基于网络的医院-社区-家庭一体化照护模式在糖尿病患者中的应用效果评价

Application effect evaluation of international-based hospital-community-family care model in patients with type 2 diabetes mellitus

目的评价基于网络的医院-社区-家庭一体化照护模式对糖尿病患者自我管理水平和生活质量的影响。方法选择2016年2月至2017年2月郑州大学第一附属医院收治的2型糖尿病患者120例,将患者分为对照组和观察组,每组60例,2组患者在研究过程中各失访5例,最终纳入分析患者均为55例。对照组患者由责任护士实施常规健康指导和随访,观察组患者采用基于网络的医院-社区-家庭一体化照护模式进行管理。2组患者在出院后随访6个月,采用自我管理能力量表(SDSCA)评估患者出院后1、3、6个月的自我管理水平,采用糖尿病患者生活质量特异性量表(DAQL)评估患者3、6个月的生活质量,比较2组患者干预前后SDSCA、DAQL评分。结果 2组患者干预前SDSCA评分比较差异无统计学意义(P>0.05);2组患者各时间点SDSCA评分组内两两比较差异均有统计学意义(P<0.05);观察组患者出院1、3、6个月SDSCA评分均高于对照组(P<0.05)。2组患者干预前DAQL评分比较差异无统计学意义(P>0.05);2组患者各时间点DAQL评分组内两两比较差异均有统计学意义(P<0.05);出院3个月2组患者DAQL评分比较差异无统计学意义(P>0.05),出院6个月观察组患者DAQL评分低于对照组(P<0.05)。结论基于网络的医院-社区-家庭一体化照护能提高糖尿病患者的生活质量和自我管理水平。

Objective To explore the influence of international-based hospital-community-family care model on self-care level and quality of life of patients with diabetes mellitus.Methods One hundred and twenty type 2 diabetes mellitus patients in the First Affiliated Hospital of Zhengzhou University from February 2016 to February 2017 were selected and divided into observation group （n =60） and control group （n =60）.In the course of the study,10 patients （5 patients in each groups） were lost;so 55 patients in each group were included the analysis.The patients in the control group received normal discharge guidance and follow-up;the patients in the observation group received international-based hospital-community-family care.All patients were followed-up for 6 months post-discharge.The self-care level of patients was evaluated by the summary of diabetes self-care activities questionnaire（SDSCA）;the quality of life of patients was evaluated by diabetes specific quality of life scale （DAQL）;then the changes of SDSCA and DAQL score before and after intervention were compared between the two groups.Results There was no statistic difference in the score of SDSCA between the two groups （P 〉 0.05）;there was statistic difference in the score of SDSCA among the each time point in the two groups（P 〈0.05）;the SDSCA score of patients in the observation group was significantly higher than that in the control group at 1 month,3,6 months post-discharge （P 〈 0.05）.There was no statistic difference in the score of DAQL between the two groups（P 〉 0.05）;there was statistic difference in the score of DAQL among the each time point in the two groups（P 〈 0.05）;there was no statistic difference in the score of DAQL between the two groups at 3 months post-discharge（P 〉0.05）;the DAQL score of patients in the observation group was significantly lower than that in the control group at 6 months post-discharge（P 〈 0.05）.Conclusion The international-based hospital-community-family care model can improve the quality of life and self-care level of patients with diabetes mellitus.