基于糖尿病“五辆马车”齐抓的儿童糖尿病患儿基层慢性病管理效果研究

Study on effect of chronic disease management in children with diabetes based on“five carriages”of diabetes

目的 研究基于糖尿病(DM)“五辆马车”齐抓的儿童糖尿病患儿基层慢性病管理效果。方法 选择绍兴文理学院附属医院基层慢性病管理辖区内的64例DM患儿作为研究对象,采取随机数字表法分为对照组和管理组,每组各32例。其中前者给予常规基层慢性病管理模式,后者给予基于DM管理“五辆马车”齐抓干预。比较两组患儿干预前后血糖水平、自我管理能力和应对方式,并评估患儿生存质量及家属护理满意度。结果 两组患儿干预前FPG、2 hPG及HbA1c水平比较,差异无统计学意义(P>0.05),干预后管理组患儿上述血糖水平显著低于对照组(P<0.05)。干预后两组自我管理能力各项评分均明显上升,且管理组患儿分值显著高于对照组,差异有统计学意义(P<0.05)。干预后两组积极应对分值显著升高,且管理组高于对照组,两组消极应对分值显著降低,且管理组低于对照组,差异有统计学意义(P<0.05)。干预后两组生存质量各项分值均显著升高,且管理组显著高于对照组,差异有统计学意义(P<0.05)。管理组患儿家属对护理技术、健康教育的满意分值显著高于对照组,差异有统计学意义(P<0.05)。结论 基于DM管理“五辆马车”齐抓的方案应用于儿童DM的疾病管理,可有效增强患儿自我管理能力,维持血糖稳定,从而提高生存质量及家属满意度。

Objective To investigate the effect of chronic disease management in children with diabetes based on“five carriages”of diabetes.Methods A total of 64 children with DM in the primary chronic disease management area of Affiliated Hospital of Shaoxing University of Arts and Sciences were selected as the research objects.They were divided into the control group(n=32)and the management group(n=32)by the random number table method.The former group was given the conventional primary chronic disease management mode,and the latter group was given the intervention based on the“five carriages”of DM management.The blood glucose level,self-management ability and coping style of the two groups were compared before and after the intervention,and the quality of life and nursing satisfaction of the children's families were evaluated.Results No significant differences were observed in FPG,2 hPG and HbA1c levels between the two groups before intervention(P>0.05),but the above blood glucose levels in the management group were significantly lower than those in the control group after intervention(P<0.05).The scores of self-management ability in both groups were significanly higher after intervention than those before intervention,and the above scores in the management group were significantly higher than those in the control group(P<0.05).The scores of positive response in both groups were significanly higher after intervention than those before intervention,and the scores of positive response in the management group were significantly higher than those in the control group(P<0.05).The scores of negative coping score in both groups were significanly lower after intervention than those before intervention,and the scores of negative coping score in the management group were significantly lower than those in the control group(P<0.05).The scores of quality of life score in both groups were significanly higher after intervention than those before intervention,and the scores of quality of life score in the management group were significantly higher than those in the control group(P<0.05).The satisfaction scores of nursing technology and health education in the management group were significantly higher than those in the control group,with significant difference(P<0.05).Conclusion Applied to the disease management of children with DM,the“five carriages”scheme based on DM management can effectively enhance the children′s self-management ability,maintain the stability of blood glucose,and thus improve the quality of life and family satisfaction.