基于HAPA理论的护理干预在糖尿病视网膜病变患者中的应用

Effects of nursing intervention based on HAPA theory in patients with diabetes retinopathy

目的研究基于健康行动过程取向(HAPA)理论的护理干预对糖尿病视网膜病变患者随访依从性及血糖管理的影响。方法采用便利抽样法, 选取2022年10月-2023年5月在山西省眼科医院糖尿病眼底病科门诊就诊的102例糖尿病视网膜病变患者作为研究对象, 将2022年10月-2023年1月就诊的51例患者作为对照组, 2023年2-5月就诊的51例患者作为观察组。对照组接受常规护理, 观察组在此基础上接受基于HAPA模型的护理干预, 比较两组患者随访依从率、糖尿病眼科随访依从性问卷(CADEES-C)得分、空腹血糖(FBG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbA1c)的水平差异。结果观察组患者6个月后随访依从率高于对照组, 差异有统计学意义(P<0.05)。观察组患者6个月后CADEES-C各维度评分及总分均高于对照组, 差异有统计学意义(P<0.05)。观察组患者在3个月、6个月后的FBG和2hPG均低于对照组, 差异具有统计学意义(P<0.05)。但干预6个月后观察组和对照组的HAb1c水平差异无统计学意义(P>0.05)。结论基于HAPA理论的护理干预可有效提高糖尿病视网膜病变患者的随访依从性, 增强患者随访健康信念, 同时改善了患者的血糖控制。

Objective To explore the effect of nursing intervention based on the health action process approach(HAPA)theory on follow-up compliance and blood glucose management of patients with diabetes retinopathy(DR).Methods From October 2022 to May 2023,102 DR patients who visited the Diabetes Fundus Clinic of Shanxi Eye Hospital were selected by convenience sampling as participants.A total of 51 patients who visited from October 2022 to January 2023 were selected as control group,and 51 patients who visited from February to May 2023 were selected as observation group.Control group received routine nursing,while observation group received nursing intervention based on HAPA theory on this basis.The follow-up compliance,Chinese version of the Compliance with Annual Diabetic Eye Exams Survey(CADEES-C)score,fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG)and glycosylated hemoglobin(HbA1c)were compared between the two groups.Results The compliance of DR patients in observation group after six months of follow-up was higher than that in control group,and the difference was statistically significant(P<0.05).After six months,the CADEES-C dimension scores and total score of DR patients in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).FBG and 2hPG of DR patients in observation group were lower than those in control group after three and six months,and the dfferences were statistically significant(P<0.05).After six months of intervention,there was no statistically significant difference in HbAlc between observation group and control group(P>0.05).Conclusions Nursing interventions based on HAPA theory can effectively improve the follow-up compliance of DR patients,enhance their health beliefs during follow-up,and improve their blood glucose.