同伴支持理念对1型糖尿病患儿延续护理应用效果探讨

Application of peer support concept in continuous nursing of children with type 1 diabetes mellitus

目的 由大数据显示,儿童青少年1型糖尿病已经成为继哮喘之后的又一大疾病,一旦发病则需要终身治疗。但少年儿童在治疗期间表现出的低依从性为临床工作带来了一定的阻碍。本研究探讨同伴支持理念在1型糖尿病患儿延续护理中的应用效果。方法 选取2017-01-03-2018-03-30郑州儿童医院收治的80例1型糖尿病患儿作为研究对象,根据护理方法分为常规组与支持组,每组40例。常规组予以常规延续性护理,支持组予以同伴支持理念进行延续性护理。对比两组护理后血糖情况及慢性病儿童应对方式(copingwitha disease,CODI)量表评分。结果 护理后,支持组空腹血糖为(7.25±0.67)mmol/L,低于常规组的(9.05±0.84)mmol/L,t=10.595,P<0.001;餐后2h血糖为(8.11±0.59)mmol/L,低于常规组的(10.08±0.78)mmol/L,t=12.739,P<0.001;糖化血红蛋白为(7.28±0.51)%,低于常规组的(9.13±0.46)%,t=17.036,P<0.001。支持组CODI量表中接受(t=31.622,P<0.001)、自我安慰(t=30.000,P<0.001)及幻想(t=19.799,P<0.001)得分均高于常规组,逃避(t=76.462,P<0.001)及负性情绪反应(t=30.771,P<0.001)得分均低于常规组,差异有统计学意义。结论 同伴支持理念应用在1型糖尿病患儿的延续护理中,可以显著改善患儿血糖水平,同时还可帮助患儿提升对待疾病的应对态度。

OBJECTIVE According to big data,type 1diabetes mellitus in children and adolescents has become another major childhood disease after asthma.Once the onset of type 1diabetes in adolescents and children,they need lifelong treatment.However,the low compliance of children and adolescents during treatment has brought some obstacles to clinical work.Therefore,this study aims to explore the application effect of peer support concept in the continuing care of children with type 1diabetes mellitus.METHODS 80children with type 1diabetes who were treated and discharged from our hospital were randomly divided into routine group and support group,40cases in each group.Children in routine group were given routine continuing nursing,while those in support group were given peer support concept for continuing nursing.The blood sugar of the two groups after nursing and the score of CODI scale of children with chronic diseases were compared.RESULTS After nursing,the fasting blood glucose in the support group was(7.25±0.67)mmol/L,lower than that in the routine group(9.05±0.84)mmol/L,t=10.595,P<0.001.The blood glucose at 2hours after meal was(8.11±0.59)mmol/L,lower than that in the routine group(10.08±0.78)mmol/L,t=12.739,P<0.001.The glycosylated hemoglobin was(7.28±0.51)%,lower than that in the routine group(9.13±0.46)%,t=17.036,P<0.001.The scores of acceptance(t=31.622,P<0.001),self-comfort(t=30.000,P<0.001),fantasy(t=19.799,P<0.001)in the support group were higher than those in the routine group.The scores of avoidance(t=76.462,P<0.001)and negative emotional reaction(t=30.771,P<0.001)were lower than those in the routine group,with significant differences.CONCLUSION The application of peer support concept in the continuing nursing of children with type 1diabetes can significantly improve their blood sugar level and help them improve their coping attitude toward the disease.