全科诊疗模式对老年2型糖尿病病人自我效能的影响研究  

Effect of general practice mode on self-efficacy in the elderly patients with T2DM

作　　者：麦华德 宋艳玲[1] 林芸芸[1] 纪新博[1] 王雅纯[1] 陈明慧 顾申红[1] MAI Hua-de;SONG Yan-ling;LIN Yun-yun;JI Xin-bo;WANG Ya-chun;CHEN Ming-hui;GU Shen-hong(Department of General Medicine,the First Affiliated Hospital of Hainan Medical University,Haikou 570100,China)

机构地区：[1]海南医学院第一附属医院全科医学科,海南省海口市570100

出　　处：《实用老年医学》2020年第6期551-553,557,共4页Practical Geriatrics

基　　金：海南省医药卫生科研项目(18A200072)。

摘　　要：目的探讨全科诊疗模式在以解决老年慢性病(以T2DM为例)为核心的医联体建设与创新中的应用。方法选择2018年8月至2019年5月在我院医联体海口市大园、金贸、滨海、金盘4个社区治疗的老年T2DM病人200例作为对象,按随机数字表分为对照组和观察组,每组各100例。对照组给予传统诊疗模式,观察组采用全科诊疗模式,比较2组病人满意度、自我效能、血糖水平、住院时间及医疗费用。结果观察组诊疗方法、诊疗形式、服务态度、诊疗内容满意度及整体满意度均高于对照组,差异有统计学意义(P<0.05)。观察组诊疗后情绪控制评分、合理休息评分、疼痛及不适的控制评分、自我保健评分、遵医用药管理评分及健康问题评分均高于对照组(P<0.05);观察组治疗后FPG、HbA1c、住院时间、医疗费用均低于对照组,差异有统计学意义(P<0.05)。结论将全科诊疗模式用于老年T2DM病人,能提高其满意度及自我效能,且有助于改善病人血糖水平,缩短住院时间,减少医疗费用,值得推广应用。Objective To explore the application of the general diagnosis and treatment model in the elderly patients with type 2 diabetes from the medical alliance.Methods A total of 200 elderly patients with type 2 diabetes who treated in the community of Dayuan,Jinmao,Binhai and Jinpan,from August 2018 to May 2019 were selected and divided into control group and observation group,with 100 cases in each group.The control group was treated with the traditional diagnosis and treatment mode,and the observation group was treated with the general practice mode.The satisfaction,self-efficacy,blood glucose level,hospitalization time and medical expenses of the two groups were compared.Results The satisfaction of treatment form,service attitude,diagnosis and treatment content,and the overall satisfaction in the observation group after intervention were significantly higher than those in the control group(P<0.05);The scores of emotional control,reasonable rest,pain and discomfort control,self-care,medical management and health problem in the observation group after intervention were higher than those in the control group(P<0.05).The fasting blood glucose,glycated hemoglobin and hospitalization time in the observation group were statistically lower than those in the control group(P<0.05).Conclusions The general diagnosis and treatment model can improve the satisfaction and self-efficacy of the elderly patients with type 2 diabetes,which can improve the blood glucose level,shorten the hospital stay and reduce the medical expenses.It is worthy of popularization and application.

关 键 词：全科诊疗模式 老年人 2型糖尿病 满意度 自我效能 医联体 

分 类 号：R587.1[医药卫生—内分泌]