基于代谢性疾病管理中心平台健康教育在出院后2型糖尿病患者中的应用
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摘要
目的评价基于国家标准化代谢性疾病管理中心(National Metabolic Management Center,MMC)平台在出院后2型糖尿病患者综合管理中的应用效果观察。方法选择2017年11月-2018年4月在本院内分泌科住院的150例2型糖尿病患者为研究对象,按入院先后次序编号,根据随机数字表法,将150例患者随机分为对照组和试验组各75例。两组患者在住院期间均接受常规的综合护理,对照组出院后采用电话随访和糖尿病门诊教育、健康讲座进行干预;试验组在对照组基础上基于MMC平台实施健康教育,评价两组患者干预前后自我管理行为和血糖值的差异。结果干预后,试验组患者足部护理、饮食控制、血糖监测、规律锻炼、糖尿病知识、遵嘱用药评分和自我管理行为总分均高于对照组;试验组空腹血糖、餐后2h血糖和糖化血红蛋白值均低于对照组,差异均有统计学意义(P<0.001)。结论基于MMC平台健康教育在提高出院后2型糖尿病患者的自我管理行为,改善患者空腹血糖、餐后血糖及糖化血红蛋白水平均较常规健康教育方法具有显著优势,有利于糖尿病控制。
Objective To evaluate the efficacy of health education based onNational Metabolic Management Center(MMC platform in self-management behavior and control of blood sugar level in patients with type 2 diabetes after discharge from hospital.Method From November 2017 to April 2018, 150 patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology in our hospital were selected as study subjects. According to the order of admission, 150 patients were divided into control group and observation group by random number table method. The patients in the control group were given the health education guidance of diabetes knowledge on the day of discharge, and the patients were given health education by telephone follow-up and outpatient medication after discharge. The observation group strengthened the blood glucose management based on the MMC platform in the control group. Result The total scores of diet control, blood glucose monitoring, regular exercise, diabetes knowledge, medication,prevention and treatment of hypoglycemia and self-management behavior in the observation group were higher than those in the control group. The difference between the two groups was statistically significant(P <0.001);After intervention, fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin in the observation group were significantly lower than those in the control group,and the difference was statistically significant.(P<0.01). Conclusion Health education based on metabolic disease management information platform can improve the self-management behavior scores of type 2 diabetes patients after discharge, and effectively control fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin levels, which is worthy of clinical promotion.
Objective To evaluate the efficacy of health education based onNational Metabolic Management Center(MMC platform in self-management behavior and control of blood sugar level in patients with type 2 diabetes after discharge from hospital.Method From November 2017 to April 2018, 150 patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology in our hospital were selected as study subjects. According to the order of admission, 150 patients were divided into control group and observation group by random number table method. The patients in the control group were given the health education guidance of diabetes knowledge on the day of discharge, and the patients were given health education by telephone follow-up and outpatient medication after discharge. The observation group strengthened the blood glucose management based on the MMC platform in the control group. Result The total scores of diet control, blood glucose monitoring, regular exercise, diabetes knowledge, medication,prevention and treatment of hypoglycemia and self-management behavior in the observation group were higher than those in the control group. The difference between the two groups was statistically significant(P <0.001);After intervention, fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin in the observation group were significantly lower than those in the control group,and the difference was statistically significant.(P<0.01). Conclusion Health education based on metabolic disease management information platform can improve the self-management behavior scores of type 2 diabetes patients after discharge, and effectively control fasting blood glucose, postprandial blood glucose and glycosylated hemoglobin levels, which is worthy of clinical promotion.
引文
[1]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)[J].中国实用内科杂志,2018, 38(4):292-342.
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[3]MCCOY R G,VAN HOUTEN H K, ZIEGENFUSS J Y,et al.Increased mortality of patients with diabetes reporting severe hypoglycemia[J].Diabetes Care, 2012,35(9):1897-1901.
[4]张申秀,孙新,戴俭慧,等.糖尿病健康教育模式的进展[J].临床护理,2011,10(4):60-62.
[5]叶山东.2型糖尿病患者个体化血糖达标对策[J].中国临床保健杂志,2014,17(1):1-2.
[6]曹雪莲,刘俐惠,刘焕宁.糖尿病健康宣教网络化构想[J].中华糖尿病杂志,2014,22(7):216-219.
