医院慢性病管理团队联合分级护理对城镇糖尿病患者自我管理行为的影响

Effect of hospital chronic disease management team combined with graded nursing on self-management behavior of diabetic patients in Urban areas

目的探讨医院慢性病管理团队联合分级护理对城镇糖尿病患者自我管理行为的影响。方法回顾性分析2019年1月至2020年5月广东省潮州市人民医院收治的121例城镇糖尿病患者临床资料,根据护理方法的不同分对照组(61例)和观察组(60例)。同时以糖化血红蛋白水平进行亚组分组,其中4%<糖化血红蛋白≤6%的患者为A组26例;6%<糖化血红蛋白≤8%为B组20例,糖化血红蛋白>8%为C组14例。对照组实施常规护理,观察组实施医院慢性病管理团队参与和分级护理。比较两组的自我管理行为评分,观察空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平,并分析不同血糖患者自我管理行为。结果观察组护理后的自我管理行为评分高于对照组,差异有统计学意义(P<0.05)。观察组护理后的FPG、2 h PG、HbA1c水平低于对照组,差异均有统计学意义(P<0.05)。A组的SDSCA-6评分护理前与护理后比较,差异无统计学意义(P>0.05);B组的SDSCA-6评分护理前与护理后比较,差异有统计学意义(P<0.05);C组的SDSCA-6评分护理前与护理后比较,差异有统计学意义(P<0.05)。结论实施医院慢性病管理联合分级护理,让患者快速形成良好自我管理行为,使血糖水平控制在正常范围,有助于生活质量提升。

Objective To explore the influence of chronic disease management team combined with graded nursing on the self-management behavior of diabetic patients in urban areas.Methods The clinical data of 121 cases of diabetic patients admitted to Chaozhou People′s Hospital in Guangdong Province from January 2019 to May 2020 were retrospectively analyzed and divided into the control group(61 cases)and the observation group(60 cases)according to different nursing methods.At the same time,all the patients were divided into subgroups according to the level of glycosylated hemoglobin.26 patients whose glycosylated hemoglobin>4%and≤6%were taken as group A;20 patients whose glycosylated hemoglobin>6%and≤8%were taken as group B;14 patients whose glycosylated hemoglobin>8%were taken as group C.The control group received routine nursing,and the observation group received hospital chronic disease management team participation and graded nursing.The self-management behavior scores of the two groups were compared;the changes of fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG)and glycosylated hemoglobin(HbA1c)were observed;and the self-management behavior of patients with different blood glucose was analyzed.Results The score of self-management behavior in the observation group was higher than that in the control group,with statistical difference(P<0.05).The levels of FPG,2 h PG and HbA1c in the observation group were lower than those of the control group after nursing,with statistical differences(P<0.05).There were no statistically significant differences of the SDSCA-6 scores in group A before and after nursing(P>0.05);there were statistically significant differences of the SDSCA-6 scores in group B before and after nursing(P<0.05);there were statistically significant differences of the SDSCA-6 scores in group C before and after nursing(P<0.05).Conclusion After the implementation of hospital chronic disease management combined with graded nursing,patients can quickly form good self-management behavior,control the blood glucose level within the normal range,and contribute to the improvement of quality of life.