三元联动整合照护模式在老年2型糖尿病患者中的应用

Application of trinal-integrated nursing mode in the care of patients with type 2 diabetes mellitus

目的探讨医院-社区-家庭三元联动整合照护模式在2型糖尿病患者中的应用效果研究。方法选择2015年12月至2017年6月医院收治的128例2型糖尿病患者,随机分成对照组和研究组,各64例,对照组给予常规健康宣教和出院指导,并出院后常规门诊复诊,研究组给予医院-社区-家庭三元联动整合照护模式;观察干预前、干预6个月后2组患者糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PBG)、空腹血糖(FBG)、体质量指数(BMI)等变化,并采用中文版糖尿病自我效能量表及自制不良生活习惯量表对患者的自我效能及不良生活习惯进行调查。结果干预后,研究组HbA1c、2 h PBG、FBG、BMI等指标的改善均明显优于对照组[(10.95±1.00)%,(11.20±1.71)mmol/L,(9.11±1.48)mmol/L,(25.72±5.23)kg/m^2],差异有统计学意义(P<0.05);干预后,研究组自我效能各项评分均优于对照组[(8.31±0.99)%,(9.33±1.39)mmol/L,(7.33±1.40)mmol/L,(23.62±5.48)kg/m^2],差异均有统计学意义(P<0.05);干预后,研究组不良生活习惯优良率高于对照组(P<0.05)。结论三元联动整合照护模式能有效控制老年2型糖尿病患者的血糖水平,改善患者的自我效能,改变患者的不良生活习惯。

Objective To investigate the effect of trinal-integrated nursing（hospital-community-family integrated nursing） in the care of patients with type 2 diabetes mellitus. Methods Two hundred and twenty-eight patients with type 2 diabetes mellitus who received medical care in the hospital from December 2015 to June 2017 were selected as research subjects,and were randomly assigned to the study group（ n = 64） and the control group（ n = 64）. At the time of discharge from hospital,the patients in the control group were given routine health education and related medical advice,and were instructed to have routine clinical visit after discharge,while the patients in the study group were given trinal-integrated nursing. Changes in glycosylated hemoglobin（ HbA1 c）,2 h postprandial blood glucose（ 2 h PBG）,fasting blood glucose（ FBG） and body mass index（ BMI） were observed both before intervention and 6 months after intervention. Patient self-efficacy and poor life habit were investigated by using the Chinese version of the self-efficacy scale of diabetes mellitus and the scale of self-made poor life habit. Results After intervention,such medical data as HbA1 c,2 h PBG,FBG and BMI in the study group were all significantly better than those in the control group [（ 10. 95 ± 1. 00） %,（ 11. 20 ± 1. 71）mmol/L,（9. 11 ± 1. 48） mmol/L,（25. 72 ± 5. 23） kg/m2],and statistical significance could be seen,when comparisons were made between them（ P〈0. 05）. The self-efficacy scores of the study group[（8. 31 ± 0. 99） %,（ 9. 33 ± 1. 39） mmol/L,（ 7. 33 ± 1. 40）mmol/L,（23. 62 ± 5. 48） kg/m2]were all superior to those of the control group,also with statistical significance（P〈0. 05）. The rate of poor life habit of the study group was lower than that of the control group（ P〈0. 05）. Conclusion Trinal-integrated nursing could effectively decrease serum sugar level of the patients with type 2 diabetes,improve patient self-efficacy and change their poor life habit.