问题导向式护理干预对老年2型糖尿病患者自护能力及疾病感知能力的影响

Effect of problem-oriented nursing intervention on self-care ability and disease perception ability of elderly patients with type 2 diabetes mellitus

目的:探究问题导向式护理干预对老年2型糖尿病(T2DM)患者自护能力和疾病感知能力的影响。方法:选择2016年11月至2018年11月海军第九七一医院的老年T2DM患者42例,进行为期6个月的问题导向式护理干预。对比护理干预前后患者的血糖控制情况、自护能力和疾病感知能力。自护能力使用糖尿病自护行为量表进行评价,疾病感知能力使用糖尿病疾病感知问卷简表进行评价。干预前后各指标的比较采用t检验。结果:与干预前比较,护理干预后患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均明显下降(t=5.183、14.188、4.926,P<0.05),自护能力各项目(总体饮食、具体饮食、运动、血糖测试、足部护理、吸烟)和疾病感知能力各项目(认知描绘、情绪描绘、综合理解)评分均明显提高(t=14.730、12.965、6.414、10.995、10.525、10.502、9.879、10.926、23.662,P<0.05)。结论:问题导向式护理干预能够通过提高老年T2DM患者的自护能力和疾病感知能力,达到更好地控制血糖的目的。

Objective To investigate the effect of problem-oriented nursing intervention on self-care ability and disease perception ability of elderly patients with type 2 diabetes mellitus(T2DM).Methods Totally 42 elderly patients with T2DM in the No.971 Hospital of Chinese PLA Navy from November 2016 to November 2018 were selected for 6 months of problem-oriented nursing intervention.The blood glucose control,self-care ability and disease perception ability of patients before and after nursing intervention were compared.The self-care ability was evaluated by the summary of diabetes self-care activities questionnaire,and the disease perception ability was evaluated by brief illness perception questionnaire.T test was used to compare the indexes before and after intervention.Results After nursing intervention,the levels of fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin of patients decreased(t=5.138,14.188,4.926,P<0.05),and the scores of selfcare ability(including general diet,specific diet,exercise,blood sugar testing,foot care and smoking)and disease perception ability(including cognitive representation,emotional representation,illness coherence)were improved(t=14.730,12.965,6.414,10.995,10.525,10.502,9.879,10.926,23.622,P<0.05).Conclusion Problem-oriented nursing intervention can better control blood glucose in elderly patients with T2DM by improving their self-care ability and disease perception ability.