分层随访在2型糖尿病患者中的应用研究
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摘要
目的 :分析分层随访对2型糖尿病患者自我效能水平、自我管理能力以及糖代谢指标的影响。方法 :本研究为随机对照试验,便利选取大连市某三级甲等医院内分泌科住院的2型糖尿病患者100例为研究对象,通过区组随机方法将其分为实验组和对照组,每组50例。对照组给予常规随访干预,实验组按照分层随访管理方案进行随访。在干预前后,分别评估两组患者的自我效能水平、自我管理能力、空腹血糖、餐后2 h血糖和糖化血红蛋白值。结果 :通过6个月的干预,实验组患者的自我效能水平和自我管理能力得分高于对照组,差异均有统计学意义(P<0.05);与对照组相比,实验组患者的空腹血糖、餐后2 h血糖和糖化血红蛋白值下降,差异均具有统计学意义(P<0.05)。结论:分层随访可以提高2型糖尿病患者的自我效能水平和自我管理能力,改善患者的糖代谢指标,是一种有效的糖尿病随访方法。
Objective: To analyze the effects of stratified follow-up intervention on self-efficacy, self-management and glucose metabolism in type 2 diabetic patients. Methods: A total of 100 patients with type 2 diabetes in the department of endocrinology in a tertiary grade A hospital were randomly divided into the experimental group(n=50) and the control group(n=50). The patients in the control group were given routine follow up, meanwhile patients in the experimental group were treated according to the standards of stratified follow-up. The self-efficacy, self-management ability, fasting blood-glucose,2 hours postprandial blood glucose and glycosylated hemoglobin were measured before and after the intervention. Results:After 6 months of intervention, the scores of self-efficacy and self-management in the experimental group were significantly higher than those in the control group(P<0.05). Compared with the control group, the fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin decreased in the experimental group(P<0.05). Conclusion: Stratified follow-up can improve the self-efficacy and self-management ability of patients with type 2 diabetes mellitus, and effectively improve the glucose metabolism. It is an effective follow-up plan for patients with diabetes mellitus.
Objective: To analyze the effects of stratified follow-up intervention on self-efficacy, self-management and glucose metabolism in type 2 diabetic patients. Methods: A total of 100 patients with type 2 diabetes in the department of endocrinology in a tertiary grade A hospital were randomly divided into the experimental group(n=50) and the control group(n=50). The patients in the control group were given routine follow up, meanwhile patients in the experimental group were treated according to the standards of stratified follow-up. The self-efficacy, self-management ability, fasting blood-glucose,2 hours postprandial blood glucose and glycosylated hemoglobin were measured before and after the intervention. Results:After 6 months of intervention, the scores of self-efficacy and self-management in the experimental group were significantly higher than those in the control group(P<0.05). Compared with the control group, the fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin decreased in the experimental group(P<0.05). Conclusion: Stratified follow-up can improve the self-efficacy and self-management ability of patients with type 2 diabetes mellitus, and effectively improve the glucose metabolism. It is an effective follow-up plan for patients with diabetes mellitus.
引文
[1]InternationalDiabetes Federation. IDF Diabetes Atlas-8th ed.(2017). http://www.diabetesatlas.org/.
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[4] Feachem GA, Sekhri NK,White KL. Getting more for their dollar:a comparison of the NHS with California's Kaiser Permanente. BMJ, 2002,324(7330):135-141.
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[6]吴林秀,应燕萍,罗霰宇.出院高血压患者Triangle分层分级管理标准的制定.中国全科医学,2017,20(12):1415-1421.Wu LX, Ying YP, Luo XY. Establishment of triangle hierarchical classification management standards of discharged patients with hypertension.Chin Gen Prac, 2017,20(12):1415-1421.
[7]倪平,陈京立,刘娜.护理研究中量性研究的样本量估计.中华护理杂志,2010,45(4):378-380.Ni P, Chen JL, Liu N. Sample size estimation of quantitative research in nursing research. Chin J Nurs, 2010,45(4):378-380.
[8]中华医学会内分泌学分会.中国成人2型糖尿病HbA1C控制目标的专家共识.中华内分泌代谢杂志,2011,27(5):371-374.Chinese Society of Endocrinology. Expert consensus of HbA1C control target for Chineses adult with type 2 diabetes. Chin J Endocrinol Metab, 2011,27(5):371-374.
[9] Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure:results from 7 studies and a revised scale. Diabetes Care, 2000,23(7):943-950.
[10]万巧琴,尚少梅,来小彬,等.2型糖尿病患者自我管理行为量表的信、效度研究.中国实用护理杂志,2008,24(7):26-27.Wan QQ, Shang SM, Lai XB, et al. Study on the reliability and validity of summary of diabetes self-care activities for type 2 diabetes patients.Chin J Prac Nurs, 2008,24(7):26-27.
[11] Bijl JV, Poelgeest-Eeltink AV, ShortridgeBaggett L. The psychometric properties of the diabetesmanagementself-efficacyscalefor patients with type 2 diabetes mellitus. J Adv Nurs,1999,30(2):352-359.
[12]刘维维,王翠翠,刘聪兰.2型糖尿病患者自我效能与生活质量的相关性研究.中国实用护理杂志,2008,24(25):11-13.Liu WW, Wang CC, Liu CL. Relationship between quality of life and self-efficacy of patients with type-2 diabetes mellitus. Chin J Prac Nurs,2008,24(25):11-13.
[13]高翔.自理理论在护理管理中的应用.中国医院管理,2009,29(4):73.Gao X. Application of self-care theory in nursing management. Chin Hosp Manag, 2009,29(4):73.
