院外延伸护理对精神分裂症合并糖尿病患者自我管理水平和控糖效果的影响

Effect of extended nursing care outside hospital on self-management level and glucose control in patients with schizophrenia complicated with diabetes mellitus

目的:探讨院外延伸护理对精神分裂症(schizophrenia,SCH)合并糖尿病(diabetes mellitus,DM)患者自我管理水平和控糖效果的影响。方法:选取2018年10月至2021年11月上海市精神卫生中心闵行院区收治的拟出院90例SCH合并DM患者,按住院单双号分成对照组(45例)与研究组(45例),对照组给予常规出院指导和随访,研究组开展院外延伸护理干预,持续观察6个月,比较两组糖尿病自我效能量表(Chinese Version Diabetes Management Self-Efficacy Scale,C-DMSES)、血糖指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(postprandial blood glucose,PBG)、糖化血红蛋白(hemoglobin A1C,HbA1C)]和血糖控制达标率。结果:对照组出院后6个月“饮食”“运动”评分和C-DMSES量表总分较护理前明显提高(P<0.05),研究组出院后6个月C-DMSES量表各维度评分及总分较护理前明显提高(P<0.05),也明显高于对照组(P<0.05)。两组出院后6个月FBG、PBG、HbA1C均较护理前明显下降(P<0.05),研究组出院后6个月FBG、PBG、HbA1C低于对照组,血糖控制达标率57.78%高于对照组35.56%(P<0.05)。结论:开展院外延伸护理能明显提高SCH合并DM患者的自我管理水平,降低血糖指标水平和提高血糖控制达标率。

Objective: To explore the effect of extended nursing care outside hospital on self-management level and glucose control in schizophrenia(SCH) patients with diabetes mellitus(DM). Methods: Ninety patients with SCH complicated with DM who were discharged from the Minhang District of Shanghai Mental Health Center from October 2018 to November 2021 were selected. According to the hospitalized odd and even numbers, they were divided into control group and study group, each with 45 cases. The control group was given routine discharge guidance and follow-up, whereas the study group was given extended nursing intervention outside the hospital. After continued observation for 6 months, the Chinese Version Diabetes Management Self-Efficacy Scale(C-DMSES), blood glucose indexes [fasting blood glucose(FBG), 2-hour postprandial blood glucose(PBG), hemoglobin A1C(HbA1C)] and the standard rate of blood glucose control were compared between the 2 groups. Results: The scores of adieto, aexerciseo and the total score of C-DMSES in the control group were significantly higher than those before nursing(P<0.05), and the scores of various dimensions and total scores of C-DMSES in the study group were significantly higher than those before nursing(P<0.05). FBG, PBG, and HbA1C in the 2 groups were significantly lower than those before nursing at 6 months a?ter hospital(P<0.05). FBG, PBG, and HbA1C in the study group were lower than those in the control group at 6 months a?ter hospital, and the standard rate of blood glucose control was 57.78% higher than 35.56% in the control group(P<0.05). Conclusion: Extended nursing outside the hospital can significantly improve the self-management level of SCH patients with DM, reduce the blood glucose index level and improve the standard rate of blood glucose control.