综合健康教育对社区2型糖尿病患者血糖控制、焦虑情绪及自我管理水平的影响

Effects of comprehensive health education on glucose control, anxiety and self-management level in patients with type 2 diabetes mellitus in community

目的 探讨综合健康教育对社区2型糖尿病患者血糖控制、焦虑情绪及自我管理水平的影响.方法 采用便利抽样法,选取2013年1月—2016年12月在山东省聊城市王口新村社区2型糖尿病门诊就诊的患者92例,采用随机数表法分为观察组和对照组,每组46例患者.对照组给予常规健康教育,观察组在常规健康教育的基础上应用家庭关爱式教育的综合健康教育.比较两组患者干预前后空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）水平,评价患者干预前后焦虑评分和自我管理行为评分.结果 干预前,两组患者血糖水平、焦虑评分及自我管理行为评分差异均无统计学意义（P〉0.05）;干预后,两组患者的FPG、2hPG、HbA1c水平及焦虑评分下降,自我管理行为评分升高,与干预前比较差异具有统计学意义（P〈0.05）;干预后观察组患者FPG、2hPG、HbA1c水平、焦虑评分较对照组低,自我管理行为评分较对照组高,差异具有统计学意义（P〈0.05）.结论 对社区2型糖尿病患者采用综合健康教育,通过医护人员、患者及家属的共同护理,提高了患者自我管理行为能力,降低患者血糖和焦虑水平,值得推广.

Objective To explore the effects of comprehensive health education on glucose control, anxiety and self-management level in patients with type 2 diabetes mellitus in community. Methods A total of 92 outpatients with type 2 diabetes mellitus （T2DM） of Wangkouxincun community in Liaocheng City of Shandong Province were selected by convenience sampling from January 2013 to December 2016. Patients were divided into observation group （n=46, routine health education along with comprehensive health education by the educational form of family-friendly） and control group （n=46, routine health education） with the random number table. This study compared the fasting plasma glucose （FPG）, plasma glucose two hours after glucose load （2hPG）, glycosylated hemoglobin （HbA1c） and the scores of anxiety and diabetes self-care activities of patients between two groups before and after intervention. Results Before intervention, there was no significant difference in blood glucose levels, the score of anxiety and self-care activities （P〉0.05）. After intervention, the FPG, 2hPG, HbA1c and the score of anxiety of patients between two groups all decreased; the score of self-care activities increased with significant differences （P〈0.05）. The FPG, 2hPG, HbA1c and the score of anxiety of patients in observation group after intervention was lower than those in control group along with the score of self-care activities higher than that in control group with significant differences （P〈0.05）. Conclusions The implementation of comprehensive health education for patients with T2DM in community by nursing care involving health care providers, patients and family members improves the capability of self-management and decreases the blood glucose and anxiety levels. It is worth to be used widely in clinical application.