基于行为目标达成度理念的健康教育对老年糖尿病患者服药依从性、自我效能及健康素养的影响

Effects of health education based on behavioral goal achievement concept on medication adherence,self-efficacy and health literacy in elderly patients with diabetes mellitus

目的 探究基于行为目标达成度理念的健康教育干预模式对老年糖尿病患者服药依从性、自我效能及健康素养的影响,以期优化老年糖尿病患者的护理选择。方法 回顾性分析2021年5月—2023年4月于中国中医科学院望京医院社区站就诊的134例老年糖尿病患者的临床资料,以是否接受基于行为目标达成度理念的健康教育,将患者分为观察组(n=67)和对照组(n=67)。2组在相同治疗基础上,对照组给予常规护理,观察组给予基于行为目标达成度理念的健康教育。观察并比较干预前及干预30 d时2组的空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)水平差异,以及健康素养(采用慢性病患者健康素养调查量表评估)、自我管理能力[采用糖尿病自我管理行为量表(SDSCA)评估]、生活质量[采用糖尿病生命质量量表(A-DQOL)评估]情况;观察并比较干预前、干预15 d、干预30 d时2组的自我效能感[采用糖尿病自我效能感量表(PDSMS)评估];比较干预30 d后2组的服药依从性[采用Morisky服药依从性量表(MMAS-8)评估]差异。结果 干预30 d, 2组患者FPG、 2 hPG、 HbA1c水平均低于同组干预前(P<0.05),观察组上述指标值均低于对照组(P<0.05);2组患者健康素养、 SDSCA、 PDSMS评分均高于同组干预前(P<0.05),观察组上述指标值高于对照组(P<0.05);2组患者A-DQOL评分均低于同组干预前(P<0.05),观察组A-DQOL评分低于对照组(P<0.05);观察组总依从率高于对照组(P<0.05)。结论 基于行为目标达成度理念的健康教育可提高老年糖尿病患者对糖尿病的认知水平;定期评估患者短期目标完成情况,有助于提高其自我效能感和服药依从性,增强个体自我管理能力,有助于控制疾病发展,最终改善其生活质量,具有良好的应用前景。

Objective To explore the effects of health education based on behavioral goal achievement concept on medication adherence,self-efficacy and health literacy in elderly patients with diabetes mellitus,and optimize the nursing options for elderly patients with diabetes mellitus.Methods The clinical data of elderly patients with diabetes mellitus who were admitted to Community Health Station of Wangjing Hospital of Chinese Academy of Chinese Medical Sciences from May 2021 to April 2023 were retrospectively analyzed.They were divided into observation group(n=67)and control group(n=67)according to whether they accepted health education based on behavioral goal achievement concept.On the basis of the same treatment,the control group was given routine nursing,and the observation group was given health education based on behavioral goal achievement concept.The levels of fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG)and glycosylated hemoglobin(HbA1c),as well as health literacy(assessed by Health Literacy Survey Scale for Patients with Chronic Diseases),self-management ability[assessed by Summary of Diabetes Self-Care Activities(SDSCA)]and quality of life[assessed by Adjusted Diabetes Quality of Life Scale(A-DQOL)]were observed and compared between the two groups before intervention and after 30 days of intervention.The self-efficacy[assessed by Perceived Diabetes Self-Management Scale(PDSMS)]was observed and compared between the two groups before intervention and after 15 days and 30 days of intervention.The difference of medication adherence[assessed by 8-item Morisky Medication Adherence Scale(MMAS-8)]was observed and compared between the two groups after 30 days of intervention.Results After 30 days of intervention,the levels of FPG,2 hPG and HbA1c of the two groups were lower than those of the same group before intervention(P<0.05),and the levels of above indexes of the observation group were lower than those of the control group(P<0.05);the scores of health literacy,SDSCA and PDSMS of the two groups were higher than those of the same group before intervention(P<0.05),and the above scores of the observation group were higher than those of the control group(P<0.05);A-DQOL scores of the two groups were lower than those of the same group before intervention(P<0.05),and A-DQOL score of the observation group was lower than that of the control group(P<0.05).The total adherence rate of the observation group was higher than that of the control group(P<0.05).Conclusion Health education based on behavioral goal achievement concept can improve the cognitive level of diabetes in elderly diabetes patients.Regular assessment of patients achievement of short-term goals can help improve their self-efficacy and medication adherence.Enhancing the self-management ability of individuals is helpful to control the development of diseases and ultimately improve their quality of life.It has a good application prospect.