2型糖尿病患者社区个案管理模式的效果研究  

Effect of community case management model in patients with type 2 diabetes mellitus

作　　者：徐婕[1] 洪都[2] 戴丽学[1] 沈华英[1] 章丽英[1] 倪林[1] 

机构地区：[1]浙江省湖州市第一人民医院内分泌科,浙江湖州313000 [2]湖州师范学院护理学院护理教研室,浙江湖州313000

出　　处：《中国现代医生》2015年第25期132-136,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2012ZHB017);浙江省湖州市科技计划项目(2012YSB07)

摘　　要：目的探讨社区个案管理模式的运用对长期血糖控制不佳的2型糖尿病患者（T2DM）自我管理水平及生存质量的影响。方法采用随机对照试验（RCT）研究,将2013年6~12月在湖州市第一人民医院确诊的飞英街道社区2型糖尿病患者105例按随机数字表法随机分为干预组（53例）和对照组（52例）。干预组在常规护理基础上接受6个月的社区个案管理干预,对照组接受常规管理和护理。干预前及干预6个月后检测并比较两组患者糖化血红蛋白（Hb A1C）和空腹血糖水平;采用中文版糖尿病自我管理行为量表（SDSCA）评价两组患者自我管理水平并进行比较。结果干预6个月后两组患者Hb A1C水平和空腹血糖变化差异无统计学意义（P〉0.05）,但基线水平较干预前均有下降。两组患者在饮食控制、运动锻炼、血糖监测、用药安全等自我管理行为方面的差异有统计学意义（P〈0.05）,干预组优于对照组。结论社区糖尿病个案管理模式不仅对T2DM患者的血糖和Hb A1C控制有一定的作用,可以显著改善其自我管理水平,提高其生存质量。Objective To evaluate the effect of community case management model（CCMM） on quality of life and selfmanagement ability in type 2 diabetes patients with poor control of blood glucose. Methods Totally 105 patients in feiying street community diagnosed with type 2 diabetes by Huzhou First people＇s Hospital were randomly divided into two groups（experimental group： n=53; control group： n=52）. The patients in the control group received routine diabetes management and nursing,while the patients in the experimental group received community case management model intervention. Before intervention and six months after intervention, Hb A1 C level and fasting blood-glucose of two groups＇ patients were checked and compared. Chinese version scale of the diabetes self-care activities（SDSCA） were used to evaluated self-management ability and quality of life. Results There was no significant difference in Hb A1 C level and fasting blood glucose level between the two groups after 6 months of intervention（P〉0.05）, but the baseline level was decreased. In the two groups of patients in the diet control, exercise, blood glucose monitoring, drug safety and other self management behavior differences were statistically significant（P〈0.05）, the intervention group was better than the control group. Conclusion CCMM intervention is more effective than routine diabetes management and nursing on the improvement of self-management ability and quality of life in type 2 diabetes patients with poor control of blood glucose.

关 键 词：个案管理 2型糖尿病 社区卫生服务 健康教育 自我管理 

分 类 号：R473.2[医药卫生—护理学]