糖尿病联络护士个体化出院随访在非内分泌科糖尿病患者中的应用效果
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摘要
目的探讨糖尿病联络护士(diabetes liaison nurse,DLN)个体化出院随访在改善非内分泌科糖尿病患者自我管理行为及提高患者糖尿病相关知识、态度及自我管理行为的效果。方法将纳入的74例非内分泌科住院的2型糖尿病患者随机分为实验组和对照组,每组各37例,对照组出院后接受病区随访护士提供的3个月常规出院随访,实验组出院后接受DLN提供的3个月个体化出院随访。比较2组干预前及干预6个月后糖尿病相关知识、态度、自我管理行为及糖化血红蛋白的改善效果。结果干预后2组糖尿病相关知识、态度、自我管理行为在时间效应和交互效应上差异有统计学意义,糖化血红蛋白水平在主效应及时间效应上差异有统计学意义。结论糖尿病联络护士个体化出院随访能显著提高非内分泌科糖尿病患者的糖尿病相关知识、态度、自我管理行为,降低非内分泌科糖尿病患者的糖化血红蛋白水平。
Objectives To study the effect of individualized follow-up by diabetes liaison nurses(DLN) in improving the diabetes knowledge, attitude and self-care activities for patient having comorbidity with diabetes mellitus(DM). Methods Seventy-four DM inpatients not treated in the department of endocrinology was randomly divided into an experimental group and a control group, each of 37. After discharge, the control group was followed up for 3 months in the conventional way, while the experimental group was followed up for the same time by DLN. The knowledge about and attitude to diabetes, self-care behavior and glycosylated hemoglobin(HbA1 c) were compared between the two group before and 6 th months after the intervention. Results After the intervention, the two groups had significant differences in the time and interaction effect in the knowledge about and attitude to diabetes, and self management. The HbA1 c of the experimental group was significantly lower than that of the control group after the intervention(P<0.05). Conclusion Individualized follow-up by diabetes liaison nurses can significantly promote the DM related knowledge, attitude and self-care behavior of the non-endocrine ward's DM patients, and lower their HbA1 c.
Objectives To study the effect of individualized follow-up by diabetes liaison nurses(DLN) in improving the diabetes knowledge, attitude and self-care activities for patient having comorbidity with diabetes mellitus(DM). Methods Seventy-four DM inpatients not treated in the department of endocrinology was randomly divided into an experimental group and a control group, each of 37. After discharge, the control group was followed up for 3 months in the conventional way, while the experimental group was followed up for the same time by DLN. The knowledge about and attitude to diabetes, self-care behavior and glycosylated hemoglobin(HbA1 c) were compared between the two group before and 6 th months after the intervention. Results After the intervention, the two groups had significant differences in the time and interaction effect in the knowledge about and attitude to diabetes, and self management. The HbA1 c of the experimental group was significantly lower than that of the control group after the intervention(P<0.05). Conclusion Individualized follow-up by diabetes liaison nurses can significantly promote the DM related knowledge, attitude and self-care behavior of the non-endocrine ward's DM patients, and lower their HbA1 c.
引文
[1] Guariguata L,Whiting DR,Hambleton I,et al. Global estimates of diabetes prevalence for 2013 and projections for 2035[J]. Diabetes Res Clin Pract, 2014,103(2):137-149.
[2] Flores-Le Roux JA,Comin J,Pedro-Botet J,et al. Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational study[J]. Cardiovasc Diabetol, 2011(10):39.
[3] Plantinga LC,Crews DC,Coresh J,et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes[J]. Clin J Am Soc Nephrol, 2010, 5(4):673-682.
[4] Xu Y,Wang L,He J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013,310(9):948-959.
[5] 廖涌.中国糖尿病的流行病学现状及展望[J].重庆医科大学学报, 2015,40(7):1042-1045.
[6] 杨华章,邝建,余桂芳,等.住院患者糖尿病临床特点分析[J].循证医学,2006,6(2):97-100.
[7] 李娟,李乐之,杨玲凤,等.长沙市三级甲等综合医院非内分泌科护士糖尿病护理知信行的调查研究[J].中国护理管理,2013,13(6):91-94.
[8] 任改瑛,周明群,白灵,等.非内分泌科护士对糖尿病知识掌握的现状及培训对策[J].护理研究,2014,28(12A):4336-4337.
[9] 熊燕,徐静,赵益,等.临床非内分泌科护士糖尿病知识的认知现状及培训需求调查[J].解放军护理杂志,2013,30(9):5-8.
[10] 盛荣,王世英,沈锡珊,等.延续护理在出院糖尿病患者中的应用[J].解放军护理杂志,2009,26(10B):6-7.
[11] 李琪瑛,吴飞.我国糖尿病病人院后延续护理的研究进展[J].全科护理,2014,12(24):2219-2221.
[12] 张艳,高珊,李辉,等.延续护理对初发2型糖尿病病人血糖、血脂、血压及自我管理能力的影响[J].护理研究,2015,29(12B):4421-4423.
[13] 杨玲凤,刘芳,黄金,等.糖尿病多学科教育团队的建立与培训[J].护理学杂志,2014,29(9):54-56.
[14] Speight J,Bradley C. The ADKnowl: identifying knowledge deficits in diabetes care[J]. Diabet Med, 2001, 18(8):626-633.
[15] 朱伟燕.糖尿病患者知识量表的汉化及在杭州市区三甲医院糖尿病人群中的调查[D].杭州:浙江大学,2010.
[16] Anderson RM,Fitzgerald JT,Funnell MM,et al. The third version of the Diabetes Attitude Scale[J]. Diabetes Care, 1998, 21(9):1403-1407.
