采取常规护理,观察组在常规护理基础上采取协同护理模式:包括重点指导患者正确掌握胰岛素规范注射9步骤方法、注射角度及手法、常用注射部位的轮换及消毒、注射针头一次性使用、注射完毕停留的时间及胰岛素的正确保存方法等。比较两组患者出院3个月后的生活质量和空腹血糖、餐后2 h血糖、糖化血红蛋白、低血糖发生率及胰岛素规范注射技术。结果应用协同护理模式干预后,观察组患者生活质量评分高于对照组(P<0.01),空腹血糖、餐后2 h血糖、糖化血红蛋白、低血糖发生率明显低于对照组(P<0.01或P<0.05),胰岛素规范注射技术高于对照组(P<0.01)。结论协同护理模式应用于2型糖尿患者,可提高患者的生活质量,有效控制血糖及糖化血红蛋白,降低低血糖发生率,规范患者胰岛素注射技术。

Objective To evaluate the effect of colloborative care model on quality of life ,fasting blood - glucose ,2 - hour plasma glucose, glycosylated he- moglobin ,incidence of hypnglyeemia and insulin injection technology in patients with type 2 diabetes. Methods Totally 240 patients with type 2 diabetes who re- ceived insulin therapy were randomly divided into the experimental group and the control group,and each group had 120 cases. The control group received con- ventional nursing, the expermental group received collaborative care model, which included strengthening guiding patients the correct 9 - step method of insulin injection ,injection angle and technique ,rotation and disinfection of commonly used at the injection site ,injection needle disposable ,the residence time after injec- tion and the correct preserving method of insulin. The quality of life, fasting blood - glucose,2 - hour plasma glucose, glycosylated hemoglobin,incidence of hypo- glycemia and insulin injection technology between two groups 3 months after discharge were compared. Results After application of collaborative nursing model intervention, the expermental group had higher quality of life score （ P 〈 0.01 ） ,lower level of fasting blood - glucose, 2 - hour plasma glucose, glyeosylated hemo- globin ,and lower incidence of hypoglycemia （ P 〈 0.01 or P 〈 0.05 ） and better insulin injection technology （ P 〈 0.01 ） than what they were in the control group. Conclusion The application of collaborative care model in patients with type 2 diabetes can improve their quality of life, effectively control blood - glu- cose and glycosylated hemoglobin, decrease the incidence of hypoglycemia, and improve patients＇ insulin injection technology.