医护患一体化教育对老年2型糖尿病患者自我效能、健康知识及生活质量的影响

Effect of integrated education of doctors,nurses,and patients on self-efficacy,health knowledge,and quality of life in elderly patients with type 2 diabetes mellitus

目的 探讨医护患一体化教育对老年2型糖尿病患者自我效能、健康知识及生活质量的影响.方法 选取沈阳市第四人民医院2018年4月至2019年4月间收治的老年2型糖尿病患者180例,按照随机数表法将患者分为对照组和观察组,每组90例.所有患者均采用口服药物方式进行血糖控制.对照组行常规护理,观察组则予以医护患一体化教育护理干预.干预前及干预1个月后,采用一般自我效能感量表(GSES)评估患者的自我效能,采用Morisky量表评价患者的治疗依从性,采用糖尿病知识问卷表调查患者的糖尿病健康知识掌握程度,采用宗氏抑郁自评量表(SDS)与宗氏焦虑自评量表(SAS)评估患者的抑郁与焦虑程度,采用生存质量量表(QOL-BREF)评估患者生存质量.同时比较两组患者护理干预后的血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 hPG)以及糖化血红蛋白(HbAlc)].结果 护理干预前两组患者的自我效能、健康知识掌握情况、治疗依从性评分比较差异均无统计学意义(P>0.05);护理干预后,两组患者的自我效能、健康知识掌握情况、治疗依从性评分均较干预前明显提高,且观察组患者护理干预后的自我效能评分,健康知识掌握评分,治疗依从性评分明显高于对照组,差异均有统计学意义(P<0.05);护理干预前,两组患者的FBG、2 hPG、HbAlc比较差异无统计学意义(P>0.05),护理干预后,两组患者的FBG、2 hPG、HbAlc均较干预前降低,且观察组患者护理干预后的FBG、2 hPG、HbAlc明显低于对照组,差异均有统计学意义(P<0.05);护理干预前,两组患者的SAS评分及SDS评分比较差异均无统计学意义(P>0.05),护理干预后,两组患者的SAS评分及SDS评分较干预前降低,且观察组患者护理干预后的SAS评分、SDS评分明显低于对照组,差异均有统计学意义(P<0.05);护理干预前,两组患者的QOL-BREF量表中的心理维度评分、生理维度评分、环境维度评分、社会维度评分比较差异均无统计学意义(P>0.05),护理干预后两组患者的QOL-BREF量表各维度评分较干预前提高,且观察组患者护理干预后的QOL-BREF量表各维度评分明显高于对照组,差异均有统计学意义(P<0.05).结论 医护患一体化教育护理干预2型糖尿病患者可显著提升患者的自我效能、提高健康知识的掌握程度和治疗依从性,改善不良情绪,提高血糖控制水平和生活质量.

Objective To explore the effect of integrated education of doctors,nurses,and patients on self-efficacy,health knowledge and quality of life in elderly patients with type 2 diabetes mellitus.Methods A total of 180 elderly patients with type 2 diabetes mellitus who were admitted to Shenyang Fourth People's Hospital from April 2018 to April 2019 were divided into control group and observation group according to random number table,with 90 patients in each group.All patients were controlled by oral medication.The control group received routine nursing,while the observation group received integrated education of doctors,nurses,and patients for nursing intervention.Before and one month after the intervention,the general self-efficacy scale(GSEs)was used to evaluate the patients'self-efficacy;the Morisky scale was used to evaluate the patients'treatment compliance;the diabetes knowledge questionnaire was used to investigate the patients'mastery of diabetes health knowledge;the self-rating depression scale(SDS)and self-rating anxiety scale(SAS)were used to evaluate the patients'depression and anxiety;QOL-BREF was used to evaluate the quality of life.At the same time,the blood glucose indexes of the two groups after nursing intervention were compared,including fasting blood glucose(FBG),postprandial 2 h blood glucose(2 hPG),and HbAlc.Results There was no significant difference in the scores of self-efficacy,health knowledge mastery,and treatment compliance between the two groups before nursing intervention(P>0.05);after nursing intervention,the scores of self-efficacy,health knowledge mastery,and treatment compliance of the two groups were significantly higher than those before nursing intervention,and the scores in the observation group were significantly higher than those in the control group(P<0.05).Before nursing intervention,there was no significant difference in FBG,2 hPG,and HbAlc between the two groups(P>0.05);after nursing intervention,the FBG,2 hPG,and HbAlc levels of the two groups were significantly lower than those before intervention,and the levels in the observation group were significantly lower than those in the control group(P<0.05).Before nursing intervention,there was no significant difference in SAS and SDS scores between the two groups(P>0.05);after nursing intervention,the SAS and SDS scores of the two groups were significantly lower than those before intervention,and the scores of the observation group were significantly lower than those of the control group(P<0.05).Before nursing intervention,there was no significant difference in QOL-BREF scores of psychological dimension,physiological dimension,environmental dimension,and social dimension between the two groups(P>0.05);after nursing intervention,the scores of the two groups were significantly higher than those before intervention,and the scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion The integrated education of doctors,nurses,and patients and nursing intervention can significantly improve the self-efficacy,health knowledge mastery,and treatment compliance of patients with type 2 diabetes mellitus,and also improve the bad mood,the level of blood glucose control,and quality of life.