本文選題：跨理論模型 + 2型糖尿病　； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：[目的]探討基于跨理論模型的認(rèn)知干預(yù)模式在2型糖尿病合并輕度認(rèn)知功能障礙患者中應(yīng)用的可行性與有效性,通過(guò)對(duì)患者所處的認(rèn)知行為階段的評(píng)估,給予該階段相匹配的認(rèn)知干預(yù),旨在降低患者的認(rèn)知功能障礙程度,提高其日常生活活動(dòng)能力、糖尿病自我管理能力,最終達(dá)到促進(jìn)患者建立良好的健康行為,降低并發(fā)癥,提高生活質(zhì)量的目的。[方法]前瞻性隨機(jī)對(duì)照研究,選擇2014年01月至2015年06月入住南京鼓樓醫(yī)院老年科的120例2型糖尿病合并輕度認(rèn)知功能障礙患者,計(jì)算機(jī)生成隨機(jī)號(hào),裝入不透光的密閉信封,尾數(shù)單號(hào)為對(duì)照組(n=60),尾數(shù)雙號(hào)為實(shí)驗(yàn)組(n=60)。對(duì)照組給予常規(guī)認(rèn)知干預(yù),包括記憶能力訓(xùn)練、空間障礙訓(xùn)練、邏輯能力障礙訓(xùn)練、運(yùn)算能力訓(xùn)練、日常生活能力訓(xùn)練等項(xiàng)目；實(shí)驗(yàn)組實(shí)施基于跨理論模型的認(rèn)知干預(yù),對(duì)患者所處的認(rèn)知行為階段進(jìn)行評(píng)估,給予相匹配的認(rèn)知干預(yù)。在干預(yù)前、干預(yù)后1個(gè)月、3個(gè)月和6個(gè)月分別評(píng)估認(rèn)知訓(xùn)練行為變化階段、認(rèn)知功能狀態(tài)(簡(jiǎn)易精神狀態(tài)檢查表)、日常生活活動(dòng)能力(Barthel指數(shù))、糖尿病自我管理能力(糖尿病自我管理能力量表)、餐后2h血糖及糖化血紅蛋白等指標(biāo)。[結(jié)果]1.兩組研究對(duì)象一般人口學(xué)資料進(jìn)行比較：包括年齡、性別、職業(yè)、婚姻狀況、文化程度、家庭月收入、醫(yī)療費(fèi)用來(lái)源、居住方式、照顧者、病程及發(fā)生低血糖的次數(shù)共11個(gè)項(xiàng),差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2.兩組研究對(duì)象認(rèn)知訓(xùn)練行為改變階段比較,在干預(yù)前和干預(yù)后1個(gè)月時(shí)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)3個(gè)月和干預(yù)6個(gè)月時(shí)有統(tǒng)計(jì)學(xué)意義(P0.05)3.兩組研究對(duì)象認(rèn)知功能及日常生活活動(dòng)能力進(jìn)行比較,在干預(yù)前和干預(yù)后1個(gè)月時(shí)兩組MMSE及Barthel指數(shù)量表得分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)3個(gè)月和干預(yù)6個(gè)月時(shí)實(shí)驗(yàn)組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；4.兩組研究對(duì)象糖尿病自我管理能力及血糖控制指標(biāo)進(jìn)行比較,在于預(yù)前和干預(yù)后1個(gè)月時(shí)兩組DSCS、2hPBG及Hb值差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)3個(gè)月和干預(yù)6個(gè)月時(shí)實(shí)驗(yàn)組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]基于跨理論模型的認(rèn)知干預(yù)模式可以促進(jìn)2型糖尿病合并輕度認(rèn)知功能障礙患者的認(rèn)知訓(xùn)練行為的轉(zhuǎn)變,降低干預(yù)過(guò)程中的退出率,同時(shí)可以更好地改善2型糖尿病合并輕度認(rèn)知功能障礙患者的認(rèn)知水平、糖尿病自我管理能力及血糖控制水平,適合在臨床上推廣使用。
[Abstract]:[objective] to explore the feasibility and effectiveness of cognitive intervention model based on cross-theoretical model in patients with type 2 diabetes mellitus with mild cognitive impairment, and to evaluate the cognitive behavior stage of patients with type 2 diabetes mellitus. In order to reduce the degree of cognitive dysfunction, improve the ability of daily life and self-management of diabetes mellitus, the cognitive intervention can promote the patients to establish good healthy behavior and reduce the complications. The purpose of improving the quality of life. [methods] A prospective randomized controlled study was conducted in 120 patients with type 2 diabetes mellitus complicated with mild cognitive impairment who were admitted to the Geriatrics Department of Nanjing Gulou Hospital from January 2014 to June 2015. The Mantissa single number was the control group, and the Mantissa number was the experimental group. The control group was given routine cognitive intervention, including memory training, spatial disorder training, logic disorder training, arithmetic training and daily living ability training, while the experimental group was given cognitive intervention based on cross-theoretical model. The cognitive behavior stage was evaluated and matched cognitive intervention was given. Before intervention, 1 month, 3 months and 6 months after intervention, cognitive training behavior changes were evaluated, respectively. Cognitive function (simple mental state examination table, activity of daily living (ADL) and Barthel index), diabetes self-management ability (diabetes self-management ability scale), 2 h postprandial blood glucose and glycosylated hemoglobin, and so on. [result] 1. The data of general demography were compared between the two groups: age, sex, occupation, marital status, education, monthly income of family, source of medical expenses, living style, caregivers, course of disease and frequency of hypoglycemia were 11 items. The differences were not statistically significant (P 0.05), and were comparable. There was no significant difference in cognitive training behavior between the two groups before and 1 month after intervention, but there was significant difference between the two groups at 3 months and 6 months. Cognitive function and activity of daily living (ADL) were compared between the two groups. There was no significant difference in the scores of MMSE and Barthel index between the two groups before and 1 month after intervention. The experimental group was superior to the control group at 3 months and 6 months of intervention. The difference was statistically significant (P 0.05). The diabetic self-management ability and blood glucose control index were compared between the two groups. The results showed that there was no significant difference in PBG and HB between the two groups before and 1 month after intervention. The experimental group was superior to the control group at 3 months and 6 months of intervention. The difference was statistically significant (P 0.05). [conclusion] the cognitive intervention model based on cross-theoretical model can promote the change of cognitive training behavior in patients with type 2 diabetes mellitus with mild cognitive impairment, and reduce the withdrawal rate during the intervention process. At the same time, it can improve the cognitive level of type 2 diabetes mellitus patients with mild cognitive dysfunction, diabetes self-management ability and blood glucose control level, which is suitable for clinical use.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R473.5

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