延续护理对2型糖尿病患者疾病转归及生活质量的影响研究

发布时间：2018-05-27 19:05

本文选题：延续护理 + 2型糖尿病　；参考：《南昌大学》2015年硕士论文

【摘要】：目的:本课题通过为2型糖尿病患者提供延续护理服务,评价延续护理对糖尿病患者疾病转归、生活质量的影响效果;为糖尿病延续护理服务广泛开展提供科学依据;这对提高糖尿病患者生活质量,改善其疾病预后具有重要意义。方法:本研究为类实验性研究,于2014年6月至2015年2月施行;采用方便抽样方法,选取深圳市某三级甲等医院121例2型糖尿病住院患者并分为干预组和对照组;干预组采用延续护理服务措施,对照组则不采取任何干预;于患者出院前1天、出院后3个月、出院后6个月3个时间点评估患者空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2h plasma glucose,2h PG)、糖化血红蛋白(hemoglobin A1c,Hb A1c)、体重指数(body mass index,BMI)、舒张压(diastolic pressure,DS)、收缩压(Systolic pressure,SD)、自我管理行为和生活质量情况。采用糖尿病延续护理评估量表(diabetes continuity of care questionnaire,DCCQ)对患者接受到的延续护理水平进行描述;采用糖尿病特异性生活质量量表(chinese normal audit of diabetes dependent quality of life,CN-ADDQOL)、糖尿病自我管理行为量表(diabetes self-efficacy scale,DSES)对干预结果进行描述和评价。结果:1、出院后6个月,干预组患者延续护理背景资料管理得(77.89±11.11)分、糖尿病咨询(66.19±10.26)分、沟通(72.31±10.34)分;体格检查(69.20±6.04)分、合作(63.59±12.92)分、关系处理(77.34±12.90)分、护理进程(3.00±1.01)分、信任(71.78±5.89)分。2、两组患者出院前1天血糖水平及代谢特征无明显差异,基线相同;两组患者糖化血红蛋白值在出院后3个月和6个月有差异(t=4.206,P0.05;t=5.336,P0.05);两组患者空腹血糖值在出院后6个月有差异(t=1.788,P0.05)。3、血糖水平重复测量结果显示,空腹血糖、餐后2h血糖和糖化血红蛋白的时间点因素都有显著意义(F=33.249,P=0.000;F=153.694,P=0.000;F=117.066,P=0.000);三者观测时间点和组别之间存在交互作用(F=9.070,P=0.001;F=7.213,P=0.002;F=13.522,P=0.000);空腹血糖和餐后2h血糖组别无显著意义(F=9.070,P=0.118;F=0.000,P=0.994);糖化血红蛋白组别有显著意义(F=10.992,P=0.001)。4、两组患者自我管理行为总分及各个维度得分在出院前1天和出院后3个月的差异均无统计学意义(均P0.05);出院6个月后,两组患者在规律锻炼、遵医嘱服药和血糖监测、足部护理三个维度得分差异具有统计学意义(P值分别为0.003、0.030、0.000,均小于0.05)。重复测量模型中时间点因素(F=11170.713,P=0.000)和组别(F=8268.386,P=0.000)亦有差异。5、两组患者在出院前1天和出院后3个月两个时间点生活质量总分及各个维度得分无差异(均P0.05);出院后6个月饮食维度得分存在差异(P=0.003,P0.05),其他维度得分无差异(均P0.05);重复测量模型中时间点因素(F=7456.659,P=0.000)、观测时间点和组别之间有交互关系(F=277.957,P=0.000)、组别间都有显著性意义(F=12.628,P=0.000)。6、本研究多元回归分析显示:延续护理量表中信息合成、人际关系维度与病程、年龄共同解释血糖下降80.1%的变异量。结论:1、参与本研究的2型糖尿病患者接受的延续护理水平较高,自我管理水平和生活质量水平均较低。2、延续护理干预可提高2型糖尿病患者自我管理水平,对患者的生活质量有提升的作用,干预实施时间越长效果越好。3、血糖水平的影响因素有病程、年龄和延续护理水平等,延续护理的实施可以有效降低患者的血糖水平,且施行时间越长,干预效果越明。
[Abstract]:Objective: to provide continuous nursing service for patients with type 2 diabetes, to evaluate the effect of continuous nursing on the outcome of diabetes and the quality of life, and to provide a scientific basis for the extensive development of diabetes care service, which is of great significance for improving the quality of life and improving the prognosis of the patients with diabetes. The study was carried out from June 2014 to February 2015. Using the convenient sampling method, 121 hospitalized patients with type 2 diabetes in the three grade a hospital in Shenzhen were selected and divided into the intervention group and the control group. The intervention group adopted the continuation nursing service measures and the control group did not take any intervention; 1 days before discharge, 3 months after discharge from the hospital. Fasting plasma glucose (FPG), 2 hours 2H plasma glucose, 2h PG, glycated hemoglobin (hemoglobin A1c, Hb), diastolic pressure, systolic blood pressure, self management behavior and quality of life were assessed at 6 months and 3 hours after discharge. Diabetes continuity of care questionnaire (DCCQ) was used to describe the level of continuity of care received by the patients; the diabetes specific quality of life scale (Chinese normal audit of diabetes dependent), the diabetes self-management behavior scale The results were described and evaluated by betes self-efficacy scale, DSES). Results: 1, 6 months after