ADOPT联合自我管理教育与支持干预对学龄期1型糖尿病患儿血糖管理的影响

Effects of ADOPT model combined with Diabetes Self-Management Education and Support program on glycemic management in school-aged children diagnosed with type 1 diabetes

目的探讨提高学龄期1型糖尿病患儿血糖控制水平、自我管理能力及生活质量的有效方法。方法将90例学龄期1型糖尿病患儿按照入院时间分为对照组与干预组各45例。对照组实施常规健康教育,干预组在此基础上实施ADOPT(态度Attitude、定义Definition、开放性思维Open mind、计划Planning、实施Trying)模式联合自我管理教育与支持干预。比较干预前,出院后1个月、3个月两组血糖水平及自我管理能力、生活质量。结果对照组44例、干预组42例完成研究。干预组患儿空腹血糖、餐后2 h血糖、自我管理能力及生活质量(除学校表现外)评分在时间效应、组间效应和交互效应上有统计学意义(均P<0.05)。出院后3个月干预组糖化血红蛋白显著低于对照组(P<0.05)。结论ADOPT模式联合自我管理教育与支持干预可改善患儿血糖控制水平,提高患儿自我管理能力及生活质量。

Objective To explore effective methods to improve the level of glycemic control,self-management ability and quality of life of school-age children with type 1 diabetes.Methods A total of 90 school-aged children with type 1 diabetes were divided into 45 cases each in a control group and an intervention group according to admission time.The control group was given routine health education,while the intervention group was additionally given the ADOPT(Attitude,Definition,Open mind,Planning,Trying)model combined with Diabetes Self-management Education and Support(DSMES)program.The blood glucose level,self-management ability and quality of life were compared between the two groups before the intervention,1 month and 3 months after discharge.Results There were 44 patients in the control group and 42 patients in the intervention group had completed the study.The fasting blood glucose,2h postprandial blood glucose,self-management ability and quality of life(except school performance)of the children in the intervention group were statistically significant in time effects,inter-group effects and interaction effects(all P<0.05).After 3 months of discharge,the glycosylated hemoglobin in the intervention group was significantly lower than that in the control group(P<0.05).Conclusion ADOPT model combined with DSMES program can improve the level of glycemic control,self-management ability and quality of life of children diagnosed with type 1 diabetes.