三维质量评价模式在老年糖尿病患者个案管理中的应用研究  

Application of 3D quality evaluation system on case management of elderly patients with diabetes mellitus

作　　者：方英[1] 贡浩凌[1] 贾悦[1] 戴莉敏[1] FANG Ying;GONG Haoling;JIA Yue;DAI Limin(Department of Endocrinology,People's Hospital Affiliated to Jiangsu University,Zhenjiang212001,China)

机构地区：[1]江苏大学附属人民医院内分泌科,镇江市212001

出　　处：《护理管理杂志》2018年第12期900-904,共5页Journal of Nursing Administration

基　　金：镇江市卫生和计划生育委员会项目(SHW2016006);镇江市科技计划项目(SH2015048);镇江重点研发计划-社会发展(SHW2017028)

摘　　要：目的探讨三维质量评价模式在老年糖尿病患者个案管理中的应用效果。方法选择某三级甲等医院的97例老年糖尿病患者为研究对象,分为干预组48例与对照组49例,对照组实施常规健康教育及指导,干预组在对照组基础上实施三维质量评价模式的个案管理,包括构建质量评价方案、细化个案管理结构和过程及制订系统评价指标等。结果干预后干预组得分均降低,且疾病、生理、社会及满意度4个维度低于对照组(P<0.01或P<0.05);饮食管理、运动管理、遵医嘱服药、自我血糖监测、足部护理、吸烟状况各维度得分均高于对照组(P<0.01或P<0.05);空腹血糖、糖化血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血清胰岛素等代谢指标与对照组比较差异有统计学意义(P<0.01或P<0.05)。结论三维质量评价模式提高了老年糖尿病患者对疾病的认知、生活质量和满意度,改善了治疗效果。Objective To explore the effect of structure-process-outcome3D quality evaluation system on case management of elderly patients with diabetes mellitus(DM).Methods A total of97elderly patients with DM were divided into intervention group(n=48)and control group(n=49).The control group received routine health education and guidance.The intervention group received structure-processoutcome quality evaluation system on case management,including designed quality evaluation program,case management structure and evalua-tion index system.Results The four dimensions and total scores in intervention group were lower than those of control group(P<0.01or P<0.05).Self-management in diet and exercise,medicine-taking compliance,self-blood glucose monitoring,foot nursing and smoke were higher than the control group(P<0.01or P<0.05).Fasting plasma glucose,glycosylated hemoglobin,triglycerides,high density lipoprotein cholesterol,low density lipoprotein,free immunoreactive insulin metabolism indexes were statistically different with control group(P<0.01or P<0.05).Conclusion Structure-process-outcome3D quality evaluation system can improve the cognition of disease the quality of life and satisfaction in elderly patients with DM.

关 键 词：老年 糖尿病 个案管理 生活质量 

分 类 号：R473.58[医药卫生—护理学]