妊娠期糖尿病患者基于O2O的医护志愿者联动健康教育的实施
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摘要
目的探讨基于O2O理念的医护志愿者联动健康教育对妊娠期糖尿病患者孕期管理效果及分娩结局的影响。方法将妊娠期糖尿病患者140例采用随机数字表法分为对照组、观察组各70例。对照组按常规实施健康教育,观察组实施基于O2O理念的医护志愿者联动健康教育。比较两组自我管理行为、自我管理效能和血糖及分娩结局。结果观察组干预后自我管理行为、自我管理效能总分显著高于对照组;妊娠期血糖与糖化血红蛋白水平显著优于对照组;剖宫产率、新生儿低血糖发生率显著低于对照组(P<0.05,P<0.01)。结论对妊娠期糖尿病患者实施基于O2O理念的医护志愿者联动健康教育,有利于提高其自我管理行为、自我管理效能,控制孕期血糖及体质量,降低不良妊娠结局的发生。
Objective To explore the effect of the health education coordinated by medical staff and volenteers based on online-to-offline(O2 O) conception on management effect during pregnancy and delivery outcome for patients with gestational diabetes mellitus.Methods Totally 140 patients with gestational diabetes mellitus were randomized into a control group and an observation group using a random number table, with 70 patients in each group.The control group were given routine health education, while the observation group received the health education coordinated by medical staff and volenteers based on O2 O conception. The self-management behavior, self-management efficacy, blood glucose and delivery outcomes between the two groups were compared.Results After the intervention, the score of self-management behavior and self-management efficacy in the observation group were significantly higher than those of the control group, the blood glucose during pregnancy and glycosylated hemoglobin were significantly better than those of the control group, the rate of cesarean section and neonatal hypoglycemia were significantly lower than that of the control group(P<0.05,P<0.01).Conclusion Implementation of the health education coordinated by medical staff and volenteers based on O2 O conception for patients with gestational diabetes mellitus, is conducive to improving patients′ self-management behavior and self-management efficacy, controlling blood glucose and body weight during pregnancy, and reducing adverse pregnancy outcomes.
Objective To explore the effect of the health education coordinated by medical staff and volenteers based on online-to-offline(O2 O) conception on management effect during pregnancy and delivery outcome for patients with gestational diabetes mellitus.Methods Totally 140 patients with gestational diabetes mellitus were randomized into a control group and an observation group using a random number table, with 70 patients in each group.The control group were given routine health education, while the observation group received the health education coordinated by medical staff and volenteers based on O2 O conception. The self-management behavior, self-management efficacy, blood glucose and delivery outcomes between the two groups were compared.Results After the intervention, the score of self-management behavior and self-management efficacy in the observation group were significantly higher than those of the control group, the blood glucose during pregnancy and glycosylated hemoglobin were significantly better than those of the control group, the rate of cesarean section and neonatal hypoglycemia were significantly lower than that of the control group(P<0.05,P<0.01).Conclusion Implementation of the health education coordinated by medical staff and volenteers based on O2 O conception for patients with gestational diabetes mellitus, is conducive to improving patients′ self-management behavior and self-management efficacy, controlling blood glucose and body weight during pregnancy, and reducing adverse pregnancy outcomes.
引文
[1] 谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:75-79.
[2] Bhavadharini B,Uma R,Saravanan P,et al.Screening and diagnosis of gestational diabetes mellitus-relevance to low and middle income countries[J].Clin Diabetes Endocrinol,2016,13(2):1-8.
[3] 中华医学会妇产科学分会产科学组,中华医学会围产医学分会妊娠合并糖尿病协作组.妊娠合并糖尿病诊治指南(2017)[J].中国实用内科杂志,2018,38(4):328-330.
[4] Kleinwechter H,Sch?fer-Graf U,Bührer C,et al.Gestational diabetes mellitus (GDM) diagnosis,therapy and follow-up care:Practice Guideline of the German Diabetes Association (DDG) and the German Association for Gynaecology and Obstetrics (DGGG)[J].Exp Clin Endocrinol Diabetes,2014,122(7):395-405.
[5] Ferranti E P,Narayan K M,Reilly C M,et al.Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes[J].Diabetes Educ,2014,40(5):688-699.
[6] 姚丽萍,李兵晖,郭江波,等.妊娠糖尿病患者回馈教学式健康教育的实施[J].护理学杂志,2018,33(10):9-12.
[7] 徐蓉,尹世玉,汪晖,等.“O2O”理念在护理质量管理信息化平台构建中的应用[J].中国卫生质量管理,2015,6(22):7-8.
[8] 梁丽霞,昝琼,吴伟珍,等.一种妊娠期糖尿病饮食计算盘:201420019164.4[P].2014-01-13.
[9] 王璟璇,王瑞霞,林秋菊.门诊诊断初期非胰岛素依赖型糖尿病患者的自我照顾行为及其相关因素之探讨[J].护理杂志(台湾),1998,45(2):60-74.
[10] Wallston K A,Rothman R L,Cherrington A.Psychometric properties of the Perceived Diabetes Self-Management Scale (PDSMS)[J].J Behav Med,2007,30(5):395-401.
