家庭自我管理在糖尿病儿童居家护理中的应用效果研究

Effect of family self-management on home nursing of diabetic children

目的:研究家庭自我管理在糖尿病儿童居家护理中的应用效果。方法:选取2015年3月至2016年7月医院住院部收治的糖尿病儿童80例,随机分为对照组(n=40)和观察组(n=40)。对照组采用常规健康宣教的方法护理,观察组在对照组基础上采用家庭自我管理护理,通过出院后的家庭访视及电话回访指导患儿家庭进行居家护理,强化家庭在疾病治疗中的作用。比较两组患儿血糖控制情况、遵医率、并发症发生率及患儿家长糖尿病健康知识掌握度。结果:两组患儿出院前空腹血糖、餐后2 h血糖及糖化血红蛋白水平比较差异无统计学意义(P>0.05);观察组通过家庭自我管理后空腹血糖、餐后2 h血糖及糖化血红蛋白水平,均低于对照组(P<0.05),差异有统计学意义;观察组家庭自我管理后遵医行为中门诊就诊、血糖监测、饮食规律、运动锻炼及安全用药率,均高于对照组(P<0.05);观察组并发症发生率,低于对照组(P<0.05),差异有统计学意义。两组出院前患儿家长糖尿病健康知识掌握度比较差异无统计学意义(P>0.05);观察组出院3个月后患儿家长糖尿病健康知识掌握度高于对照组(P<0.05),差异有统计学意义。结论:糖尿病儿童治疗中实施家庭自我管理效果理想,有利于控制患儿血糖,降低并发症发生率,值得推广应用。

Objective: To study the effect of family self-management in the home care of children with diabetes mellitus. Methods: 80 children with diabetes mellitus admitted to the hospital from March 2015 to July 2016 were chosen and randomly divided into the control group( n = 40) and observation group( n = 40). The control group was given conventional health education nursing. And the observation group was given both conventional nursing and family self-management nursing,which was achieved by guiding patients to receive home care through home visiting and telephone visiting after hospital discharge,so as to strengthen the family's role in disease treatment. The glycemic control,compliance rate,complication rate and parents' knowledge of diabetes mellitus were compared between the two groups. Results: Before hospital discharge,the comparative difference of patients' fasting blood glucose,blood glucose and glycosylated hemoglobin 2h after meal is not of statistical significance( P > 0. 05). The observation group has higher rates of obedient treatment,blood glucose monitoring,regular diet,exercise and safe medication than the control group( P < 0. 05). Through family selfmanagement,the observation group has lower fasting blood glucose,blood glucose and glycosylated hemoglobin 2h after meal,and lower incidence of complications than the control group( P < 0. 05) with statistically significant difference. Before hospital discharge,parents of two groups had no statistically significant difference in the knowledge of diabetes mellitus( P > 0. 05); and 3 months after hospital discharge,parents of observation group master more knowledge of diabetes mellitus than parents of the control group( P < 0. 05) with statistically significant difference. Conclusion: The family self-management is of significant effect in the treatment of children's diabetes,which can control patients' blood glucose and reduce the incidence of complications. It is worthy of popularization and application.