叙事医学教育模式对中高危糖尿病足患者血压、血糖水平和足部知识掌握的影响
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摘要
目的:观察叙事医学教育模式对中高危糖尿病足患者血压、血糖水平和足部知识掌握评分的影响。方法:以2014年10月至2015年10月就诊55例患者为对照组,实施常规护理教育;以2015年11月至2016年11月就诊的55例患者为观察组,实施叙事医学教育模式。2组均干预6个月,对比干预前后血压、血糖水平变化及足部知识掌握情况。结果:收缩压、舒张压及空腹血糖、餐后2小时血糖、糖化血红蛋白水平干预前后2组组内比较,差异有统计学意义(P<0.05);干预6个月后2组组间比较差异也有统计学意义(P<0.05)。对糖尿病基本知识、足部保健知识、糖尿病足的认识、足部损伤知识、正确穿鞋袜知识评分,干预6个月后2组组间比较差异有统计学意义(P<0.05)。结论:叙事医学教育模式能有效降低中高危糖尿病足患者血压水平,控制血糖,提高足部知识掌握率。
Objective:To discuss the influence of narrative medical education model on the scores of foot knowledge mastery, the level of blood pressure and blood glucose of middle and high risk diabetic foot patients.Methods: All 55 patients who visited from October, 2014 to October, 2015 were chosen as the control group, who accepted conventional nursing education; another 55 cases who visited from November, 2015 to November, 2016 were taken as the observation group, who received narrative medical education model. Foot knowledge mastery conditions, the levels of blood pressure and blood glucose were compared before and after the intervention after they were intervened for six months. Results: The difference had statistical meaning in the comparisons of systolic pressure, diastolic pressure, the levels of FBG, 2 hours postprandial blood glucose and glycosylated hemoglobin before and after the intervention within two groups(P <0.05); the difference showed statistical meaning in the comparisons of these indexes after intervening for six months between both groups(P<0.05). The difference had statistical meaning in the comparisons of basic knowledge of diabetes mellitus, foot healthcare knowledge, the understanding to diabetic foot, the knowledge of avoiding foot injury, the knowledge of wearing shoes and socks correctly and total scores of foot knowledge mastery between both groups after the intervention for six months(P <0.05). Conclusion: Narrative medical education model could effectively reduce the level of blood pressure of middle and high risk diabetic foot patients, control blood glucose and enhance foot knowledge mastery conditions.
Objective:To discuss the influence of narrative medical education model on the scores of foot knowledge mastery, the level of blood pressure and blood glucose of middle and high risk diabetic foot patients.Methods: All 55 patients who visited from October, 2014 to October, 2015 were chosen as the control group, who accepted conventional nursing education; another 55 cases who visited from November, 2015 to November, 2016 were taken as the observation group, who received narrative medical education model. Foot knowledge mastery conditions, the levels of blood pressure and blood glucose were compared before and after the intervention after they were intervened for six months. Results: The difference had statistical meaning in the comparisons of systolic pressure, diastolic pressure, the levels of FBG, 2 hours postprandial blood glucose and glycosylated hemoglobin before and after the intervention within two groups(P <0.05); the difference showed statistical meaning in the comparisons of these indexes after intervening for six months between both groups(P<0.05). The difference had statistical meaning in the comparisons of basic knowledge of diabetes mellitus, foot healthcare knowledge, the understanding to diabetic foot, the knowledge of avoiding foot injury, the knowledge of wearing shoes and socks correctly and total scores of foot knowledge mastery between both groups after the intervention for six months(P <0.05). Conclusion: Narrative medical education model could effectively reduce the level of blood pressure of middle and high risk diabetic foot patients, control blood glucose and enhance foot knowledge mastery conditions.
引文
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[9]何红,许亚红,徐国丽,等.“足底操”对0级糖尿病足患者周围神经病变及足底压力的影响[J].现代临床护理,2017,16(2):51-56.
[10]王丽芹,李思慕,孙忠人,等.应用协同护理模式减轻糖尿病足病人照顾者照顾负担的效果观察[J].护理研究,2017,31(11):1354-1356.
[11]冯泽会,龚芸,兰红敏,等.老年糖尿病足清创术后患者延续护理效果观察[J].护理学报,2017,24(2):70-72.
