社区延续护理对居家胰岛素注射患者管理的效果

Effect of community continuing nursing on the management of patients with insulin injection at home

目的:评价社区延续护理对居家胰岛素注射患者的管理效果。方法:采用整群入组方法选取2018年7月—2019年1月在中心全科团队内进行家庭医生签约管理的糖尿病居家胰岛素注射患者117例。将西区、北区全科团队签约的患者作为对照组(60例),采用常规门诊管理方法;将中远、东区全科团队签约的患者作为观察组(57例),在门诊管理基础上增加社区延续护理方法。两组研究随访周期均为24周。采用问卷调查了解患者的胰岛素规范注射知识掌握程度,采用焦虑自评量表(SAS)和胰岛素注射评分标准分别评估患者的焦虑状态和规范注射技术得分。结果:24周后,观察组的胰岛素规范注射知识掌握以及规范注射技术得分明显高于对照组(P<0.01);SAS得分明显低于对照组(P<0.01)。观察组空腹血糖和糖化血红蛋白达标率均较干预前有显著提高(P<0.01),但观察组优于对照组(P<0.05)。结论:社区延续护理有助于患者掌握胰岛素注射知识、规范化注射技术、降低因注射而引发的焦虑情绪,并可提高患者空腹血糖和糖化血红蛋白达标率,值得推广。

Objective: To evaluate the management effect of community continuing nursing on insulin injection patients at home. Methods: A total of 117 patients with diabetes mellitus insulin injections who were contracted by family doctors in the general practitioner team of the center from July 2018 to January 2019 were selected by the whole group enrollment method. The patients contracted by the general practitioner teams in the Western and Northern Areas were taken as the control group with 60 cases, and the routine outpatient management method was adopted;the patients contracted by the general practitioner team of Zhongyuan and Eastern Areas were taken as the observation group with 57 cases, and community continuing nursing method was added on the basis of the outpatient management. The follow-up period of both groups was 24 weeks. Questionnaire survey was conducted to understand the patients’ knowledge of insulin standard injection, the anxiety status and standard injection technique scores were evaluated by self-rating anxiety scale(SAS) and insulin injection scoring standard. Results: After 24 weeks, the scores of knowledge and technology of insulin injection in the observation group were significantly higher than those in the control group(P<0.01). SAS score in the observation group was significantly lower than that in the control group(P<0.01). The fasting blood sugar and glycosylated hemoglobin in the observation group were significantly higher than those before intervention(P<0.01), but the observation group was better than the control group(P<0.05). Conclusion: Community continuous nursing is helpful for patients to master the knowledge of insulin injection and standardized injection technology, reduce the anxiety caused by injection and improve the rate of reaching the standard of fasting blood sugar and glycosylated hemoglobin, which is worth popularizing.