基于焦点解决技能教养法的糖尿病性视网膜病变患者自我管理及生存质量的干预研究

Intervention study on self-management and quality of life of patients with diabetic retinopathy based on solution-focused skills approach

目的评价焦点解决技能教养法对糖尿病性视网膜病变(DR)患者自我管理及生存质量的干预效果。方法选取2021年1月至2023年3月在树兰(杭州)医院眼科门诊就诊的DR患者123例,采用随机数字表法分为对照组60例和观察组63例。对照组进行传统健康宣教,观察组进行传统健康宣教联合焦点解决技能教养法。两组患者于干预前和干预后3个月分别接受中文版糖尿病自我管理行为量表(SDSCA)、糖尿病生存质量量表(DSQL)和中文版视功能相关生存质量量表(NEI-VFQ-25)的评估。结果在SDSCA中,观察组患者干预后总体饮食、具体饮食、运动锻炼、血糖监测、足部护理维度得分均高于干预前,差异均有统计学意义(均P<0.05)。在DSQL中,观察组患者干预后心理/精神和社会关系维度得分均低于对照组,差异均有统计学意义(均P<0.01)。在NEI-VFQ-25中,观察组患者干预后社交功能、精神健康、社会角色限制、依赖程度维度得分均高于对照组,差异均有统计学意义(均P<0.05)。结论焦点解决技能教养法能够有效提高DR患者的糖尿病自我管理行为能力及生存质量。

Objective To investigate the intervention effect of solution-focused skills approach on self-management and quality of life of patients with diabetic retinopathy(DR).Methods A total of 123 DR outpatients admitted to the Department of Ophthalmology of Shulan(Hangzhou)Hospital from January 2021 to March 2023 were selected and divided into two groups according to random number table method,with 60 cases in control group and 63 cases in observation group.The control group received the traditional health education,and the observation group was treated with solutionfocused skills approach in addition to the traditional health education.Patients of both groups were evaluated using the Chinese version scale of the diabetes self-care activities(SDSCA),the diabetes specific quality of life scale(DSQL),and the 25-item National Eye Institute visual function questionnaire(NEI-VFQ-25)before and 3 months after the intervention.Results In the SDSCA,the scores of the general diet,specific diet,exercise,blood-glucose testing and foot care dimensions in the observation group were higher after the intervention compared to before,and the differences were statistically significant(all P<0.05).In the DSQL,the scores of the psychological/mental dimension and social relationship dimension in the observation group were lower than those in the control group after the intervention,and the differences were statistically significant(both P<0.01).In the NEI-VFQ-25,the scores of the social functioning,mental health,role difficulties and dependency dimensions in the observation group were higher than those in the control group after the intervention,and the differences were statistically significant(all P<0.05).Conclusion Solution-focused skills approach can effectively improve the ability of self-management on diabetes and quality of life of patients with DR.