个案管理师主导的糖尿病足部溃疡患者照护方案实施  

Implementation of case manager-led care program for diabetic foot ulcer patients

作　　者：张英英[1] 胡迪[2] 曹圆琦 江哲珍[1] 刘丽丽[1] Zhang Yingying;Hu Di;Cao Yuanqi;Jiang Zhezhen;Liu Lili(Department of Trauma and Microorthopedics,Central South Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创伤与显微骨科,湖北武汉430071 [2]武汉大学中南医院Ⅰ期临床研究室,湖北武汉430071

出　　处：《护理学杂志》2023年第7期31-34,共4页Journal of Nursing Science

基　　金：武汉大学中南医院临床护理研究项目(LCHLYJ202224)。

摘　　要：目的实施个案管理师主导的糖尿病足部溃疡患者照护方案,提高糖尿病足护理效果。方法选取伤口治疗师担任个案管理师,依托创面治疗医生、康复师、骨科专科护士、糖尿病专科护士组成多学科协作团队,对146例糖尿病足部溃疡住院患者实施个案管理。结果146例患者均没有新发足部溃疡,患者出院后6个月的Wagner分级较干预前显著改善(P<0.05);患者出院后6个月空腹血糖及糖化血红蛋白水平较出院前显著下降(均P<0.05)。患者出院后糖尿病自我管理活动评分、足部护理知识和行为得分较入院时显著提高(均P<0.05)。结论实施个案管理师主导的照护方案可以有效提高糖尿病足部溃疡患者自我管理活动能力,改变其足部护理知识和行为,有效控制血糖,促进创面愈合。Objective To implement the case manager-led care program for diabetic foot ulcer patients,and to improve care results of diabetic foot ulcers.Methods Wound therapists were selected as case managers,who worked in tandem with a multidisciplinary team consisting of wound therapists,rehabilitation therapists,orthopedic nurses and diabetes nurses,to carry out case management for 146 hospitalized patients with diabetic foot ulcers.Results None of the 146 patients had new foot ulcers,and Wagner′s score at 6 months after discharge was significantly improved compared with that before intervention(P<0.05).Fasting blood glucose and glycosylated hemoglobin levels were significantly decreased 6 months after discharge compared with those before discharge(all P<0.05).The scores of self-management activities,knowledge of foot care and behavior of patients after discharge were significantly higher than those at admission(all P<0.05).Conclusion The implementation of case manager-led care program can effectively improve self-management activities of patients with diabetic foot ulcers,change their knowledge and behavior of foot care,effectively control blood sugar,and promote wound healing.

关 键 词：糖尿病 糖尿病足 溃疡 创面 个案管理 多学科协作团队 照护方案 

分 类 号：R473.5[医药卫生—护理学]