本文選題：延續(xù)護理 + 2型糖尿病�。� 參考：《南昌大學》2015年碩士論文

【摘要】：目的:本課題通過為2型糖尿病患者提供延續(xù)護理服務,評價延續(xù)護理對糖尿病患者疾病轉歸、生活質量的影響效果;為糖尿病延續(xù)護理服務廣泛開展提供科學依據(jù);這對提高糖尿病患者生活質量,改善其疾病預后具有重要意義。方法:本研究為類實驗性研究,于2014年6月至2015年2月施行;采用方便抽樣方法,選取深圳市某三級甲等醫(yī)院121例2型糖尿病住院患者并分為干預組和對照組;干預組采用延續(xù)護理服務措施,對照組則不采取任何干預;于患者出院前1天、出院后3個月、出院后6個月3個時間點評估患者空腹血糖(fasting plasma glucose,FPG)、餐后2小時血糖(2h plasma glucose,2h PG)、糖化血紅蛋白(hemoglobin A1c,Hb A1c)、體重指數(shù)(body mass index,BMI)、舒張壓(diastolic pressure,DS)、收縮壓(Systolic pressure,SD)、自我管理行為和生活質量情況。采用糖尿病延續(xù)護理評估量表(diabetes continuity of care questionnaire,DCCQ)對患者接受到的延續(xù)護理水平進行描述;采用糖尿病特異性生活質量量表(chinese normal audit of diabetes dependent quality of life,CN-ADDQOL)、糖尿病自我管理行為量表(diabetes self-efficacy scale,DSES)對干預結果進行描述和評價。結果:1、出院后6個月,干預組患者延續(xù)護理背景資料管理得(77.89±11.11)分、糖尿病咨詢(66.19±10.26)分、溝通(72.31±10.34)分;體格檢查(69.20±6.04)分、合作(63.59±12.92)分、關系處理(77.34±12.90)分、護理進程(3.00±1.01)分、信任(71.78±5.89)分。2、兩組患者出院前1天血糖水平及代謝特征無明顯差異,基線相同;兩組患者糖化血紅蛋白值在出院后3個月和6個月有差異(t=4.206,P0.05;t=5.336,P0.05);兩組患者空腹血糖值在出院后6個月有差異(t=1.788,P0.05)。3、血糖水平重復測量結果顯示,空腹血糖、餐后2h血糖和糖化血紅蛋白的時間點因素都有顯著意義(F=33.249,P=0.000;F=153.694,P=0.000;F=117.066,P=0.000);三者觀測時間點和組別之間存在交互作用(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血糖組別無顯著意義(F=9.070,P=0.118;F=0.000,P=0.994);糖化血紅蛋白組別有顯著意義(F=10.992,P=0.001)。4、兩組患者自我管理行為總分及各個維度得分在出院前1天和出院后3個月的差異均無統(tǒng)計學意義(均P0.05);出院6個月后,兩組患者在規(guī)律鍛煉、遵醫(yī)囑服藥和血糖監(jiān)測、足部護理三個維度得分差異具有統(tǒng)計學意義(P值分別為0.003、0.030、0.000,均小于0.05)。重復測量模型中時間點因素(F=11170.713,P=0.000)和組別(F=8268.386,P=0.000)亦有差異。5、兩組患者在出院前1天和出院后3個月兩個時間點生活質量總分及各個維度得分無差異(均P0.05);出院后6個月飲食維度得分存在差異(P=0.003,P0.05),其他維度得分無差異(均P0.05);重復測量模型中時間點因素(F=7456.659,P=0.000)、觀測時間點和組別之間有交互關系(F=277.957,P=0.000)、組別間都有顯著性意義(F=12.628,P=0.000)。6、本研究多元回歸分析顯示:延續(xù)護理量表中信息合成、人際關系維度與病程、年齡共同解釋血糖下降80.1%的變異量。結論:1、參與本研究的2型糖尿病患者接受的延續(xù)護理水平較高,自我管理水平和生活質量水平均較低。2、延續(xù)護理干預可提高2型糖尿病患者自我管理水平,對患者的生活質量有提升的作用,干預實施時間越長效果越好。3、血糖水平的影響因素有病程、年齡和延續(xù)護理水平等,延續(xù)護理的實施可以有效降低患者的血糖水平,且施行時間越長,干預效果越明。
[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.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R473.5

【引證文獻】

相關期刊論文 前1條

1 金莉;;我國中老年糖尿病患者延續(xù)性護理的研究進展[J];齊齊哈爾醫(yī)學院學報;2017年04期

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本文編號：1943403