基于互动达标理论的延续性护理在糖尿病视网膜病变患者中的应用

Study on the application of continuity nursing in patients with diabetic retinopathy based on the interactive attainment theory

目的 观察基于互动达标理论的延续性护理对糖尿病视网膜病变(DR)患者血糖水平、自我管理能力及生命质量的影响。方法 选择2020年6月—2021年7月在温州医科大学附属衢州医院接受治疗的DR患者92例,依照建档顺序,分为2组,每组46例。对照组采取常规护理,试验组在对照组基础上采取互动达标理论主导的延续性护理,均干预1年。比较2组视力、血糖、自我管理能力及视功能生活质量等指标变化。结果 干预后,试验组视力下降率为2.17%(1/46),明显低于对照组的17.39%(8/46,χ^(2)=4.343,P=0.035);干预后试验组空腹血糖、餐后2 h血糖水平分别为(5.74±0.66)mmol/L、(9.35±0.92)mmol/L,均低于对照组[(6.79±0.87)mmol/L、(11.41±1.00)mmol/L,t=6.521、10.282,均P<0.001]。干预后试验组饮食、运动、遵医嘱用药、血糖监测及足部管理得分均高于对照组(均P<0.01)。干预后,试验组除眼痛、色觉外,其余各项视功能相关生命质量评分均高于对照组(均P<0.01)。结论 基于互动达标理论的延续性护理可提高DR患者的自我管理能力,控制血糖、视力水平,改善患者生活质量。

Objective To observe the effect of continuous nursing based on the interactive attainment theory on blood glucose levels,self-management ability and quality of life in patients with diabetes retinopathy(DR).Methods A total of 92 patients with DR who were treated at the Quzhou Hospital of Wenzhou Medical University from June 2020 to July 2021 were selected and divided into 2 groups of 46 cases each,according to the order of the files.The control group received regular nursing care,and the experimental group received continuity nursing based on the interactive standard theory.Both interventions were continued for 1 year.Changes of visual acuity,blood glucose,self-management ability,visual function and quality of life were compared between the 2 groups.Results After the intervention,the visual acuity decline rate in the experimental group was 2.17%(1/46),which was significantly lower than 17.39% in the control group(8/46,χ^(2)=4.343,P=0.035);After the intervention,the fasting blood glucose and 2 h postprandial blood glucose levels in the experimental group were(5.74±0.66) mmol/L,(9.35±0.92) mmol/L respectively,which were lower than those in the control group [(6.79±0.87) mmol/L,(11.41±1.00) mmol/L,t=6.521,10.282,both P<0.001].After the intervention,scores for diet,exercise,medication according to medical advice,blood glucose monitoring and foot management were higher in the experimental group than those in the control group(all P<0.01).Except for eye pain and color perception,all quality of life scores related to visual function were higher in the experimental group than in the control group(all P<0.01).Conclusion The continuity nursing based on the theory of interactive standard can improve self-management ability,blood glucose control and visual acuity and quality of life for patients with DR.