叙事医学模式结合看图对话工具在2型糖尿病高危足患者中的干预研究  

An Intervention Study of Narrative Medicine Mode Combined with Conversation Map in Patients with High-risk Type 2 Diabetic Foot

作　　者：封爱婷 杨思红 徐笑[1] 陆晓东[1] 钱守莉 Feng Aiting;Yang Sihong;Xu Xiao;Lu Xiaodong;Qian Shouli(Department of Diabetes,Lianyungang Hospital of Chinese Medicine,Lianyungang City,Jiangsu 222004,China)

机构地区：[1]连云港市中医院糖尿病科

出　　处：《中国烧伤创疡杂志》2019年第6期394-399,共6页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：江苏省连云港市中医院“赵化南”青年科技基金项目(Lzyq1806)~~

摘　　要：目的研究叙事医学模式结合看图对话工具在2型糖尿病高危足患者中的应用效果。方法选取2017年11月至2018年11月连云港市中医院糖尿病科收治的80例2型糖尿病高危足患者作为研究对象,并按照随机数表法将其随机分为观察组(40例)与对照组(40例),其中观察组患者采用叙事医学模式结合看图对话工具进行健康教育,对照组患者采用传统授课方式进行健康教育,对比观察两组患者足趾畸形、甲沟炎、足麻木、足皲裂等发生情况,温度觉、振动觉、压力觉、痛觉与下肢动脉血流异常情况,以及焦虑自评量表(selfrating anxiety scale,SAS)评分和抑郁自评量表(self-rating depression scale,SDS)评分。结果护理干预后,观察组患者甲沟炎与足皲裂发生例数较对照组明显减少,差异具有统计学意义(χ^2=5.591、5.952,P=0.018、0.015),温度觉、振动觉、压力觉、痛觉与下肢动脉血流异常发生例数均明显少于对照组,差异具有统计学意义(χ^2=6.054、8.455、6.146、4.114、6.146,P=0.014、0.004、0.013、0.043、0.013);护理干预后,观察组患者SAS评分及SDS评分均明显低下对照组,差异具有统计学意义(t=3.629、13.559,P=0.001,0.001),且两组患者SAS评分及SDS评分与干预前相比均显著降低,P均<0.05,差异具有统计学意义,结论叙事医学模式结合看图对话刁工具能够有效改善2型糖尿病高危足患者的足部相关症状,缓解其焦虑、抑郁情绪。Objective To study the application effect of narrative medicine mode combined with conversation map in patients with high-risk type 2 diabetic foot.Methods Eighty patients with high-risk type 2 diabetic foot,admitted to the Department of Diabetes,Lianyungang Hospital of Chinese Medicine from November 2017 to November 2018,were divided,according to the random number table,into an observation group(40 cases)and a control group(40 cases).The patients in the observation group were given narrative medicine mode combined with conversation map for health education whereas the patients in the control group were managed with the traditional teaching method for health education.The following indicators including the occurrence of toe deformity,paronychia,foot numbness and foot rhagades,abnormalities of temperature sensation,vibration sensation,pressure sensation,pain sensation and lower extremity arterial blood flow,as well as self-rating anxiety scale(SAS)score and self-rating depression scale(SDS)score were observed and compared between the two groups.Results After the nursing intervention,the numbers of cases with paronychia and foot rhagades in the observation group were reduced more markedly than that in the control group and the differences were statistically significant(χ^2=5.591 and 5.952 respectively,P=0.018 and 0.015 respectively);the numbers of cases with abnormilies of temperature sensation,vibration sensation,pressure sensation,pain sensation and lower extremity arterial blood flow in the observation group were all obviously less than that in the control group and also all the differences were statistically significant(χ^2=6.054,8.455,6.146,4.114 and 6.146 respectively,P=0.014,0.004,0.013,0.043 and 0.013 respectively).After the nursing intervention,the SAS score and SDS score in the observation group were both markedly lower than that in the control group and the differences showed statistical significance(t=3.629 and 13.559 respectively,P=0.001 and 0.001 respectively).And moreover,the SAS score and SDS scor

关 键 词：叙事医学 看图对话 2型糖尿病 糖尿病高危足 健康教育 效果 

分 类 号：R47[医药卫生—护理学]