以专科护士为主导的健康管理在糖尿病前期患者中的实践研究  

The practical exploration of health management led by specialist nurses on patients with prediabetes

作　　者：方英[1] 贡浩凌[1] 贾悦[1] FANG Ying;GONG Haoling;JIA Yue(Department of Endocrinology,People's Hospital Affiliated to Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属人民医院内分泌科

出　　处：《护理管理杂志》2019年第11期794-798,共5页Journal of Nursing Administration

基　　金：江苏省卫生和计划生育委员会科研项目(N2017012);镇江市卫生和计划生育委员会项目(SHW2016006);镇江市重点研发计划-社会发展项目(SH2017028)

摘　　要：目的探讨以糖尿病专科护士主导的优化策略在糖尿病前期患者健康管理中应用的效果。方法选取68例糖尿病前期患者作为研究对象,专科护士协同参与包括质量控制、专科培训和健康信息采集、糖尿病风险评估、多形式分层个案健康管理及持续健康干预和跟踪随访等全程无缝隙健康管理全过程,评估干预前及干预后6个月糖尿病前期患者自我管理能力、代谢指标和体质指数及满意度状况。结果干预后6个月糖尿病前期患者健康观念、自我效能、饮食管理、运动管理、休息与睡眠管理、压力应对、依从性管理与干预前比,差异均具有统计意义(P<0.01)。家庭环境管理以及社会环境管理与入组前的差异无统计学意义;干预后6个月糖尿病前期患者空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等代谢指标及体质指数比干预前改善明显(P<0.01或P<0.05);且患者对健康管理的满意度提高。结论以专科护士为主导的健康管理有效提高糖尿病前期患者自我管理能力、代谢指标及体质指数和满意度,保障了院内、院外无缝式护理,满足了糖尿病前期患者多层次的健康需求。Objective To explore the practical effect of health management led by specialist nurses on patients with prediabetes.Methods A total of 68 patients with prediabetes were selected as research objects.The health management included specialist nurses participation in quality control,specialized training,pre-test health information collection,diabetes risk assessment,multi-level case health management,continuous health intervention,and follow-up.The self-management ability,metabolic index and body mass index of patients with prediabetes before and 6 months after intervention were evaluated.Results Six months after intervention,there were statistically significant differences in health concept,self-efficacy,diet management,exercise management,rest and sleep management,stress response,and compliance management than those of pre-intervention(P<0.01).There were no statistically significant difference between family environmental management and social environmental management.Fasting blood glucose,2-h postprandial blood glucose,glycosylated hemoglobin,cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,body mass index and other metabolic indexes of patients with impaired glucose regulation 6 months after intervention were significantly improved compared with those before intervention(P<0.01 or P<0.05).The satisfaction rate of patients to health management improved after 6 months of intervention.Conclusion The health management led by specialist nurses can effectively improve the self-management ability,metabolic index,body mass index and satisfaction rate of patients with impaired sugar regulation,and guarantee the seamless in-hospital and out-of-hospital nursing to meet the multi-level health needs of patients with impaired sugar regulation.

关 键 词：糖尿病前期 专科护士 健康管理 延续护理 

分 类 号：R473.58[医药卫生—护理学] C931.2[医药卫生—临床医学]