PRECEDE模式联合饮食指导在糖尿病患者延续护理中的应用

Application of PRECEDE model combined with diet guidance in continuing nursing for diabetics

目的:观察PRECEDE模式联合饮食指导在2型糖尿病(T2DM)患者延续性护理中的应用效果。方法:采用便利抽样法,选取济宁医学院附属医院2017年8月—2019年4月的108例T2DM患者,采用随机数字表法分为对照组和观察组,各54例。对照组实施常规随访护理,观察组在此基础上实施PRECEDE模式联合饮食指导。比较两组患者出院时、出院6个月后的糖代谢相关指标[空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)]、自我管理能力评分,出院6个月后健康知识掌握情况以及慢性并发症发生情况。结果:出院时,两组患者血糖指标和自我管理能力评分差异均无统计学意义(P>0.05)。出院6个月,两组患者的空腹血糖、餐后2 h血糖、HbA1c水平均较出院前降低,且观察组低于对照组,差异均有统计学意义(P<0.01)。出院6个月,对照组患者的自我管理能力评分与出院前比较,差异无统计学意义(P>0.05);观察组患者出院6个月的自我管理能力各项评分均高于出院前,且高于对照组,差异有统计学意义(P<0.01)。观察组患者出院6个月的健康知识调查表评分优良率高于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组患者的总并发症发生率低于对照组,差异有统计学意义(P<0.01)。结论:PRECEDE模式联合饮食指导应用于T2DM患者随访可提高患者健康知识掌握情况与出院后自我管理能力,有助于血糖控制,减少并发症。

Objective:To explore the effects of PRECEDE model combined with diet guidance in continuing nursing for patients with type 2 diabetes mellitus(T2DM).Methods:The convenience sampling was used to select 108 T2DM patients from the Affiliated Hospital of Jining Medical University from August 2017 to April 2019,and they were divided into control group and observation group with the method of random number table,with 54 cases in each group.Control group carried out the routine follow-up nursing.On this basis,observation group implemented the PRECEDE model combined with diet guidance.We compared the glucose metabolism related indicators[fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin(HbA1c)],and self-management ability score of patients between two groups at discharge and six months after discharge,and health knowledge mastery as well as chronic complications of those six months after discharge.Results:At discharge,there was no statistical difference in blood glucose indicators and score of self-management ability of patients between two groups(P>0.05).Six months after discharge,fasting blood glucose,2-hour postprandial blood glucose and HbA1c of patients between two groups were lower than those before discharge,and those of observation group were lower than those of control group,the differences were statistically significant(P<0.01).Six months after discharge,there was no statistically significant difference in the score of self-management ability of patients in control group compared with that before discharge(P>0.05);scores of self-management ability of patients in observation group six months after discharge were higher than those before discharge and those of control group with statistical differences(P<0.01).The rate of good scores on the Health Knowledge Questionnaire of patients in observation group six months after discharge was higher than that in control group with a statistical difference(P<0.05).Followed up for six months,the total incidence of complication of observation group was lower than that of control group also with a statistical difference(P<0.01).Conclusions:The application of PRECEDE model combined with diet guidance in the follow-up of T2DM patients can improve patients'health knowledge and self-management ability after discharge,help blood glucose control and reduce complications.