[7]内分泌代谢病研究所.关于开展“标准化代谢性疾病管理中心(MMC)项目的通知[EB/OL].(2018-01-15)(2018-05-12). http://www.national-mmc.com/.
[8]余珊,王波.糖尿病健康教育研究进展[J].昆明医科大学学报,2018,39(4):130-134.
[9]路云,章蓉,常峰,等.不同健康教育投入程度对糖尿病患者的影响分析[J].重庆医学,2015,44(9):1244-1246.
[10]张兆楠,蔺芊菲,李响.住院糖尿病患者自我管理水平与健康教育的需求[J].国际护理学杂志,2016,35(21):2952-2953.
[11]杨晶,李菁,周立新,等.2型糖尿病患者自我管理行为与血糖波动现状的研究[J].中国临床医生杂志,2017,45(10):53—55.
[12]A P M, G M D. Response to comment on powers et al.Diabetes self-management education and support in type2 diabetes:A joint position statement of the American diabetes association, the American association of diabetes educations,and the academy of nutrition and dietetics[J].Diabetes care,2016,39(1):1372-1382.
[13]朱戊冲,陈文亮,黄燕杏,等.知信行模式健康教育对社区糖尿病患者的干预效果[J].广东医学,2018,39(9):1395-1397.
[14]SHAHANI S,SHAHANI L.Use of insulin in diabetes:a century of treatment[J]. Hong Kong Med J,2015,21(6):553-559.
[15]段荣华,徐晓燕,郁红,等.个体化全程健康教育模式在糖尿病患者护理中的作用[J].解放军护理杂志,2018,35(13):33-36.
[16]夏景波.个体化健康教育对糖尿病患者治疗依从性的影响[J].中国继续医学教育,2017,9(4):204-206.
[17]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[J].中华护理杂志,2014,49(5):618-620.
[2]黄济华,梁瑜祯.识别及处置糖尿病并发低血糖的“窍门”[J].中华内科杂志,2016,55(12):959-961.
[3]MCCOY R G,VAN HOUTEN H K, ZIEGENFUSS J Y,et al.Increased mortality of patients with diabetes reporting severe hypoglycemia[J].Diabetes Care, 2012,35(9):1897-1901.
[4]张申秀,孙新,戴俭慧,等.糖尿病健康教育模式的进展[J].临床护理,2011,10(4):60-62.
[5]叶山东.2型糖尿病患者个体化血糖达标对策[J].中国临床保健杂志,2014,17(1):1-2.
[6]曹雪莲,刘俐惠,刘焕宁.糖尿病健康宣教网络化构想[J].中华糖尿病杂志,2014,22(7):216-219.
[7]内分泌代谢病研究所.关于开展“标准化代谢性疾病管理中心(MMC)项目的通知[EB/OL].(2018-01-15)(2018-05-12). http://www.national-mmc.com/.
[8]余珊,王波.糖尿病健康教育研究进展[J].昆明医科大学学报,2018,39(4):130-134.
[9]路云,章蓉,常峰,等.不同健康教育投入程度对糖尿病患者的影响分析[J].重庆医学,2015,44(9):1244-1246.
[10]张兆楠,蔺芊菲,李响.住院糖尿病患者自我管理水平与健康教育的需求[J].国际护理学杂志,2016,35(21):2952-2953.
[11]杨晶,李菁,周立新,等.2型糖尿病患者自我管理行为与血糖波动现状的研究[J].中国临床医生杂志,2017,45(10):53—55.
[12]A P M, G M D. Response to comment on powers et al.Diabetes self-management education and support in type2 diabetes:A joint position statement of the American diabetes association, the American association of diabetes educations,and the academy of nutrition and dietetics[J].Diabetes care,2016,39(1):1372-1382.
[13]朱戊冲,陈文亮,黄燕杏,等.知信行模式健康教育对社区糖尿病患者的干预效果[J].广东医学,2018,39(9):1395-1397.
[14]SHAHANI S,SHAHANI L.Use of insulin in diabetes:a century of treatment[J]. Hong Kong Med J,2015,21(6):553-559.
[15]段荣华,徐晓燕,郁红,等.个体化全程健康教育模式在糖尿病患者护理中的作用[J].解放军护理杂志,2018,35(13):33-36.
[16]夏景波.个体化健康教育对糖尿病患者治疗依从性的影响[J].中国继续医学教育,2017,9(4):204-206.
[17]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[J].中华护理杂志,2014,49(5):618-620.