协同护理模式对阴虚热盛型T2DM患者出院后自我管理能力的影响
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摘要
目的探讨基于中医特色健康教育的协同护理模式(CCM)对阴虚热盛型T2DM(2型糖尿病)患者出院后自我管理能力的影响。方法选取84例于2017年4月—2017年9月在河南省中医院内分泌科住院的阴虚热盛型T2DM患者进行观察,每组各42人。对照组给予常规护理,试验组在对照组的基础上采取基于中医特色健康教育的协同护理模式,干预3个月后,分别评估2组患者的2型糖尿病自我管理行为能力、糖尿病患者生存质量特异性、糖尿病知识测评及相关生理指标,探讨基于中医特色健康教育的协同护理模式对出院后阴虚热盛型2型糖尿病患者的干预效果。结果试验组在2型糖尿病自我管理行为能力、糖尿病患者生存质量特异性、糖尿病知识测评得分与对照组相比,差异具有统计学意义(P<0.05);干预组FPG、2hFBG与HbA1c显著低于对照组(P<0.05)。结论患者出院后,协同护理干预小组成员继续运用协同护理模式随访患者、进行健康教育,可帮助患者在院外持续改善其自我管理能力、生活质量及血糖控制情况。基于中医特色健康教育的协同护理模式的干预效果明显优常规宣教和护理,值得进一步坚持和完善,为中医慢病管理模式提供依据。
Objective To explore the effec t of cooperative nur sing mode based on characteristic health education of TCM on selfmanagement ability of type 2 diabetes mellitus with yin deficiency and heat. Methods Using the method of convenient sampling, 84 cases of T2 dm with yin deficiency and heat were selected from April 2017 to September 2017 in department of endocrinology of Henan Province Hospital of Traditional Chinese Medicine. Excel2007 was used to divide the subjects into two groups, with 42 in the experimental group and 42 in the control group. The control group was given routine nursing. The experimental group adopted the cooperative nursing model based on the health education of traditional Chinese medicine on the basis of the control group. After 3months of intervention, the two groups of patients were assessed the self-management behavior scale of type 2 diabetes mellitus. The quality of life(QOL) scale, diabetes knowledge scale(DKM) and related physiological indexes were used to explore the intervention effect of the cooperative nursing model based on the characteristic health education of traditional Chinese medicine on type 2 diabetes mellitus with yin deficiency and heat. Results The self-management behavior ability, quality of life specificity scale and diabetes knowledge test score of the patients in the experimental group were compared with those in the control group, and the difference had statistical significance(P<0.05). The FPG, 2hFBG and HbA1 c in the experimental group were significantly lower than those in the control group(P<0.05). Conclusion After discharge from hospital, the members of the cooperative nursing intervention group continue to follow up the patients using the cooperative nursing model, and carry out health education, which can help the patients to continuously improve their self-management ability, quality of life and blood sugar control outside the hospital. The intervention effect of synergetic nursing model based on health education with TCM characteristics is obviously superior to that of routine education and nursing. It is worth to adhere to and improve further, and to provide the basis for the management mode of chronic disease in TCM.
Objective To explore the effec t of cooperative nur sing mode based on characteristic health education of TCM on selfmanagement ability of type 2 diabetes mellitus with yin deficiency and heat. Methods Using the method of convenient sampling, 84 cases of T2 dm with yin deficiency and heat were selected from April 2017 to September 2017 in department of endocrinology of Henan Province Hospital of Traditional Chinese Medicine. Excel2007 was used to divide the subjects into two groups, with 42 in the experimental group and 42 in the control group. The control group was given routine nursing. The experimental group adopted the cooperative nursing model based on the health education of traditional Chinese medicine on the basis of the control group. After 3months of intervention, the two groups of patients were assessed the self-management behavior scale of type 2 diabetes mellitus. The quality of life(QOL) scale, diabetes knowledge scale(DKM) and related physiological indexes were used to explore the intervention effect of the cooperative nursing model based on the characteristic health education of traditional Chinese medicine on type 2 diabetes mellitus with yin deficiency and heat. Results The self-management behavior ability, quality of life specificity scale and diabetes knowledge test score of the patients in the experimental group were compared with those in the control group, and the difference had statistical significance(P<0.05). The FPG, 2hFBG and HbA1 c in the experimental group were significantly lower than those in the control group(P<0.05). Conclusion After discharge from hospital, the members of the cooperative nursing intervention group continue to follow up the patients using the cooperative nursing model, and carry out health education, which can help the patients to continuously improve their self-management ability, quality of life and blood sugar control outside the hospital. The intervention effect of synergetic nursing model based on health education with TCM characteristics is obviously superior to that of routine education and nursing. It is worth to adhere to and improve further, and to provide the basis for the management mode of chronic disease in TCM.
引文
[1] International DF:IDF Diabetes Atlas 6th edn. Brussels,Belgium:International Diabetes Federation,2013.