discharge, the nursing background information of the patients in the intervention group was managed (77.89 + 11.11), diabetes consultation (66.19 + 10.26), communication (72.31 + 10.34), physical examination (69.20 + 6.04), cooperation (63.59 + 12.92), and relationship processing (77.34 + 12.90) points. The nursing process (3 + 1.01) and trust (71.78 + 5.89) were.2. There was no significant difference in blood glucose level and metabolic characteristics in the two groups at 1 days before discharge. The values of glycated hemoglobin in two groups were different at 3 and 6 months after discharge (t=4.206, P0.05; t=5.336, P0.05), and the value of fasting blood glucose in two groups was different in the 6 months after discharge (t=1.788). P0.05).3, blood glucose level repeated measurements showed that fasting blood glucose, postprandial 2H blood sugar and glycated hemoglobin have significant time point factors (F=33.249, P=0.000; F=153.694, P=0.000; F=117.066, P=0.000), and there was a interaction between the observation time points and the group (F=9.070, P=0.001; F=7.213, F=117.066,); There was no significant difference between blood glucose and postprandial 2H blood glucose groups (F=9.070, P=0.118; F=0.000, P=0.994); the group of glycated hemoglobin was significant (F=10.992, P=0.001).4. There was no significant difference between the total scores of self management behavior and each dimension in the two groups at 1 days before discharge and 3 months after discharge (all P0.05); two groups after 6 months discharged from hospital. The scores of three dimensions in the foot care were statistically significant (P value was 0.003,0.030,0.000, respectively less than 0.05). The time point factor (F=11170.713, P=0.000) and group (F=8268.386, P= 0) in the repeated measurement model were also different in.5, and the two groups were 1 days before discharge and 3 after discharge. There was no difference in the score of quality of life and the scores of each dimension at the two time of the month (all P0.05); the scores of dietary dimensions in the 6 months after discharge were different (P=0.003, P0.05), and there was no difference in the other dimensions (all P0.05); the time point factors in the repeated measurement model (F=7456.659, P= 0), and the interaction between the observation time points and the groups (F=277.957, P=0.000), There was a significant (F=12.628, P=0.000).6 among the groups. The multivariate regression analysis of this study showed that information synthesis in the continuous nursing scale, the relationship dimension and the course of illness, and the age were the same to explain the variation in blood glucose drop by 80.1%. Conclusion: 1, the level of continuous care accepted in the patients with type 2 diabetes in this study was higher, self management level and birth. The living quality level is low.2, continuous nursing intervention can improve the level of self management of type 2 diabetes patients, improve the quality of life of patients, the longer the intervention implementation time the better.3, the influence factors of blood sugar level are disease course, age and continuous nursing level and so on. Continuous nursing implementation can effectively reduce the patient's blood sugar water. The longer the time is, the more effective the intervention is.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.5

【引证文献】