Cox健康行为互动模式在糖尿病肾病患者运动管理中的实践

Practice of interaction model of client health behaviour in exercise management of patients with diabetic kidney disease

目的探讨Cox健康行为互动模式对糖尿病肾病(diabetic kidney disease,DKD)患者运动自我管理行为和依从性、代谢指标、生活质量的影响。方法采用时间分组法,选择某三级甲等综合医院内分泌肾病内科2021年2月至5月入院的45例DKD患者为对照组,同年6月至9月入院的45例DKD患者为试验组。对照组接受常规健康护理指导和随访,试验组在对照组的基础上实施Cox健康行为互动模式干预,3个月后评价效果。结果与干预前、干预后的对照组相比,干预后试验组患者的糖尿病自我管理行为量表(summary of diabetes self-care activities,SDSCA)运动维度总分以及条目得分更高(均P<0.05),空腹血糖、餐后2h血糖、糖化血红蛋白水平更低(均P<0.05),生活质量量表(12-item short-form health survey,SF-12)总分及分维度得分更高(均P<0.05)。干预后试验组患者运动依从性中等及以上占比为73.8%,明显高于对照组的30.0%和干预前的31.0%,差异均有统计学意义(χ~2=15.766,P<0.001;χ~2=12.637,P=0.002)。结论基于Cox健康行为互动模式的运动干预,可提高DKD患者运动自我管理行为和依从性,改善血糖代谢指标和生活质量。

Objective To explore the effect of interaction model of client health behaviour(IMCHB) on behaviour of self-managed exercise,compliance,metabolic indicators and quality of life in patients with diabetic kidney disease(DKD). Methods From February2021 to May 2021,45 patients with DKD hospitalised in the Department of Endocrinology and Nephrology in our hospital were recruited as the control group using the time grouping method. Other group of 45 patients with DKD hospitalised from June 2021 to September 2021 were recruited as the trial group. Patients in the control group received routine health care guidance and follow-up. Patients in the trial group implemented IMCHB in addition to the control group. The effect was evaluated 3 months alter. Results Compared with what were before and after the intervention in the control group,in the trial group showed higher scores of exercise in the summary of diabetes self-care activities(SDSCA)(all P<0.05) and lower in level of fasting blood glucose,2 hrs postprandial blood glucose and glycosylated haemoglobin(all P<0.05),and higher the total score and sub dimension score in 12 item short-form health survey(SF-12)(all P <0.05). After the intervention,a moderate or higher exercise compliance of the patients in the trial group was at 73.8%. It was significantly higher than 30.0%in the control group and 31.0% seen in the trial group before intervention( χ~2=15.766,P <0.001;χ~2=12.637,P =0.002). Conclusion Exercise intervention based on IMCHB can improve the behaviour in exercise self-management and the compliance of DKD patients,as well as improve the blood glucose metabolism index and quality of life of patients.