金字塔式分层滚动照护模式在糖尿病足风险管理中的应用

Application of the stratified care based on pyramid model in management of diabetic patients with risk of developing diabetic foot

目的探讨金字塔式分层滚动照护模式在老年糖尿病患者糖尿病足风险管理中的应用效果。方法 2018年1月—6月医院收治的老年2型糖尿病患者80例,处于不同等级的糖尿病风险足状态。采用随机数字表法将患者分为对照组与研究组,各40例。对照组出院后接受无差别化的糖尿病足风险管理,开展定期糖尿病足防控教育。研究组接受金字塔式分层滚动照护管理。采用糖尿病自我管理活动问卷(SDSCA)和慢性病管理评价量表(PACIC)评价患者糖尿病自我管理效果,记录干预后6个月内的糖尿病足发生情况。结果随访6个月,研究组SDSCA评分和PACIC量表各维度评分均高于对照组(P<0.05)。随访6个月内,研究组无患者进展为糖尿病足,对照组4(10.00%)例患者进展为糖尿病足,差异有统计学意义(P<0.05)。结论采用金字塔式分层滚动照护模式进行糖尿病足风险管理,可提高患者糖尿病自我管理水平,降低糖尿病足发生风险,是一种高质量的糖尿病足预防和风险管理模式。

Objective To evaluate the stratified care based on pyramid model in management of diabetic patients with risk of developing diabetic foot.Methods Totally 80 type 2 diabetic patients with risk of developing diabetic foot were randomly divided into the control group and the study group,with 80 cases in each group.After discharge from hospital,patients in the control group received undifferentiated risk management and regular health education on diabetic foot,and those in the study group were given stratified nursing interventions based on pyramid model.The Summary of Diabetes Self-Care Activities (SDSCA) and Patient Assessment of Chronic Illness Care (PACIC) questionnaires were used to assess the diabetes self-management of patients.The rate of patients developing diabetic foot at 6 months after intervention was compared between two groups.Results Patients in the study group achieved higher total score of SDSCA and scores in each dimension of PACIC compared with those in the control group(P<0.05).There was no patient in the study group and 4 patients in the control group who developed the diabetic foot,with a significant difference (P<0.05).Conclusion The stratified care based on pyramid model is an high-quality tool in management of diabetic patients with risk of developing diabetic foot.It can improve the self-management skills of patients and reduce the risk of developing diabetic foot.