教练式医学营养干预在老年糖尿病患者中的实践应用

Efficacy of health coaching in medical nutrition intervention for elderly patients with diabetes mellitus

目的对老年2型糖尿病患者进行健康教练式医学营养干预,提高饮食管理依从性,达到控制血糖的目的。方法310例老年2型糖尿病患者随机分为观察组与对照组,观察组由营养师对其进行一对一健康教练式医学营养干预,对照组由医护人员对患者进行常规集体健康宣教,观察两组患者干预后空腹血糖、餐后2 h血糖、糖化血红蛋白及各类膳食满意度情况。结果观察组与对照组FPG、2hPG及HbA1c(%)均较干预前下降,但对照组干预前后差异无统计学意义(P>0.05);观察组干预效果优于对照组,差异有统计学意义(P<0.05)。干预后,观察组患者对膳食营养科的满意度高于对照组,差异具有统计学意义(P<0.05)。结论健康教练式医学营养干预能有效提高老年糖尿病患者的饮食健康管理效果,提升患者对膳食营养工作的满意度。

Objective To evaluate the efficacy of health coaching in medical nutrition intervention in improving diet management compliance and hence control of blood sugar of elderly patients with type 2 diabetes mellitus.Methods Firstly,310 cases of elderly patients with type 2 diabetes mellitus were randomly divided into an experimental group and a control.Then the experimental group was subjected to sessions of one nutritionist to one patient health coaching based medical nutrition intervention.The control group was subjected to conventional collective health education given by medical workers.The levels of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin and dietary satisfaction of the two groups as observed after intervention were documented.Results The levels of FPG,2hPG and HbA1c(%)of both groups were found to be lower than before the intervention.However,there was no significant difference before and after intervention in the control group(P>0.05).The result of intervention in the experimental group was greater than that in the control.The difference was statistically significant(P<0.05).After the intervention,the level of satisfaction of the experimental group with the dietary nutrition department was higher than that of the control.The difference was statistically significant(P<0.05).Conclusions Health coaching based medical nutrition intervention can effectively improve the dietary health management in elderly diabetic patients and improve the patients’satisfaction with dietary nutrition work.