慢性疾病轨迹模式护理干预在1型脆性糖尿病患者中的应用

Application of nursing intervention based on chronic disease trajectory model in patients with type 1 fragile diabetes mellitus

目的:探讨慢性疾病轨迹模式护理干预在1型脆性糖尿病患者中的应用效果。方法:选择我院2020年1月至2021年6月收治的112例1型脆性糖尿病患者为研究对象,采用双盲法分为观察组与对照组,每组56例。对照组患者实施常规医学护理干预,观察组患者采用慢性疾病轨迹模式的护理干预,采用糖尿病生存质量特异性量表(disease specific quality of life,DSQL)、连续葡萄糖监测系统(continuous glucose monitoring system,CGMS)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)等量表评价,比较2组不同护理干预对患者生存质量评分、血糖变化监测情况、心理焦虑和抑郁评分、护理满意度等。结果:观察组患者DSQL评分低于对照组(P<0.01);平均血糖标准差(standard deviation of blood glucose,SDBG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)等连续葡萄糖监测指标低于对照组(P<0.01);观察组患者SAS、SDS评分均低于对照组(P<0.01);血清尿酸(serum uric acid,UA)、体重指数(body mass index,BMI)均高于对照组(P<0.01);观察组患者护理满意度高于对照组(P<0.05)。结论:慢性疾病轨迹模式的目标护理干预应用于1型脆性糖尿病患者效果显著,可有效改善糖尿病患者相关血液指标,降低血糖,提高生存质量,从心理层面消除焦虑、抑郁等情绪,提高患者满意度。

Objective:To explore the application effect of nursing intervention based on chronic disease trajectory model in patients with type 1 diabetes mellitus.Methods:A total of 112 patients with type 1 fragile diabetes mellitus treated in our hospital from Jan 2020 to Jun 2021 were selected and divided into the observation group and the control group by double blind method,with 56 patients in each group.The control group received routine medical nursing intervention,and the observation group received nursing intervention based on chronic disease trajectory model.The diabetes-specific quality of life scale(DSQL),continuous glucose monitoring system(CGMS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the quality of life,blood glucose monitoring,psychological anxiety and depression score of the two groups,and satisfaction degree was compared.Results:Compared with the control group,the DSQL score in the observation group was significantly lower(P<0.01).The continuous glucose monitoring indexes such as standard deviation of blood glucose(SDBG)and mean amplitude of glycemic excursions(MAGE)in the observation group were significantly lower(P<0.01).And the scores of SAS and SDS in the observation group were also lower(P<0.01).Serum uric acid(UA),body mass index(BMI)and nursing satisfaction in the observation group were higher than those in the control group(P<0.05).Conclusions:The target nursing intervention based on chronic disease trajectory model is effective in the treatment of type 1 fragile diabetes patients.It can effectively improve blood related indexes of diabetic patients,reduce blood sugar,improve the quality of life,eliminate anxiety and depression,and improve patients'satisfaction.