基于行为转变理论的健康管理在妊娠期糖尿病患者中的应用效果

Application effects of health management based on behavioral change theory in patients with gestational diabetes mellitus

目的:观察基于行为转变理论的健康管理在妊娠期糖尿病(GDM)患者中的应用效果。方法:选取2019年9月至2021年10月该院收治的92例GDM患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各46例。对照组采用常规健康管理,研究组在对照组基础上采用基于行为转变理论的健康管理。比较两组护理前后自护能力[糖尿病患者自我管理行为量表(SDSCA)]评分、血糖指标[糖化血红蛋白(HbA1c)、餐后2 h血糖(2hPG)、空腹血糖(FBG)]水平,不良妊娠结局发生率和护理满意度。结果:护理1个月后,两组足部护理、运动护理、饮食护理、血糖监测、药物治疗等SDSCA评分均高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05);两组HbA1c、2hPG、FBG水平均低于护理前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组剖宫产、胎儿窘迫、巨大儿、早产儿、新生儿低血糖、新生儿窒息等不良妊娠结局发生率均低于对照组,差异有统计学意义(P<0.05);研究组护理满意度为93.48%(43/46),高于对照组的76.09%(35/46),差异有统计学意义(P<0.05)。结论:在常规健康管理基础上采用基于行为转变理论的健康管理可提高GDM患者的自护能力评分和护理满意度,降低血糖指标水平和不良妊娠结局发生率,其效果优于单纯常规健康管理。

Objective:To observe application effects of health management based on behavioral change theory in patients with gestational diabetes mellitus(GDM).Methods:A prospective study was conducted on 92 GDM patients admitted to the hospital from September 2019 to October 2021.They were divided into study group and control group according to the random number table method,46 cases in each group.The control group was treated with routine health management,while the study group was treated with the health management based on behavioral change theory on the basis of that of the control group.The self-care ability[summary of diabetes self-care activities(SDSCA)]score,the blood glucose index[glycosylated hemoglobin(HbA1c),2 h postprandial blood glucose(2hPG),fasting blood glucose(FBG)]levels before and after the nursing,the incidence of adverse pregnancy outcomes,and the nursing satisfaction were compared between the two groups.Results:After 1 month of nursing,the SDSCA scores of foot nursing,exercise nursing,diet nursing,blood glucose monitoring and drug treatment in the two groups were higher than those before the nursing,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of HbA1c,2hPG and FBG in the two groups were lower than those before the nursing,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse pregnancy outcomes such as cesarean section,fetal distress,macrosomia,premature infants,neonatal hypoglycemia,and neonatal asphyxia in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Further,the nursing satisfaction of the study group was 93.48%(43/46),which was higher than 76.09%(35/46)of the control group,and the difference was statistically significant(P<0.05).Conclusions:On the basis of the routine health management,the health management based on the behavioral change theory can improve the self-care ability scores and the nursing satisfaction of the GDM patients,and reduce the levels of blood glucose index and the incidence of adverse pregnancy outcomes.Moreover,it is superior to single routine health management.