[17] 周小萍.糖尿病态度量表的汉化及在杭州市区三甲医院糖尿病人群中的调查[D].浙江大学,2010.
[18] Toobert DJ,Hampson SE,Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale[J]. Diabetes Care, 2000, 23(7):943-950.
[19] Whittemore R,D′Eramo Melkus G,Grey M. Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes[J]. J Clin Nurs, 2005, 14(2):195-203.
[20] 华丽,朱伟萍.中文版《糖尿病自我管理行为量表》的信效度验证[J].解放军护理杂志,2014,31(16):5-8.
[21] 万巧琴,尚少梅,来小彬,等.2型糖尿病患者自我管理行为量表的信、效度研究[J].中国实用护理杂志,2008,24(3A):26-27.
[22] Xu Y,Toobert D,Savage C,et al. Factors influencing diabetes self-management in Chinese people with type 2 diabetes[J]. Res Nurs Health, 2008, 31(6):613-625.
[23] Huang J,Liu Y,Zhang Y,et al. [Correlation between self-management and knowledge of and attitude to diabetes in type 2 diabetic patients in Changsha][J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2013, 38(2):176-181.
[24] 姚平,嵇加佳,薛存屹,等.糖尿病患者态度对自我管理行为及代谢指标的影响[J].护理学报, 2015,22(1):33-36.
[25] 于平平,肖湘成,王琳云,等.社区2型糖尿病患者的自我管理行为与其血糖控制的相关性研究[J].中南大学学报(医学版),2013,38(4):425-431.
[26] Parchman ML,Pugh JA,Noel PH,et al. Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes[J]. Med Care, 2002,40(2):137-144.
[2] Flores-Le Roux JA,Comin J,Pedro-Botet J,et al. Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational study[J]. Cardiovasc Diabetol, 2011(10):39.
[3] Plantinga LC,Crews DC,Coresh J,et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes[J]. Clin J Am Soc Nephrol, 2010, 5(4):673-682.
[4] Xu Y,Wang L,He J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013,310(9):948-959.
[5] 廖涌.中国糖尿病的流行病学现状及展望[J].重庆医科大学学报, 2015,40(7):1042-1045.
[6] 杨华章,邝建,余桂芳,等.住院患者糖尿病临床特点分析[J].循证医学,2006,6(2):97-100.
[7] 李娟,李乐之,杨玲凤,等.长沙市三级甲等综合医院非内分泌科护士糖尿病护理知信行的调查研究[J].中国护理管理,2013,13(6):91-94.
[8] 任改瑛,周明群,白灵,等.非内分泌科护士对糖尿病知识掌握的现状及培训对策[J].护理研究,2014,28(12A):4336-4337.
[9] 熊燕,徐静,赵益,等.临床非内分泌科护士糖尿病知识的认知现状及培训需求调查[J].解放军护理杂志,2013,30(9):5-8.
[10] 盛荣,王世英,沈锡珊,等.延续护理在出院糖尿病患者中的应用[J].解放军护理杂志,2009,26(10B):6-7.
[11] 李琪瑛,吴飞.我国糖尿病病人院后延续护理的研究进展[J].全科护理,2014,12(24):2219-2221.
[12] 张艳,高珊,李辉,等.延续护理对初发2型糖尿病病人血糖、血脂、血压及自我管理能力的影响[J].护理研究,2015,29(12B):4421-4423.
[13] 杨玲凤,刘芳,黄金,等.糖尿病多学科教育团队的建立与培训[J].护理学杂志,2014,29(9):54-56.
[14] Speight J,Bradley C. The ADKnowl: identifying knowledge deficits in diabetes care[J]. Diabet Med, 2001, 18(8):626-633.
[15] 朱伟燕.糖尿病患者知识量表的汉化及在杭州市区三甲医院糖尿病人群中的调查[D].杭州:浙江大学,2010.
[16] Anderson RM,Fitzgerald JT,Funnell MM,et al. The third version of the Diabetes Attitude Scale[J]. Diabetes Care, 1998, 21(9):1403-1407.
[17] 周小萍.糖尿病态度量表的汉化及在杭州市区三甲医院糖尿病人群中的调查[D].浙江大学,2010.
[18] Toobert DJ,Hampson SE,Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale[J]. Diabetes Care, 2000, 23(7):943-950.
[19] Whittemore R,D′Eramo Melkus G,Grey M. Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes[J]. J Clin Nurs, 2005, 14(2):195-203.
[20] 华丽,朱伟萍.中文版《糖尿病自我管理行为量表》的信效度验证[J].解放军护理杂志,2014,31(16):5-8.
[21] 万巧琴,尚少梅,来小彬,等.2型糖尿病患者自我管理行为量表的信、效度研究[J].中国实用护理杂志,2008,24(3A):26-27.
[22] Xu Y,Toobert D,Savage C,et al. Factors influencing diabetes self-management in Chinese people with type 2 diabetes[J]. Res Nurs Health, 2008, 31(6):613-625.
[23] Huang J,Liu Y,Zhang Y,et al. [Correlation between self-management and knowledge of and attitude to diabetes in type 2 diabetic patients in Changsha][J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2013, 38(2):176-181.
[24] 姚平,嵇加佳,薛存屹,等.糖尿病患者态度对自我管理行为及代谢指标的影响[J].护理学报, 2015,22(1):33-36.
[25] 于平平,肖湘成,王琳云,等.社区2型糖尿病患者的自我管理行为与其血糖控制的相关性研究[J].中南大学学报(医学版),2013,38(4):425-431.
[26] Parchman ML,Pugh JA,Noel PH,et al. Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes[J]. Med Care, 2002,40(2):137-144.