[2] Barengo N C,Tuomilehto J:Diabetes:exercise benefits in type 2 diabetes mellitus. Nat Rev Endocrinol,2012,8:635-636.
[3] Yacov Fogelman,Margalit Goldfracht,Khaled Karkabi. Managing Diabetes Mellitus:A Survey of Attitudes and Practices Among Family Physicians[J]. J Community Health(2015)40:1002-1007.
[4]王广. 116例2型糖尿病患者中医证型与相关因素研究[J]. CJCM中医临床研究,2017,9(20):11-13.
[5]张文佳,付晓乐,辛效毅. 2型糖尿病中医证型与临床生化指标的关系[J].南京中医药大学学报,2017,33(5):484-487.
[6]王家琳,陶存武,冀舒文,等. 2型糖尿病胰岛素抵抗的中医药治疗与研究[J].中医药临床杂志,2010,22(1):28-31.
[7]方平,郭敏英,何珍秀.耳穴压豆联合中药贴敷对早期糖尿病患者的护理效果观察[J].湖南中医杂志,2016,32(9):116-118.
[8]韦庆波,吴云川.八段锦对2型糖尿病患者健康状态调节临床研究[J].辽宁中医药大学学报,2014,16(1):103-105.
[9]郭焕开,陈小荷,李春喜,等.协同护理模式对血液透析患者自我护理能力和生活质量的影响[J].中国医药科学,2017,7(7):112-114.
[10]陈丽,苏晓燕,刘玉峰.协同护理模式提高血液透析患者自我护理能力和透析治疗依从性[J].中国医学创新,2017,14(7):89-91.
[11]周卫征,徐向红.协同护理模式在提高2型糖尿病患者生活质量中的应用分析[J].重庆医学,2016,45(17):2444-2446.
[12]唐艳,韦春华,邹东华.协同护理应用于2型糖尿病患者的效果[J].中国医药导报,2015,12(34):158-161.
[13]周鑫,胡正斌,叶啟发,等.协同护理模式在肾移植术后的应用[J].武汉大学学报(医学版),2016,37(4):662-665.
[14]张艳,高珊,崔鲜妮,等.协同护理模式在2型糖尿病患者中的应用研究[J].护理管理杂志,2016,16(9):664-666.
[15] Marcia V,Gregory W D,Teague S,et al. Implemen-ting the Collaborative Care Mode as Part ofa County-wide Initative[J]. Psychiatr Serv,2016,[EPub ahead of Print].
[2] Barengo N C,Tuomilehto J:Diabetes:exercise benefits in type 2 diabetes mellitus. Nat Rev Endocrinol,2012,8:635-636.
[3] Yacov Fogelman,Margalit Goldfracht,Khaled Karkabi. Managing Diabetes Mellitus:A Survey of Attitudes and Practices Among Family Physicians[J]. J Community Health(2015)40:1002-1007.
[4]王广. 116例2型糖尿病患者中医证型与相关因素研究[J]. CJCM中医临床研究,2017,9(20):11-13.
[5]张文佳,付晓乐,辛效毅. 2型糖尿病中医证型与临床生化指标的关系[J].南京中医药大学学报,2017,33(5):484-487.
[6]王家琳,陶存武,冀舒文,等. 2型糖尿病胰岛素抵抗的中医药治疗与研究[J].中医药临床杂志,2010,22(1):28-31.
[7]方平,郭敏英,何珍秀.耳穴压豆联合中药贴敷对早期糖尿病患者的护理效果观察[J].湖南中医杂志,2016,32(9):116-118.
[8]韦庆波,吴云川.八段锦对2型糖尿病患者健康状态调节临床研究[J].辽宁中医药大学学报,2014,16(1):103-105.
[9]郭焕开,陈小荷,李春喜,等.协同护理模式对血液透析患者自我护理能力和生活质量的影响[J].中国医药科学,2017,7(7):112-114.
[10]陈丽,苏晓燕,刘玉峰.协同护理模式提高血液透析患者自我护理能力和透析治疗依从性[J].中国医学创新,2017,14(7):89-91.
[11]周卫征,徐向红.协同护理模式在提高2型糖尿病患者生活质量中的应用分析[J].重庆医学,2016,45(17):2444-2446.
[12]唐艳,韦春华,邹东华.协同护理应用于2型糖尿病患者的效果[J].中国医药导报,2015,12(34):158-161.
[13]周鑫,胡正斌,叶啟发,等.协同护理模式在肾移植术后的应用[J].武汉大学学报(医学版),2016,37(4):662-665.
[14]张艳,高珊,崔鲜妮,等.协同护理模式在2型糖尿病患者中的应用研究[J].护理管理杂志,2016,16(9):664-666.
[15] Marcia V,Gregory W D,Teague S,et al. Implemen-ting the Collaborative Care Mode as Part ofa County-wide Initative[J]. Psychiatr Serv,2016,[EPub ahead of Print].