同伴支持教育联合全科团队管理模式对社区2型糖尿病患者知信行水平的影响

Effect of peer-support education combined with general practice team-management mode on the level of knowledge,attitude,and practice of type-2 diabetes patients in the community

目的探讨同伴支持教育联合全科团队管理模式对社区2型糖尿病患者知信行水平的影响,评估该模式的应用效果。方法于2018年7-10月以南京市江宁区汤山、禄口、东山社区卫生服务中心的2型糖尿病患者196例作为研究对象,采用随机数字表法将患者分为干预组(100例)和对照组(96例)。干预组采用同伴支持教育联合全科团队管理模式,对照组采用常规社区管理模式。模式实施1年后,比较2组患者知识、信念和态度、行为水平的差异。结果最终完成随访的患者,干预组95例,对照组93例。干预后,干预组患者糖尿病相关知识得分显著高于对照组(P<0.05)。2组患者自我效能的各项得分较基线均有所上升,其中2组血糖监测、病情控制及总效能得分比较差异有统计学意义(均P<0.05)。干预后干预组血糖管理、足部护理、遵医用药得分分别为(5.2±1.4)分、(4.5±1.9)分、(6.5±2.1)分,对照组分别为(4.2±1.8)分、(3.8±2.2)分、(5.8±1.9)分,2组比较差异有统计学意义(均P<0.05),2组患者饮食管理、运动管理得分比较差异无统计学意义(均P>0.05)。结论同伴支持教育联合全科团队管理模式可提高社区2型糖尿病患者相关知识水平,帮助其掌握正确的自我管理行为。

Objective To explore the effect of peer-support education combined with general practice team-management mode on the level of knowledge,attitude,and practice(KAP)of T2DM patients in community,and evaluate the effect of this model.Methods Total 196 patients with T2DM in Tangshan,Lukou and Dongshan community health-service centres in Jiangning District of Nanjing were selected as the research objects from July 2018 to October 2018,and divide into intervention group(100 cases)and control group(96 cases)used a random-number table method.The intervention group adopted peer-support education combined with general practice team-management mode,whereas the control group adopted conventional community-management mode.One year after the model was implemented,the differences in KAP levels between the two groups were compared.Results The patients who finally completed the follow-up included 95 cases in the intervention group and 93 cases in the control group.After one year of intervention,the diabetes-related knowledge scores of patients in the intervention group were significantly higher than those in the control group(P<0.05).The scores of self-efficacy in both groups increased compared with the baseline.Amongst them,the average scores of blood glucose monitoring,disease control,and total efficacy were statistically significant(all P<0.05).The score of glucose monitoring,foot care,and pharmaceutical administration for self-management ability in the intervention group were 5.2±1.4,4.5±1.9,6.5±2.1,whereas the values of these indicators in the control group were 4.2±1.8,3.8±2.2,5.8±1.9,the differences between two groups were statistically significant(all P<0.05).There were no significant differences in scores of diet management and exercise management between two groups(all P>0.05).Conclusion Peer-support education combined with general practice team-management mode can improve the knowledge level of patients with T2DM,and help them master the correct self-management behaviour.