[12]Ren M,Yang C,Lin DZ,et al.Effect of intensive nursing education on the prevention of diabetic foot ulceration among patients with high-risk diabetic foot:a follow-up analysis[J].Diabetes technology&therapeutics,2014,16(9):576-581.
[13]Chin YF,Liang J,Wang WS,etal.Theroleoffootself-care behavior on developing foot ulcers in diabetic patients with peripheral neuropathy:a prospective study[J].In ternational journal of nursing studies,2014,51(12):1568-1574.
[14]段思柳,唐玲,刘宇,等.0级糖尿病足中药足浴护理效果的Meta分析[J].中国护理管理,2016,16(2):159-163.
[15]黄玉娟,朱佩玉.焦点解决模式对2型糖尿病足高危患者护理知识和行为的影响[J].天津护理,2016,24(3):215-217.
[16]曹月琴,顾亚萍,范海波,等.手把手教育在糖尿病患者足部自我护理训练中的应用[J].上海护理,2016,16(1):27-29.
[17]罗祥蓉,谢翠华,蒋娅,等.顽固性糖尿病压力性足溃疡患者的个性化减压护理效果观察[J].护理学报,2016,23(7):57-59.
[2]周雁琼,孙丽凯,刘运娣.Wagner 0级糖尿病足患者危险等级评估及护理管理策略[J].护理学杂志,2016,31(9):40-42.
[3]Pocuis J,Janci MM,Thompson HJ.Improving diabetic foot examination performance using electronic medical record tools in a specialty clinic[J].Computers,informatics,nursing:CIN,2015,33(5):173-176.
[4]陈慧利,王平,程丹丹,等.院外随访护理模式对糖尿病足病高危患者的影响[J].国际护理学杂志,2016,35(24):3324-3326.
[5]李静,张月华,王美君,等.2型糖尿病足高危患者的足部护理行为现状及影响因素分析[J].中国实用护理杂志,2015,31(18):1357-1360.
[6]许曼音.糖尿病学[M].上海:上海科学技术出版社,2010:177.
[7]Chang CF,Chang CC,Hwang SL,et al.Effects of buerger exercise combined health-pro moting program on peripheral neurovasculopathy among community residents at high risk for diabetic foot ulceration[J].Worldviews on evidence-based nursing/Sigma Theta Tau International[J].Honor Society of Nursing,2015,12(3):145-153.
[8]丁飚,张妮娜,卢逢娣,等.2型高危糖尿病足病人糖尿病知识的认知状况及其影响因素[J].护理研究,2016,30(13):1595-1599.
[9]何红,许亚红,徐国丽,等.“足底操”对0级糖尿病足患者周围神经病变及足底压力的影响[J].现代临床护理,2017,16(2):51-56.
[10]王丽芹,李思慕,孙忠人,等.应用协同护理模式减轻糖尿病足病人照顾者照顾负担的效果观察[J].护理研究,2017,31(11):1354-1356.
[11]冯泽会,龚芸,兰红敏,等.老年糖尿病足清创术后患者延续护理效果观察[J].护理学报,2017,24(2):70-72.
[12]Ren M,Yang C,Lin DZ,et al.Effect of intensive nursing education on the prevention of diabetic foot ulceration among patients with high-risk diabetic foot:a follow-up analysis[J].Diabetes technology&therapeutics,2014,16(9):576-581.
[13]Chin YF,Liang J,Wang WS,etal.Theroleoffootself-care behavior on developing foot ulcers in diabetic patients with peripheral neuropathy:a prospective study[J].In ternational journal of nursing studies,2014,51(12):1568-1574.
[14]段思柳,唐玲,刘宇,等.0级糖尿病足中药足浴护理效果的Meta分析[J].中国护理管理,2016,16(2):159-163.
[15]黄玉娟,朱佩玉.焦点解决模式对2型糖尿病足高危患者护理知识和行为的影响[J].天津护理,2016,24(3):215-217.
[16]曹月琴,顾亚萍,范海波,等.手把手教育在糖尿病患者足部自我护理训练中的应用[J].上海护理,2016,16(1):27-29.
[17]罗祥蓉,谢翠华,蒋娅,等.顽固性糖尿病压力性足溃疡患者的个性化减压护理效果观察[J].护理学报,2016,23(7):57-59.