分阶段转变护理对糖尿病肾病患者血糖控制、肾功能及自护行为的影响

Effect of transtheoretical model on glycemic control,renal function and self-care behaviors in patients with diabetic nephropathy

目的探讨分阶段转变护理对糖尿病肾病患者血糖控制、肾功能及自护行为的影响。方法选取福州市某医院2019年6月—2020年8月收治的70例糖尿病肾病患者为研究对象,采用随机数字表法分为对照组(35例)和观察组(35例)。对照组患者给予常规护理干预,观察组患者在对照组护理基础上给予分阶段转变护理干预,2组患者均持续护理24周。比较2组患者护理前后的血糖控制情况、肾功能、自护行为评分。结果护理前,2组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平比较,差异均无统计学意义(P>0.05);护理后,2组患者空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于护理前,且观察组低于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者血清肌酐(Cr)、尿素(URE-A)、血清胱抑素C(CysC)水平比较,差异均无统计学意义(P>0.05);护理后,2组患者血清Cr、URE-A、CysC水平均低于护理前,且观察组低于对照组,差异均有统计学意义(P<0.05)。护理前,2组患者总体饮食、具体饮食、运动、血糖监测、足部护理、吸烟各维度评分比较,差异均无统计学意义(P>0.05);护理后,2组患者总体饮食、具体饮食、运动、血糖监测、足部护理、吸烟各维度评分均高于护理前,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论分阶段转变护理能明显改善糖尿病肾病患者的血糖水平、肾功能及自护行为,值得在临床上推广使用。

Objective To investigate the effects of the transtheoretical model on the glycemic control,renal function and self-care behaviors in patients with diabetic nephropathy.Methods Seventy patients with diabetic nephropathy admitted to a hospital in Fuzhou from June 2019 to August 2020 were selected as study subjects and divided into control group(35 cases)and observation group(35 cases)using a random number table.Patients in the control group were given conventional nursing interventions,and patients in the observation group were given nursing interventions based on the transtheoretical model in addition,and both groups received nursing care for 24 weeks.The glycemic control,renal function,and self-care behavior scores of patients in the 2 groups before and after care were compared.Results Before care,the differences in fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin levels between the two groups were not statistically significant(P>0.05);after care,the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin levels of the two groups were lower than those before care and lower in the observation group than in the control group,with statistically significant differences(P<0.05).Before care,the differences in serum Cr,URE-A and CysC levels between the 2 groups were not statistically significant(P>0.05);after care,the serum Cr,URE-A and CysC levels in the 2 groups were lower than those before nursing care and lower in the observation group than in the control group,with statistically significant differences(P<0.05).Before care,there was no statistically significant difference between the scores of the dimensions of overall diet,specific diet,exercise,blood glucose monitoring,foot care,and smoking in the 2 groups(P>0.05);after care,the scores of the dimensions of overall diet,specific diet,exercise,blood glucose monitoring,foot care,and smoking in the 2 groups were higher than before care and higher in the observation group than in the control group,with statistically significant differences(P<0.05).Conclusion Care based on the transtheoretical model can significantly improve the blood glucose level,renal function and self-care behaviors of patients with diabetic nephropathy,and it is worth to be promoted in clinical use.