同伴运用胰岛素使用访谈工具对糖尿病患者教育的效果评价
发布时间：2018-09-16 20:18
【摘要】：目的：探讨同伴运用胰岛素使用访谈工具对糖尿病(DM)患者教育的效果。 方法：本研究为随机对照的社区干预实验。方便抽样法选取长沙市某两个社区并随机分为实验组和对照组,每组随机抽取38例使用胰岛素的DM患者。对照组接受常规健康教育；实验组在对照组基础上,由1名同伴运用胰岛素使用访谈工具对其进行访谈。比较两组患者干预前、干预5个月末急性并发症发生次数、血糖相关指标以及对胰岛素的看法、胰岛素使用相关知识-行为等指标的变化。采用SPSS13.0统计软件进行数据整理,运用重复测量方差分析比较干预对DM患者的影响。 结果：(1)76例社区糖尿病患者空腹血糖(FBG)平均为7.80mmol/L,餐后2小时血糖(2hPBG)平均为11.19mmol/L,糖化血红蛋白(HbA,C)平均为8.58%,均不达标；接受过胰岛素使用相关健康教育的患者有50例,占65.79%。患者接受健康教育内容：如何注射胰岛素的有48例,占63.16%；如何保存胰岛素的有39例,占51.32%；如何依据自身情况调整胰岛素剂量的有22例,占28.95%；如何轮换注射部位的有33例,占43.42%；如何使用和对待针头的有19例,占25%；如何处理不良反应的有13例,占17.11%；掌握胰岛素使用相关知识情况：完全掌握的有10例,仅占13.16%；部分掌握的有40例,占52.63%；尚未掌握的有26例,占34.21%。 (2)重复测量方差分析结果表明：两组DM患者干预前后低血糖发生次数时间主效应和交互效应均有统计学差异(P0.05),干预前后实验组的低血糖发生次数减少了1.77次,对照组减少了0.63次,实验组的减少幅度大于对照组；FBG、2hPBG时间主效应和交互效应差异有统计学意义(P0.05),干预前后实验组的FBG降低了0.64mmol/L,2hPBG降低了1.71mmol/L,对照组的FBG降低了0.03mmol/L,2hPBG降低了0.35mmol/L,实验组的血糖改善效果优于对照组；对胰岛素的看法时间主效应和交互效应有统计学差异(P0.05),干预前后实验组的对胰岛素看法总得分降低了28.54分,对照组降低了17.28分,实验组的改善效果优于对照组；胰岛素使用行为方面的时间主效应及交互效应差异有统计学意义(P0.05),干预前后实验组的胰岛素使用相关行为得分提高了9.15分,对照组提高了2.00分,实验组的改善效果优于对照组；授权能力时间主效应及交互效应差异有统计学意义(P0.05),实验组干预后的授权能力得分较干预前提高了1.22分,对照组提高了0.40分,实验组的提高幅度大于对照组；生活质量时间主效应和交互效应差异有统计学意义(P0.05),实验组干预后生活质量得分较干预前降低了14.14分,对照组降低了5.03分,实验组生活质量的改善情况优于对照组；自我效能时间主效应和干预主效应差异有统计学意义(P0.05),不考虑时间因素,实验组与对照组相比自我效能总得分降低了7.08分,实验组的自我效能改善情况优于对照组。 结论：(1)社区接受胰岛素治疗的DM患者血糖控制不佳,尤其是HbA1C达标率较低,社区提供的胰岛素使用相关的健康教育内容不够全面,患者掌握胰岛素使用相关知识情况不容乐观。 (2)同伴运用胰岛素使用访谈工具进行访谈可更有效地减少DM患者低血糖的发生次数,以及降低患者FBG和2hPBG。 (3)同伴运用胰岛素使用访谈工具对社区DM患者进行指导,可更有效改变患者对胰岛素的看法,树立良好的胰岛素使用相关态度,改变不良的胰岛素使用相关行为,有效提高患者的授权能力、生活质量和总体自我效能。
[Abstract]:Objective: To explore the effect of peer interview on the education of patients with diabetes mellitus (DM).
Methods: This study was a randomized controlled community intervention experiment. Two communities in Changsha were randomly divided into experimental group and control group, 38 DM patients were randomly selected from each group. Before intervention, the incidence of acute complications, blood glucose-related indicators, insulin perception, insulin use-related knowledge-behavior and other indicators were compared between the two groups. Ringing.
Results: (1) The average fasting blood glucose (FBG) was 7.80 mmol/L in 76 community diabetics, 11.19 mmol/L in 2 hours postprandial blood glucose (2hPBG) and 8.58% in glycosylated hemoglobin (HbA, C), which were not up to the standard, and 50 patients (65.79%) received health education related to insulin use. There were 48 cases (63.16%), 39 cases (51.32%) how to preserve insulin, 22 cases (28.95%) how to adjust insulin dosage according to their own conditions, 33 cases (43.42%) how to rotate injection sites, 19 cases (25%) how to use and treat needles, 13 cases (17.11%) how to deal with adverse reactions, and 13 cases (17.11%) how to master islets of pancreas. Related knowledge of vegetarian use: 10 cases were completely mastered, accounting for only 13.16%; 40 cases were partly mastered, accounting for 52.63%; 26 cases were not mastered, accounting for 34.21%.
