TELSA结构化教育对成人1型糖尿病患者的干预效果  

Application of TELSA structured education program in adults with type 1 diabetes mellitus

作　　者：刘芳[1] 谢雨婷[1] 徐蓉[2] 范黎 李娟[1] 李霞[1] 黄金[2] 周智广[1] Liu Fang;Xie Yuting;Xu Rong;Fan Li;Li Juan;Li Xia;Huang Jin;Zhou Zhiguang(National Clinical Research Center for Metabolic Diseases,Key Laboratory of Diabetes Immunology,Ministry of Education,Department of Metabolism and Endocrinology,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Clinic Nursing Teaching and Research Section,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院代谢内分泌科国家代谢性疾病临床医学研究中心糖尿病免疫学教育部重点实验室,长沙410011 [2]中南大学湘雅二医院临床护理教研室,长沙410011

出　　处：《中华医学杂志》2022年第16期1202-1208,共7页National Medical Journal of China

基　　金：国家重点研发计划(2017YFC1309604);湖南省科技创新计划(2020RC4044)。

摘　　要：目的:评价“掌握我生活”(TELSA)结构化教育对我国成人1型糖尿病(T1DM)患者的干预效果。方法:选取2019年1月至2020年1月在中南大学湘雅二医院T1DM综合管理门诊就诊,符合入排标准且有意愿参加TELSA结构化教育的成人T1DM患者64例作为干预组,同时入组年龄、性别等匹配的64例患者作为对照组;干预过程中,干预组失访3例,对照组失访4例,最后干预组有效样本61例,对照组有效样本60例。对照组由T1DM专职教育护士进行1次面对面的教育,历时约2 h。干预组实施TELSA结构化教育项目。分别于干预前、干预后6个月、干预后12个月评估研究对象的糖化血红蛋白水平、自我管理能力、生活质量。结果:干预组和对照组年龄M(Q1,Q3)分别为30.0(22.0,43.5)、29.5(22.3,42.5)(P>0.05),男性比例分别为47.54%(29例)、45.00%(27例)(P>0.05);两组患者糖化血红蛋白水平、自我管理能力、生活质量均存在组间×时间的交互效应(P<0.05)。TELSA结构化教育干预后6和12个月,干预组患者的糖化血红蛋白由基线水平的(7.87±1.45)%分别降至(7.23±1.06)%、(7.28±0.93)%(均P<0.05),低于对照组的(7.72±1.20)%、(7.76±1.24)%(均P<0.05)。TELSA结构化教育干预后,干预组患者成人T1DM自我管理量表(SMOD-CA)得分呈上升趋势(P<0.001),糖尿病特异性生存质量量表(A-DQOL)得分呈下降趋势(P<0.001),而对照组患者得分趋势变化均差异无统计学意义(P值分别为0.853和0.227)。干预后6和12个月,干预组患者的SMOD-CA得分均高于对照组(均P<0.001),A-DQOL得分均低于对照组(均P<0.001)。结论:TELSA结构化教育可有效改善成人T1DM患者的糖代谢水平,提高患者的自我管理能力和生活质量。Objective To evaluate the effect of TELSA structured education program in adults with type 1 diabetes mellitus(T1DM)in China.Methods From January 2019 to January 2020,64 adult T1DM patients who met the standard of entry and had the intention to participate in TELSA structured education program were selected from the outpatient of type 1 diabetes comprehensive management in the Second Xiangya Hospital as intervention group.A total of 64 patients matched by age and sex were enrolled as the control group.During the program,the intervention group lost 3 cases and the control group lost 4 cases.Finally,there were 61 effective samples in the intervention group and 60 effective samples in the control group.The patients in the control group were given face-to-face education by a T1DM educator for about 2 hours.The patients in the intervention group were intervened according to TELSA structured education program.The level of glycosylated hemoglobin,the frequency of hypoglycemia,self-management ability and quality of life were evaluated before intervention,6 months after intervention and 12 months after intervention.Results The ages of the intervention group and the control group were 30.0(22.0,43.5)and 29.5(22.3,42.5)(P>0.05),and the proportions of males were 47.54%(29 cases)and 45.00%(27 cases),respectively(P>0.05).There were interaction effects(P<0.05)on the level of glycosylated hemoglobin,self-management ability and quality of life in the two groups.At 6 and 12 months after intervention of TELSA structured education program,the level of glycosylated hemoglobin in the intervention group decreased from the baseline level(7.87±1.45)%to(7.23±1.06)%and(7.28±0.93)%,respectively,which was significantly lower than that in the control group at 6 months(7.72±1.20)%and at 12 months(7.76±1.24)%(all P<0.05).After TELSA structured education intervention,the scores of self-management scale for adult type 1 diabetes mellitus(SMOD-CA)in the intervention group showed an upward trend(P<0.001),and the scores of diabetes-specific qua

关 键 词：糖尿病 1型 结构化教育 成人 

分 类 号：R473.5[医药卫生—护理学]