[11] 钟慧琴.社区糖尿病患者慢性病资源利用、自我效能及自我管理行为研究[D].石河子:石河子大学,2015.
[12] 章孟星,周英凤,钟婕,等.妊娠期糖尿病专科护士临床实践现状的质性研究[J].护理学杂志,2018,33(14):67-70.
[13] 曾超超,李晓敏,杜玉凤,等.基于微信平台的心理护理对妊娠期糖尿病患者焦虑的影响[J].中国健康心理学杂志,2017,25(8):1220-1224.
[14] 林娜佳,赵岳.网络互动式连续护理干预对妊娠期糖尿病患者生存质量的影响[J].天津护理,2017,25(2):102-105.
[15] Dennis C L.Peer support within a health care context:a concept analysis[J].Int J Nurs Stud,2003,40(3):321-332.
[16] 邹红,万小红,段嫄,等.同伴教育对妊娠期糖尿病患者自护行为的影响[J].护理学杂志,2013,28(12):79-81.
[17] 夏风华,吕燕.联动式健康教育模式在妊娠糖尿病患者中的应用[J].齐鲁护理杂志,2017,23(19):26-28.
[18] 郭红梅,尹卫,夏青.居家护理平台在妊娠期糖尿病患者随访管理中的应用[J].中华护理杂志,2018,53(5):517-522.
[19] Uauy R,Kain J,Corvalan C.How can the Developmental Origins of Health and Disease (DOHaD) hypothesis contribute to improving health in developing countries[J].Am J Clin Nutr,2011,94(6 Suppl):1759S-1764S.
[2] Bhavadharini B,Uma R,Saravanan P,et al.Screening and diagnosis of gestational diabetes mellitus-relevance to low and middle income countries[J].Clin Diabetes Endocrinol,2016,13(2):1-8.
[3] 中华医学会妇产科学分会产科学组,中华医学会围产医学分会妊娠合并糖尿病协作组.妊娠合并糖尿病诊治指南(2017)[J].中国实用内科杂志,2018,38(4):328-330.
[4] Kleinwechter H,Sch?fer-Graf U,Bührer C,et al.Gestational diabetes mellitus (GDM) diagnosis,therapy and follow-up care:Practice Guideline of the German Diabetes Association (DDG) and the German Association for Gynaecology and Obstetrics (DGGG)[J].Exp Clin Endocrinol Diabetes,2014,122(7):395-405.
[5] Ferranti E P,Narayan K M,Reilly C M,et al.Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes[J].Diabetes Educ,2014,40(5):688-699.
[6] 姚丽萍,李兵晖,郭江波,等.妊娠糖尿病患者回馈教学式健康教育的实施[J].护理学杂志,2018,33(10):9-12.
[7] 徐蓉,尹世玉,汪晖,等.“O2O”理念在护理质量管理信息化平台构建中的应用[J].中国卫生质量管理,2015,6(22):7-8.
[8] 梁丽霞,昝琼,吴伟珍,等.一种妊娠期糖尿病饮食计算盘:201420019164.4[P].2014-01-13.
[9] 王璟璇,王瑞霞,林秋菊.门诊诊断初期非胰岛素依赖型糖尿病患者的自我照顾行为及其相关因素之探讨[J].护理杂志(台湾),1998,45(2):60-74.
[10] Wallston K A,Rothman R L,Cherrington A.Psychometric properties of the Perceived Diabetes Self-Management Scale (PDSMS)[J].J Behav Med,2007,30(5):395-401.
[11] 钟慧琴.社区糖尿病患者慢性病资源利用、自我效能及自我管理行为研究[D].石河子:石河子大学,2015.
[12] 章孟星,周英凤,钟婕,等.妊娠期糖尿病专科护士临床实践现状的质性研究[J].护理学杂志,2018,33(14):67-70.
[13] 曾超超,李晓敏,杜玉凤,等.基于微信平台的心理护理对妊娠期糖尿病患者焦虑的影响[J].中国健康心理学杂志,2017,25(8):1220-1224.
[14] 林娜佳,赵岳.网络互动式连续护理干预对妊娠期糖尿病患者生存质量的影响[J].天津护理,2017,25(2):102-105.
[15] Dennis C L.Peer support within a health care context:a concept analysis[J].Int J Nurs Stud,2003,40(3):321-332.
[16] 邹红,万小红,段嫄,等.同伴教育对妊娠期糖尿病患者自护行为的影响[J].护理学杂志,2013,28(12):79-81.
[17] 夏风华,吕燕.联动式健康教育模式在妊娠糖尿病患者中的应用[J].齐鲁护理杂志,2017,23(19):26-28.
[18] 郭红梅,尹卫,夏青.居家护理平台在妊娠期糖尿病患者随访管理中的应用[J].中华护理杂志,2018,53(5):517-522.
[19] Uauy R,Kain J,Corvalan C.How can the Developmental Origins of Health and Disease (DOHaD) hypothesis contribute to improving health in developing countries[J].Am J Clin Nutr,2011,94(6 Suppl):1759S-1764S.