PBL教育模式对妊娠期糖尿病患者自我管理能力和母婴并发症的影响

Effect of problem-based education model on self-management ability and maternal as well as infant complications in patients with gestational diabetes mellitus

目的探讨以问题为基础(PBL)教育模式对妊娠期糖尿病(GDM)患者遵医行为和母婴并发症的影响.方法将96例GDM患者随机分为对照组和观察组各48例,均接受GDM常规治疗.对照组给予传统模式的GDM健康教育,观察组在对照组基础上开展PBL模式的GDM健康教育.采用糖尿病管理自我效能量表(C-DMSES)评估GDM患者的自我管理能力,并随访观察2组母婴并发症的发生情况.结果护理后,2组GDM患者C-DMSES量表中科学饮食、规律运动、定期血糖监测、遵医嘱用药的评分均较护理前显著升高(P<0.01),且观察组C-DMSES量表各维度评分均显著高于对照组(P<0.05或P<0.01);随访显示,2组胎儿畸形率无显著差异(P>0.05),但观察组羊水过多、妊娠期高血压、早产、巨大儿发生率均显著低于对照组(P<0.05).结论PBL模式的GDM健康教育可显著提高GDM患者的自我管理能力,并降低母婴并发症发生风险.

Objective To explore the effect of problem-based education (PBL) on compliance behavior and maternal as well as infant complications in patients with gestational diabetes mellitus (GDM). Methods A total of 96 patients with GDM were randomly divided into control group and observation group. Both groups received routine treatment of GDM. The control group ( n =48) was given traditional mode of GDM health education, while the observation group ( n =48) was given PBL based GDM health education on the basis of the control group. The self-management ability of GDM patients was assessed with the DM Management Self-efficacy Scale (C-DMSES), and the occurrence of complications in mother and infant were followed up. Results After nursing, the scores of scientific diet, regular exercise, regular blood sugar monitoring and medication according to doctor′s advice in C-DMSES Scale were significantly increased in both groups ( P <0.01), and the scores of C-DMSES Scale in observation group were significantly higher than those in control group ( P < 0.05 or P < 0.01). There was no significant difference in the rate of fetal malformation between the two groups during follow-up ( P >0.05), but the incidence of polyhydramnios, gestational hypertension, premature delivery and macrosomia in the observation group was significantly lower than that in the control group ( P <0.05). Conclusion PBL based GDM health education can significantly improve the self-management ability of GDM patients and reduce the risk of maternal and infant complications.