医联体模式下糖尿病专科护士共享模式在基层医疗机构糖尿病患者管理中的应用

Effects of diabetes specialist nurse sharing model in the management of diabetic patients in primary medical institutions based on the medical alliance model

目的探讨医联体模式下糖尿病专科护士共享管理对基层医疗机构糖尿病患者的影响。方法采用便利抽样法选择2018年1月—2019年12月在新乡医学院第一附属医院住院的2型糖尿病患者为研究对象,将2018年1—12月入组的147例2型糖尿病患者设为对照组,将2019年1—12月入组的162例2型糖尿病患者设为观察组。对照组采用常规糖尿病管理,观察组采用医联体模式下糖尿病专科护士共享管理。两组均管理6个月。采用Morisky服药依从性量表、糖尿病自我管理行为量表(SDSCA)评估两组患者的服药依从性和自我管理行为得分,比较两组患者干预前后空腹血糖、糖化血红蛋白水平,评估两组患者干预期间再次入院率和低血糖发生率。结果干预后观察组的服药依从性优于对照组,差异有统计学意义(P<0.05)。干预后观察组的空腹血糖、糖化血红蛋白水平低于干预前和对照组,SDSCA得分高于干预前及对照组,差异均有统计学意义(P<0.05)。观察组的再次入院率和低血糖发生率分别为8.02%和5.56%,均低于对照组的19.73%和25.17%,差异有统计学意义(P<0.05)。结论医联体模式下糖尿病专科护士共享模式管理可以有效提高基层医疗机构糖尿病患者的服药依从性和自我管理行为能力,改善患者血糖水平,降低再次住院率和低血糖发生率。

Objective To explore the effect of diabetes specialist nurse sharing management in diabetic patients in primary medical institutions under the medical alliance model.Methods From January 2018 to December 2019,convenience sampling was used to select type 2 diabetes patients in the First Affiliated Hospital of Xinxiang Medical University as the research object.A total of 147 patients with type 2 diabetes who were enrolled from January to December 2018 were set as the control group,and 162 patients with type 2 diabetes who were enrolled from January to December 2019 were set as the observation group.Control group adopted routine diabetes management,and observation group conducted the diabetes specialist nurse sharing management under the medical alliance model.Both groups of management lasted for 6 months.Morisky Medication Adherence Scale and Scale of the Diabetes Self-care Activities(SDSCA)were used to evaluate medication adherence and self-management behavior scores of the two groups of patients.The fasting blood glucose and glycosylated hemoglobin of the two groups of patients before and after the intervention were compared,and the readmission rate and the incidence of hypoglycemia of the two groups of patients during the intervention were evaluated.Results After the intervention,the observation group's medication adherence was better than that of control group,and the difference was statistically significant(P<0.05).After the intervention,the fasting blood glucose and glycosylated hemoglobin of observation group were lower than those before intervention and of control group,and the SDSCA score was higher than that before intervention and of control group,and the differences were statistically significant(P<0.05).The readmission rate and the incidence of hypoglycemia in observation group were 8.02%and 5.56%,respectively,which were lower than 19.73%and 25.17%in control group,and the differences were statistically significant(P<0.05).Conclusions The diabetes specialist nurse sharing management under the medical alliance model can effectively improve the medication adherence,self-management behavior and blood glucose of diabetic patients in primary medical institutions,and reduce the readmission rate and the incidence of hypoglycemia.