(2) The results of repeated measurement of variance analysis showed that there were significant differences in the main effect and interaction effect of hypoglycemia frequency before and after intervention between the two groups (P 0.05). Before and after intervention, the frequency of hypoglycemia in the experimental group decreased by 1.77 times, and that in the control group decreased by 0.63 times. The FBG of the experimental group decreased by 0.64 mmol/L, 2 h PBG decreased by 1.71 mmol/L, the FBG of the control group decreased by 0.03 mmol/L, 2 h PBG decreased by 0.35 mmol/L, and the blood glucose of the experimental group was better than that of the control group. (P 0.05), before and after the intervention, the total score of the experimental group on insulin attitudes decreased by 28.54 points, the control group decreased by 17.28 points, the improvement effect of the experimental group was better than that of the control group; the main time effect and interaction effect of insulin use behavior were statistically significant (P 0.05), the experimental group before and after the intervention insulin use related behavior score was raised. The improvement effect of the experimental group was better than that of the control group, and the time main effect and interaction effect of the empowerment ability were statistically significant (P 0.05). Quality-time main effect and interaction effect were statistically significant (P 0.05). The quality of life score of the experimental group was 14.14 points lower than that of the control group, 5.03 points lower than that of the control group. The improvement of the quality of life of the experimental group was better than that of the control group. The main effect of self-efficacy time and intervention had statistical significance (P 0.05). Considering the time factor, the total score of self-efficacy in the experimental group was 7.08 points lower than that in the control group, and the improvement of self-efficacy in the experimental group was better than that in the control group.
Conclusion: (1) The blood glucose control of DM patients receiving insulin therapy in the community is poor, especially the HbA1C compliance rate is low, and the health education related to insulin use provided by the community is not comprehensive enough.
(2) The frequency of hypoglycemia and FBG and 2hPBG in DM patients can be reduced more effectively by peer interviews using insulin interview tools.
(3) Peer use of insulin interview tools to guide community DM patients can more effectively change patients'views on insulin, establish a good attitude towards insulin use, change bad insulin use-related behavior, and effectively improve patients' empowerment ability, quality of life and overall self-efficacy.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R473.5
本文编号：2244675
[Abstract]:Objective: To explore the effect of peer interview on the education of patients with diabetes mellitus (DM).
Methods: This study was a randomized controlled community intervention experiment. Two communities in Changsha were randomly divided into experimental group and control group, 38 DM patients were randomly selected from each group. Before intervention, the incidence of acute complications, blood glucose-related indicators, insulin perception, insulin use-related knowledge-behavior and other indicators were compared between the two groups. Ringing.
Results: (1) The average fasting blood glucose (FBG) was 7.80 mmol/L in 76 community diabetics, 11.19 mmol/L in 2 hours postprandial blood glucose (2hPBG) and 8.58% in glycosylated hemoglobin (HbA, C), which were not up to the standard, and 50 patients (65.79%) received health education related to insulin use. There were 48 cases (63.16%), 39 cases (51.32%) how to preserve insulin, 22 cases (28.95%) how to adjust insulin dosage according to their own conditions, 33 cases (43.42%) how to rotate injection sites, 19 cases (25%) how to use and treat needles, 13 cases (17.11%) how to deal with adverse reactions, and 13 cases (17.11%) how to master islets of pancreas. Related knowledge of vegetarian use: 10 cases were completely mastered, accounting for only 13.16%; 40 cases were partly mastered, accounting for 52.63%; 26 cases were not mastered, accounting for 34.21%.
(2) The results of repeated measurement of variance analysis showed that there were significant differences in the main effect and interaction effect of hypoglycemia frequency before and after intervention between the two groups (P 0.05). Before and after intervention, the frequency of hypoglycemia in the experimental group decreased by 1.77 times, and that in the control group decreased by 0.63 times. The FBG of the experimental group decreased by 0.64 mmol/L, 2 h PBG decreased by 1.71 mmol/L, the FBG of the control group decreased by 0.03 mmol/L, 2 h PBG decreased by 0.35 mmol/L, and the blood glucose of the experimental group was better than that of the control group. (P 0.05), before and after the intervention, the total score of the experimental group on insulin attitudes decreased by 28.54 points, the control group decreased by 17.28 points, the improvement effect of the experimental group was better than that of the control group; the main time effect and interaction effect of insulin use behavior were statistically significant (P 0.05), the experimental group before and after the intervention insulin use related behavior score was raised. The improvement effect of the experimental group was better than that of the control group, and the time main effect and interaction effect of the empowerment ability were statistically significant (P 0.05). Quality-time main effect and interaction effect were statistically significant (P 0.05). The quality of life score of the experimental group was 14.14 points lower than that of the control group, 5.03 points lower than that of the control group. The improvement of the quality of life of the experimental group was better than that of the control group. The main effect of self-efficacy time and intervention had statistical significance (P 0.05). Considering the time factor, the total score of self-efficacy in the experimental group was 7.08 points lower than that in the control group, and the improvement of self-efficacy in the experimental group was better than that in the control group.
Conclusion: (1) The blood glucose control of DM patients receiving insulin therapy in the community is poor, especially the HbA1C compliance rate is low, and the health education related to insulin use provided by the community is not comprehensive enough.
(2) The frequency of hypoglycemia and FBG and 2hPBG in DM patients can be reduced more effectively by peer interviews using insulin interview tools.
(3) Peer use of insulin interview tools to guide community DM patients can more effectively change patients'views on insulin, establish a good attitude towards insulin use, change bad insulin use-related behavior, and effectively improve patients' empowerment ability, quality of life and overall self-efficacy.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R473.5
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