内分泌专科与非专科护士对住院糖尿病患者胰岛素注射管理的比较分析  

Comparison of the hospitalized patients with diabetes for insulin injection between endocrinology and non-endocrinology department nurse

作　　者：孙慧伶[1] 翟振艳[1] 叶兰[1] 唐娇艳[1] 张瑜[1] 

机构地区：[1]广州军区武汉总医院内分泌科,430070

出　　处：《国际护理学杂志》2014年第11期2986-2990,共5页international journal of nursing

基　　金：武汉市科技局课题

摘　　要：目的：调查分析综合医院内分泌专科和非内分泌专科护士对住院糖尿病患者的胰岛素注射管理情况及差异。方法2012年1月至2013年12月，共纳入三甲综合医院323例采用胰岛素治疗的糖尿病住院患者，按其来源分为内分泌科患者（ n＝213）和非内分泌科患者（ n＝110），采用填写问卷和访谈的方法对所有患者进行胰岛素注射管理层面的调查，包括是否掌握了正确的胰岛素注射方法、对胰岛素注射装置的了解、是否明确注射不良反应、接受的注射教育等，分析比较两组患者对于上述胰岛素注射管理的问题了解是否存在差异。结果内分泌科回收有效问卷181份，非内分泌科回收有效问卷99份。两组患者胰岛素基线使用时间一致，但与非内分泌科患者相比，内分泌科患者进行胰岛素规范注射的比例更高，包括注射前皮肤消毒、注射部位大轮换、皮下注射、停留时间较长等；绝大多数患者注射时无明显疼痛和出血，而最常见的引发疼痛的原因是重复使用针头，而之所以重复使用针头又多是从节约费用考虑出发。35.91％的内分泌科患者和46.46％的非内分泌科患者曾遗漏注射胰岛素，最常见的原因是忘记，其他还包括未进餐、低血糖不适或处于公共场合等原因。从教育来源来看，两组患者均100％接受了护理人员的教育，其他还包括患教活动和阅读资料等，在随访中，非内分泌科患者更注重注射部位检查，每次就诊均检查注射部位的比例较高，而内分泌科患者有65.75％的患者从未检查过注射部位。结论内分泌科护士对于胰岛素规范治疗的教育较非专科护士更为充分，同时患者良好掌握的比例更高，但对患者注射后随访指导不足；同时患者主观不重视和医疗费用障碍也是造成患者不能进行规范化胰岛素注射的原因。Objective To investigate the differences of the hospitalized patients with diabetes for insulin injection between endocri -nology and non-endocrinology department in the general hospital.Methods In general hospital from January 2012 to December 2013 , 323 hospitalized patients with diabetes for insulin injection were included ..According to the source of patients , all patients were divided into pa-tients from endocrinology （n=213） and patients from non-endocrinology （n=110） .The management of insulin for all patients was inves-tigated with questionnaire and interview , including the injection method of insulin , the acknowledge about insulin injection device , the ad-verse reactions of injection and the education of accepting injection.The differences of management of insulin were compared between the two groups.Results The valid questionnaires collected from endocrinology and non -endocrinology department were 181 and 99, respective-ly.The using time of insulin at baseline was the same between the two groups.Compared with the patients from non -endocrinology depart-ment , the proportion of regulate injections with insulin of patients in endocrine department is higher , including skin disinfection before injec-tion, the large rotation of injection site , subcutaneous , stay longer and so on.Most of patients were not obvious pain and bleeding , and the common reason for pain was reuse of needles.35.91%of patients with endocrinology and 46.46%of patients without endocrine had been o-mitted from insulin injection , and the most common reason was forgetting , but also included not eating , discomfort for low blood sugar or sta-ying in public places.The both groups accepted the education from doctors and nurses.In the following-up, the patients in non-endocrinol-ogy department pay more attention with the sites of injection , but 65.75%of patients in endocrinology department had never checked the in-jection sites.Conclusions The education of regulate treatment with insulin in endocrinology department was more

关 键 词：糖尿病 胰岛素注射 管理 

分 类 号：R473.5[医药卫生—护理学]