基于“信息—动机—行为技巧”模型的护理干预对妊娠糖尿病患者母婴分娩结局的影响

Impact of nursing intervention based on information-motivation-behavioral skills model onmaternal-infant delivery outcomesinpatients with gestational diabetes mellitus

目的探讨基于“信息—动机—行为技巧”模型(IMB)的护理干预对妊娠期糖尿病(GDM)患者母婴分娩结局的影响。方法纳入本院产科住院的GDM患者160例,按照随机数字表简单随机分组法分为IMB组与传统健康教育组,各80例,以临产前为干预终点,随访至产后12周。比较两组患者干预期间胰岛素治疗情况、干预前及干预后空腹血糖(FPG)、糖化血红蛋白(HbA1c)控制情况及母婴不良分娩结局,并在产后6~12周评估糖代谢异常状况。结果IMB组干预期间胰岛素治疗率低于传统健康教育组(P<0.05)。干预后,两组FPG、HbA1c均较干预前降低,且IMB组干预后低于传统健康教育组(P<0.05)。IMB组剖宫产率及新生儿呼吸窘迫综合征发生率、随访12周糖代谢异常总发生率均低于传统健康教育组(P<0.05)。结论基于IMB模型的护理干预在控制血糖方面优于传统健康教育模式,改善母婴结局,减少产后糖代谢异常的发生。

Objective To explore the effects of nursing intervention based on information-motivation-behavioral skills model(IMB)on maternal-infant delivery outcomes in patients with gestational diabetes mellitus(GDM).Methods 160 patients with GDM who were hospitalized in thedepartment of obstetrics of ourhospital were enrolled and divided into an IMB group and a traditional health education group according to the simple random grouping method,with 80 in each group.The intervention endpoint was before delivery and the patients were followed up to 12 weeks after delivery.The insulin treatment status during intervention,controloffasting plasma glucose(FPG)and glycosylated hemoglobin(HbA1c)before and after intervention,and adverse maternal-infant delivery outcomes were compared between the two groups,and the abnormal glucose metabolism statuswas assessed6 to 12 weeks after delivery.Results The insulin treatment rate was lower in the IMB group thanin thetraditional health education groupduring intervention(P<0.05).After intervention,FPG and HbA1c were reduced in both groups as compared with those before intervention,and the two indicators were lowerin the IMB group thanin thetraditional health education group after intervention(P<0.05).The rate of Cesarean section,incidence of neonatal respiratory distress syndrome,andtotal incidence of abnormal glucose metabolism at 12 weeks of follow-up were lower in the IMB group than in thetraditional health education group(P<0.05).Conclusions Nursing intervention based on IMB model is more effective than traditional health education in the control of blood glucose,and it can improve maternal-infant outcomes and reduce occurrence of abnormal glucose metabolism after delivery.