基于阶梯变化理论的群组管理模式在肥胖型多囊卵巢综合征中的应用  

Application of group management model based on stage change theory in obese polycystic ovary syndrome

作　　者：晋雪然 王璐鹭 史莉[1] 罗丽燕 宋东红[1] Jin Xueran;Wang Lulu;Shi Li;Luo Liyan;Song Donghong(Reproductive Medicine Center,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院生殖医学中心,北京100191

出　　处：《国际护理学杂志》2024年第1期88-94,共7页international journal of nursing

基　　金：北京大学第三医院院护理科研基金(BYSYHL2020004)。

摘　　要：目的探讨基于阶梯变化理论的群组管理模式对肥胖型多囊卵巢综合征(PCOS)患者治疗效果的影响。方法选取2020年6月至2021年6月北京大学第三医院生殖医学中心就诊的100例肥胖型PCOS患者作为研究对象,采用双盲随机分组为对照组和干预组,各50例。对照组采用常规护理及健康教育,干预组在对照组的基础上基于阶梯变化理论的群组管理模式为患者制定护理方案,群组管理活动采取集中讲座、小组讨论、典型示范、同伴教育等方式进行,通过定期反馈与随访获取患者阶段变化状况,建立动态调整干预策略,最后,对比患者治疗依从性、体重指数(BMI)、腰臀围比、生活质量水平评分、超声检查卵巢多囊样改变及血清总睾酮水平。结果通过群组管理,干预组患者的依从性评分、BMI及腰臀比与入组前比较均有明显下降,且低于对照组,差异有统计学意义(P<0.05);干预组患者的生活质量评分为(143.28±26.97)分,高于对照组(138.86±26.77)分,差异有统计学意义(t=3.60,P<0.05)。结论基于阶梯变化理论的群组管理模式有助于提高治疗依从性,进而降低肥胖型PCOS患者的BMI、腰臀比,缓解高雄激素血症及卵巢多囊样改变,同时改善了患者的生活质量。Objective To explore the effect of group management model based on ladder change theory on the treatment of obese patients with polycystic ovary syndrome(PCOS).Methods A total of 100 obese PCOS patients who were treated in this hospital from June 2020 to June 2021 were selected as the research sample,which were divided into control group and intervention group by double blind random grouping,50 cases in each group.The control group adopted routine nursing and health education,while the intervention group formulated nursing plans for patients based on the group management mode based on the ladder change theory on the basis of the control group.The group management activities were carried out by means of centralized lectures,group discussions,typical demonstrations,peer education,etc.The patients'stage changes were obtained by regular feedback and follow-up,so as to adjust the intervention strategies dynamically.The treatment compliance,Body Mass Index(BMI),waist hip circumference ratio,quality of life scale,ultrasound examination of ovarian polycystic change and serum total testosterone were used to evaluate the intervention effect.Results Through group management,the compliance scores,BMI and waist-to-hip ratio of patients in the intervention group were significantly decreased compared with those before enrollment,and were lower than those in the control group,and the difference was statistically significant(P<0.05).The quality of life score of intervention group(143.28±26.97)was higher than that of control group(138.86±26.77),and the difference was statistically significant(t=3.60,P<0.05).Conclusions The group management model based on the ladder change theory is helpful to improve the compliance of treatment,so as to reduce the BMI and waist hip ratio of obese PCOS patients,alleviate hyperandrogenism and ovarian polycystic changes,and improve the quality of life of patients.

关 键 词：多囊卵巢综合征 群组管理 生活方式干预 肥胖 阶梯变化 

分 类 号：R473.71[医药卫生—护理学]