【摘要】：目的：探討同伴運(yùn)用胰島素使用訪談工具對(duì)糖尿病(DM)患者教育的效果。 方法：本研究為隨機(jī)對(duì)照的社區(qū)干預(yù)實(shí)驗(yàn)。方便抽樣法選取長(zhǎng)沙市某兩個(gè)社區(qū)并隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,每組隨機(jī)抽取38例使用胰島素的DM患者。對(duì)照組接受常規(guī)健康教育；實(shí)驗(yàn)組在對(duì)照組基礎(chǔ)上,由1名同伴運(yùn)用胰島素使用訪談工具對(duì)其進(jìn)行訪談。比較兩組患者干預(yù)前、干預(yù)5個(gè)月末急性并發(fā)癥發(fā)生次數(shù)、血糖相關(guān)指標(biāo)以及對(duì)胰島素的看法、胰島素使用相關(guān)知識(shí)-行為等指標(biāo)的變化。采用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)整理,運(yùn)用重復(fù)測(cè)量方差分析比較干預(yù)對(duì)DM患者的影響。 結(jié)果：(1)76例社區(qū)糖尿病患者空腹血糖(FBG)平均為7.80mmol/L,餐后2小時(shí)血糖(2hPBG)平均為11.19mmol/L,糖化血紅蛋白(HbA,C)平均為8.58%,均不達(dá)標(biāo)；接受過(guò)胰島素使用相關(guān)健康教育的患者有50例,占65.79%。患者接受健康教育內(nèi)容：如何注射胰島素的有48例,占63.16%；如何保存胰島素的有39例,占51.32%；如何依據(jù)自身情況調(diào)整胰島素劑量的有22例,占28.95%；如何輪換注射部位的有33例,占43.42%；如何使用和對(duì)待針頭的有19例,占25%；如何處理不良反應(yīng)的有13例,占17.11%；掌握胰島素使用相關(guān)知識(shí)情況：完全掌握的有10例,僅占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)重復(fù)測(cè)量方差分析結(jié)果表明：兩組DM患者干預(yù)前后低血糖發(fā)生次數(shù)時(shí)間主效應(yīng)和交互效應(yīng)均有統(tǒng)計(jì)學(xué)差異(P0.05),干預(yù)前后實(shí)驗(yàn)組的低血糖發(fā)生次數(shù)減少了1.77次,對(duì)照組減少了0.63次,實(shí)驗(yàn)組的減少幅度大于對(duì)照組；FBG、2hPBG時(shí)間主效應(yīng)和交互效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)前后實(shí)驗(yàn)組的FBG降低了0.64mmol/L,2hPBG降低了1.71mmol/L,對(duì)照組的FBG降低了0.03mmol/L,2hPBG降低了0.35mmol/L,實(shí)驗(yàn)組的血糖改善效果優(yōu)于對(duì)照組；對(duì)胰島素的看法時(shí)間主效應(yīng)和交互效應(yīng)有統(tǒng)計(jì)學(xué)差異(P0.05),干預(yù)前后實(shí)驗(yàn)組的對(duì)胰島素看法總得分降低了28.54分,對(duì)照組降低了17.28分,實(shí)驗(yàn)組的改善效果優(yōu)于對(duì)照組；胰島素使用行為方面的時(shí)間主效應(yīng)及交互效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)前后實(shí)驗(yàn)組的胰島素使用相關(guān)行為得分提高了9.15分,對(duì)照組提高了2.00分,實(shí)驗(yàn)組的改善效果優(yōu)于對(duì)照組；授權(quán)能力時(shí)間主效應(yīng)及交互效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組干預(yù)后的授權(quán)能力得分較干預(yù)前提高了1.22分,對(duì)照組提高了0.40分,實(shí)驗(yàn)組的提高幅度大于對(duì)照組；生活質(zhì)量時(shí)間主效應(yīng)和交互效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組干預(yù)后生活質(zhì)量得分較干預(yù)前降低了14.14分,對(duì)照組降低了5.03分,實(shí)驗(yàn)組生活質(zhì)量的改善情況優(yōu)于對(duì)照組；自我效能時(shí)間主效應(yīng)和干預(yù)主效應(yīng)差異有統(tǒng)計(jì)學(xué)意義(P0.05),不考慮時(shí)間因素,實(shí)驗(yàn)組與對(duì)照組相比自我效能總得分降低了7.08分,實(shí)驗(yàn)組的自我效能改善情況優(yōu)于對(duì)照組。 結(jié)論：(1)社區(qū)接受胰島素治療的DM患者血糖控制不佳,尤其是HbA1C達(dá)標(biāo)率較低,社區(qū)提供的胰島素使用相關(guān)的健康教育內(nèi)容不夠全面,患者掌握胰島素使用相關(guān)知識(shí)情況不容樂(lè)觀。 (2)同伴運(yùn)用胰島素使用訪談工具進(jìn)行訪談可更有效地減少DM患者低血糖的發(fā)生次數(shù),以及降低患者FBG和2hPBG。 (3)同伴運(yùn)用胰島素使用訪談工具對(duì)社區(qū)DM患者進(jìn)行指導(dǎo),可更有效改變患者對(duì)胰島素的看法,樹(shù)立良好的胰島素使用相關(guān)態(tài)度,改變不良的胰島素使用相關(guān)行為,有效提高患者的授權(quán)能力、生活質(zhì)量和總體自我效能。
[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.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R473.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 胡夏云;莫永珍;方朝暉;;2型糖尿病患者胰島素治療認(rèn)知狀況的定性研究[J];中醫(yī)藥臨床雜志;2012年02期

2 徐詠梅;;老年糖尿病患者使用胰島素的自我管理現(xiàn)狀及分析[J];安徽醫(yī)學(xué);2011年08期

3 陳遠(yuǎn)華;農(nóng)月稠;譚小燕;林華;;注射程序卡在使用胰島素筆患者中的應(yīng)用[J];護(hù)士進(jìn)修雜志;2008年01期

4 萬(wàn)巧琴;尚少梅;來(lái)小彬;李玉玲;李治競(jìng);;同伴教育在社區(qū)2型糖尿病患者中應(yīng)用效果的研究[J];護(hù)士進(jìn)修雜志;2009年05期

5 張娃蓮;周衛(wèi)娟;鄭姍姍;;同伴教育對(duì)糖尿病患者教育效果的探討[J];護(hù)士進(jìn)修雜志;2012年01期

6 楊玲鳳;黃金;;對(duì)44例接受胰島素治療的糖尿病患者自我效能干預(yù)的效果評(píng)價(jià)[J];現(xiàn)代護(hù)理;2006年03期

7 姜麗英;朱燕勤;;家庭訪視對(duì)出院糖尿病患者使用胰島素筆的依從性影響[J];護(hù)理與康復(fù);2010年05期

8 曹小萍;;老年糖尿病患者使用胰島素現(xiàn)狀的調(diào)查與護(hù)理對(duì)策[J];護(hù)理與康復(fù);2010年08期

9 楊麗雅;胡艷飛;;社區(qū)糖尿病患者胰島素筆用針頭使用情況調(diào)查與護(hù)理干預(yù)[J];護(hù)理與康復(fù);2010年09期

10 何文靜;郭莉萍;;社區(qū)健康教育普及在老年糖尿病患者注射胰島素中的重要性[J];中外醫(yī)療;2010年12期

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