基于健康赋权的NNN-链接健康管理对妊娠期糖尿病患者妊娠结局的影响

Effects of Health Empowerment-based NNN-linked Health Management on Pregnancy Outcomes of Patients with Gestational Diabetes Mellitus

目的 分析基于健康赋权的NNN-链接健康管理对妊娠期糖尿病患者妊娠结局的影响,为临床应用提供参考。方法 选取2017年6月至2019年6月就诊于唐山市丰润区人民医院符合妊娠期糖尿病诊断标准的555例患者作为研究对象,将其简单随机分为观察组(n=278)与对照组(n=277)。对照组接受常规门诊保健指导,观察组在此基础上,围绕“健康维持无效”的护理诊断,基于健康赋权理论的4个层面及NNN-链接的5个阶段,实施基于健康赋权的NNN-链接健康管理。采用自行编制的“针对健康维持无效的NNN-链接护理结局问卷”评估比较干预前后两组患者的护理结局及妊娠结局。结果 干预后,除社会支持外,观察组患者的护理结局指标评分均高于对照组,差异有统计学意义(P<0.05)。且观察组患者孕期体质量增长情况以及妊娠期高血压疾病、胎膜早破、剖宫产、新生儿低血糖、巨大儿等情况发生率均低于对照组(P<0.05)。结论 基于健康赋权NNN-链接的健康管理可有效提高GDM患者的健康行为和自我照护能力,有利于促进妊娠结局改善。

ObjectiveTo analyze the effects of health empowerment-based NNN-linked health management on pregnancy outcomes of patients with gestational diabetes mellitus(GDM), providing a reference for clinical application.MethodsA total of 555 patients who met the diagnostic criteria of gestational diabetes mellitus and visited Tangshan Fengrun People’s Hospital from June 2017 to June 2019 were selected. They were randomly divided into the observation group(n=278) and the control group(n=277). The control group received routine healthcare guidance in the outpatient;the observation group, on this basis, received health empowerment(4 domains)-based NNN(5 stages)-linked health management, around the nursing diagnosis of "ineffective health maintenance". A self-developed NNN-linked nursing outcome questionnaire for ineffective health maintenance was used to assess and compare the nursing outcomes and pregnancy outcomes between the two groups before and after the intervention.ResultsAfter the intervention, except for social support, the scores of nursing outcomes in the observation group were higher than those in the control group, with a statistically significant difference(P<0.05). The weight gain during pregnancy and the incidence of gestational hypertension, premature rupture of membranes, cesarean section, neonatal hypoglycemia and fetal macrosomia in the observation group were lower than those in the control group(P<0.05).ConclusionHealth empowerment-based NNN-linked health management can effectively improve the health behaviors and selfcare abilities of GDM patients, which is conducive to the improvement of pregnancy outcomes.