医院社区联动自我管理教育模式对糖尿病患者治疗效果的影响研究  

Effect of Hospital-Community Integrated Self Education and Management Mode for Diabetics

作　　者：刘莉莉[1] 孙子林[1] 金晖[1] 鞠昌萍[1] 韩晶[1] 陆青松[1] 

机构地区：[1]东南大学附属中大医院内分泌科,江苏省南京市210009

出　　处：《中国全科医学》2011年第1期59-61,69,共4页Chinese General Practice

基　　金：江苏省卫生厅重大科研项目(K200608);江苏省科技厅自然科学基金重点项目(BK2010087)

摘　　要：目的评价医院社区联动自我管理教育模式对常规治疗效果不佳的2型糖尿病患者的代谢控制、自我管理水平和生活质量的影响。方法将134例常规治疗后糖化血红蛋白水平超过6.5%的2型糖尿病患者随机分为医院社区联动自我管理教育组(自我管理组,74例)和常规糖尿病健康教育管理组(对照组,60例)两组。自我管理组首先在综合医院糖尿病中心接受连续五天的全日制糖尿病自我管理教育,随后建立社区健康管理档案定期接受电话和门诊随访。对照组仅接受常规糖尿病健康教育和社区常规跟踪随访。评价干预前和实施健康教育管理1年后的血糖、血压、血脂、糖尿病知识、自我管理水平和生活质量的变化。结果干预后,两组患者的空腹血糖、餐后血糖和糖化血红蛋白水平均较干预前显著下降,差异有统计学意义(P<0.05);同时,自我管理组患者的空腹血糖、餐后血糖和糖化血红蛋白水平显著低于对照组,差异均有统计学意义(P<0.05)。干预后,自我管理组糖尿病知识、自我管理效能和技能得分均显著高于对照组,差异有统计学意义(P<0.05)。干预后,自我管理组患者的满意维度得分和生活质量总分显著提高,并且满意维度评分优于对照组,差异均有统计学意义(P<0.05)。结论医院社区联动自我管理教育模式在提高2型糖尿病患者糖尿病知识、自我管理水平与改善糖尿病控制、提高生活质量满意度方面优于常规糖尿病健康教育方法。Objective To evaluate the effect of hospital - community integrated self education and management mode on the levels of metabolic control, self - management skills and quality of life of patients with type Ⅱ diabetes mellitus who had no satisfactory response to the routine treatment. Methods A total of 134 patients with type Ⅱ diabetes mellitus, whose glycosylated hemoglobin （HbAIo） was higher than 6. 5% after routine treatment, were randomly assigned to hospital - community integrated self education and management program （self- management group, n = 74 ） and conventional education and management program （control group, n = 60）. The patients in the self - management group received diabetes self - management education for 5 sequential days in hospital and followed by telephone and outpatient interview in community. The patients in the control group only received conventional education and management. The blood glucose, blood pressure, blood fat, knowledge on diabetes mellitus, level of selfmanagement, and quality of life at baseline and 12 months after the intervention were assessed. Results After the intervention, the levels of fasting blood glucose （FBG）, 2 -hour postprandial blood glucose （2hPG）, and HbAIo in the two groups were significantly reduced （ P 〈 0. 05 ） ; and those in the self - management group were significantly lower than those in the control group （ P 〈 0.05 ）. The knowledge on diabetes mellitus, self - management efficacy and skills were increased much more in the self - management group than in the control group （P 〈 0. 05 ）, The score of satisfaction and the total score of quality of life in the self- management group were significantly increased, and the satisfaction score was higher than that in the control group （P 〈 0. 05） . Conclusion The hospital - community integrated self education and management mode is better than the conventional education and management program in improve the knowledge on diabetes mellitus, self - efficacy and self -

关 键 词：糖尿病 医院社区联动模式 健康教育 自我管理 生活质量 

分 类 号：R587[医药卫生—内分泌]