延伸护理对糖尿病合并脑卒中病人自护行为的影响

Influence of extended nursing care on self-care behavior of diabetes patients complicated with stroke

[目的]探讨实施延伸护理服务对糖尿病合并脑卒中病人自护行为的影响。[方法]选取2013年12月—2014年12月在我院住院的糖尿病合并脑卒中病人91例,采用抛硬币法将入选病人随机分成对照组和观察组。对照组出院后给予常规出院护理;观察组在常规出院护理的基础上开展延伸护理服务,落实延伸护理实施方案。观察指标为出院后病人日常生活能力(ADL)评分、糖尿病自护行为量表评分和糖化血红蛋白水平。[结果]两组病人出院时自护行为、Barthel指数和糖化血红蛋白水平比较差异无统计学意义(P>0.05)。观察组出院后12个月自护行为评分、Barthel指数明显优于对照组,差异有统计学意义(P<0.01),出院后3个月、6个月、12个月糖化血红蛋白水平为(7.99±0.94)%,(7.51±0.62)%,(7.13±0.44)%与对照组[(8.84±0.93)%,(8.55±0.84)%,(8.33±0.82)%]比较差异有统计学意义(t值分别为4.263,6.628,8.606,P<0.01)。[结论]延伸护理服务可强化糖尿病合并脑卒中病人及家属自我管理意识,有效提高病人独立生活能力。

Objective:To explore the effect of extended nursing service on self-care behavior of patients with diabetes mellitus complicated with stroke.Methods:A total of 91 patients with diabetes mellitus complicated with stroke were enrolled in our hospital from December 2013 to December 2014.All patients were randomly divided into control group and observation group by flip-coin method.Patients in the control group were given routine nursing care after discharged from the hospital.The observation group cases were carried out extended nursing service on the basis of routine discharge nursing,and implemented the extended nursing implementation plan.The ADL score,self-care behavior scale and glycosylated hemoglobin(HbA1c)of all patients were measured.Results:There was no significant difference in self-care behavior,Barthel index and glycosylated hemoglobin level between two groups(P>0.05).Both self-care behavior scoring and Barthel index of observation group patients were significantly higher than that of the control group at 12 months after discharge(P<0.01).And the level of glycosylated hemoglobin at 3months,6months and 12 months after discharge were(7.99±0.94)%,(7.51±0.62)%,(7.13±0.44)%respectively.Which were significantly different from those in the control group[(8.84±0.93)%,(8.55±0.84)%,(8.33±0.82)%,t=4.263,6.628,8.606,P<0.01].Conclusions:Extended nursing service can strengthen the awareness of self-management of diabetes patients complicated with stroke and their families.It could improve the independent living ability of patients as well.