[14]赵春宇,邢凤梅,李华丽.自我效能干预对2型糖尿病患者自我管理行为的影响.武警医学,2016,27(9):874-877.Zhao CY, Xing FM, Li HL. Self-efficacy interventiononself-managementactionsin patients with type 2 diabetes. Med J Chin Peop Arm Pol For, 2016,27(9):874-877.
[15]嵇加佳,刘林,楼青青,等.2型糖尿病患者自我管理行为及血糖控制现状的研究.中华护理杂志,2014,49(5):617-620.Ji JJ, Liu L, Lou QQ, et al. Self-management behaviors and glycemic control in patients with type 2 diabetes mellitus. Chin J Nurs, 2014, 49(5):617-620.
[16]谷伟军,纪立农,郭晓蕙,等.指南糖化血红蛋白达标值改变对中国城市2型糖尿病患者血糖控制的影响.中华内科杂志,2015,54(3):193-196.Gu WJ, Ji LN, Guo XH,et al. The impact of glycosylated hemoglobin target value in treatment guidelines on glycemic control of type 2 diabetic in Chinese cities. Chin J Intern Med, 2015,54(3):193-196.
[2]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版).中华糖尿病杂志,2018,10(1):4-67.Chinese Medical Association Diabetes Society.Guidelines for the prevention and treatment of type 2 diabetes in China(2017 Edition). Chinese Journal of Diabetes Mellitus, 2018,10(1):4-67.
[3]王艾红,尹安春,谢莹莹,等.糖尿病共病管理的研究进展.中国护理管理,2018,18(12):1709-1713.Wang AH,Yin AC,Xie YY,et al. Research progress in diabetic multimorbidity management.Chin Nurs Manag, 2018,18(12):1709-1713.
[4] Feachem GA, Sekhri NK,White KL. Getting more for their dollar:a comparison of the NHS with California's Kaiser Permanente. BMJ, 2002,324(7330):135-141.
[5]孙柳,苏春燕,孙庆华,等.门诊腹膜透析患者分层分级管理的实践.中国护理管理,2012,12(5):75-78.Sun L, Su CY, Sun QH, et al. Implementing hierarchical management approach to manage outpatients with peritoneal dialysis. Chin Nurs Manag, 2012,12(5):75-78.
[6]吴林秀,应燕萍,罗霰宇.出院高血压患者Triangle分层分级管理标准的制定.中国全科医学,2017,20(12):1415-1421.Wu LX, Ying YP, Luo XY. Establishment of triangle hierarchical classification management standards of discharged patients with hypertension.Chin Gen Prac, 2017,20(12):1415-1421.
[7]倪平,陈京立,刘娜.护理研究中量性研究的样本量估计.中华护理杂志,2010,45(4):378-380.Ni P, Chen JL, Liu N. Sample size estimation of quantitative research in nursing research. Chin J Nurs, 2010,45(4):378-380.
[8]中华医学会内分泌学分会.中国成人2型糖尿病HbA1C控制目标的专家共识.中华内分泌代谢杂志,2011,27(5):371-374.Chinese Society of Endocrinology. Expert consensus of HbA1C control target for Chineses adult with type 2 diabetes. Chin J Endocrinol Metab, 2011,27(5):371-374.
[9] Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure:results from 7 studies and a revised scale. Diabetes Care, 2000,23(7):943-950.
[10]万巧琴,尚少梅,来小彬,等.2型糖尿病患者自我管理行为量表的信、效度研究.中国实用护理杂志,2008,24(7):26-27.Wan QQ, Shang SM, Lai XB, et al. Study on the reliability and validity of summary of diabetes self-care activities for type 2 diabetes patients.Chin J Prac Nurs, 2008,24(7):26-27.
[11] Bijl JV, Poelgeest-Eeltink AV, ShortridgeBaggett L. The psychometric properties of the diabetesmanagementself-efficacyscalefor patients with type 2 diabetes mellitus. J Adv Nurs,1999,30(2):352-359.
[12]刘维维,王翠翠,刘聪兰.2型糖尿病患者自我效能与生活质量的相关性研究.中国实用护理杂志,2008,24(25):11-13.Liu WW, Wang CC, Liu CL. Relationship between quality of life and self-efficacy of patients with type-2 diabetes mellitus. Chin J Prac Nurs,2008,24(25):11-13.
[13]高翔.自理理论在护理管理中的应用.中国医院管理,2009,29(4):73.Gao X. Application of self-care theory in nursing management. Chin Hosp Manag, 2009,29(4):73.
[14]赵春宇,邢凤梅,李华丽.自我效能干预对2型糖尿病患者自我管理行为的影响.武警医学,2016,27(9):874-877.Zhao CY, Xing FM, Li HL. Self-efficacy interventiononself-managementactionsin patients with type 2 diabetes. Med J Chin Peop Arm Pol For, 2016,27(9):874-877.
[15]嵇加佳,刘林,楼青青,等.2型糖尿病患者自我管理行为及血糖控制现状的研究.中华护理杂志,2014,49(5):617-620.Ji JJ, Liu L, Lou QQ, et al. Self-management behaviors and glycemic control in patients with type 2 diabetes mellitus. Chin J Nurs, 2014, 49(5):617-620.
[16]谷伟军,纪立农,郭晓蕙,等.指南糖化血红蛋白达标值改变对中国城市2型糖尿病患者血糖控制的影响.中华内科杂志,2015,54(3):193-196.Gu WJ, Ji LN, Guo XH,et al. The impact of glycosylated hemoglobin target value in treatment guidelines on glycemic control of type 2 diabetic in Chinese cities. Chin J Intern Med, 2015,54(3):193-196.