基于IMB模型的运动干预对妊娠期糖尿病孕妇血糖控制、自我管理能力及妊娠结局的影响

Effects of exercise intervention based on IMB model on blood glucose control,self-management ability and pregnancy outcome of pregnant women with gestational diabetes mellitus

目的:探讨基于信息-动机-行为技巧模型(IMB模型)的运动干预对妊娠期糖尿病(GDM)孕妇血糖控制、自我管理能力及妊娠结局的影响。方法:将100例GDM患者根据干预方式的不同分为两组,予以常规运动干预的为对照组(n=50);予以基于IMB模型运动干预的为观察组(n=50)。两组均干预4周。比较两组干预前后GDM运动知、信、行水平[GDM运动知识-态度-行为问卷]、自我管理能力[孕妇自我保健管理评定问卷]、血糖水平[空腹血糖(FPG)、糖化血红蛋白(HbAlc)水平,餐后2 h血糖(2 hPG)],随访至患者分娩,比较两组患者血糖控制不佳入院率、孕期体重增长超标、分娩后口服葡萄糖耐量试验(OGTT)不达标率及妊娠结局。结果:相较于对照组,干预后,观察组GDM运动知识、态度及行为评分均更高(P<0.05);孕妇自我保健管理评定问卷总分及各维度评分均更高(P<0.05);观察组FBG、2 hPG及HbA1c均更低(P<0.05),血糖控制不佳入院、孕期体重增长超标及分娩后OGTT不达标总发生率均更低(P<0.05)。观察组患者妊娠不良结局总发生率均低于对照组(P<0.05)。结论:基于IMB模型的运动干预可提高GDM患者运动知、信、行水平及自我管理能力,有效控制患者血糖,改善母婴结局。

Objective:To explore the effect of exercise intervention based on information-motivation-behavioral skills model(IMB model)on blood glucose control,self-management ability and pregnancy outcome of pregnant women with gestational diabetes mellitus(GDM).Methods:A total of 100 GDM patients were divided into two groups according to the different intervention methods,50 cases of routine exercise intervention were divided into control group,50 cases of exercise intervention based on IMB model were divided into observation group.The two groups were intervened for 4 weeks.The GDM exercise knowledge,attitude and behavior level(GDM exercise knowledge-attitude-behavior questionnaire),self-management ability(self-care management assessment questionnaire for pregnant women),blood glucose level[fasting blood glucose(FPG),glycosylated hemoglobin(HbAlc)level,postprandial 2 h blood glucose(2 hPG)]before and after intervention were compared between the two groups.Follow-up to the patient's delivery.The admission rate of poor blood glucose control,excessive weight gain during pregnancy,failure rate of oral glucose tolerance test(OGTT)after delivery and pregnancy outcomes were compared between the two groups.Results:Compared with the control group,the scores of knowledge,attitude and behavior in the GDM exercise knowledge-attitude-behavior questionnaire after intervention in the observation group were higher(P<0.05),and the total score of the self-care management assessment questionnaire for pregnant women and the scores of each dimension were higher(P<0.05).Compared with the control group,FBG,2 hPG and HbA1 c were lower in the observation group after intervention(P<0.05),and the total incidence of poor blood glucose control,excessive weight gain during pregnancy and OGTT failure after delivery was lower(P<0.05).The overall incidence of adverse pregnancy outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion:Exercise intervention based on IMB model can improve the level of exercise knowledge,attitude and behavior and self-management ability of GDM patients,effectively control blood glucose and improve maternal and infant outcomes.