基于叙事护理改善社区老年2型糖尿病患者胰岛素注射痛苦的效果研究  

Study on the effect of narrative nursing on alleviating the pain of insulin injection in elderly patients with type 2 diabetes mellitus in community

作　　者：曹环 刘慧芳 何荣莉 张雅萍 巩昕[3] 周良 王朝昕 张瑞凤 CAO Huan;LIU Huifang;HE Rongli;ZHANG Yaping;GONG Xin;ZHOU Liang;WANG Zhaoxin;ZHANG Ruifeng(Meilong Community Health Service Center,Minhang District,Shanghai 201104,China;Department of Infectious Disease,Shanghai Sixth People's Hospital,Shanghai 200235,China;Department of Cardiology,East Hospital Affiliated to Tongji University,Shanghai 200120,China;School of Public Health,Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海市闵行区梅陇社区卫生服务中心,201104 [2]上海市第六人民医院感染科,200235 [3]同济大学附属东方医院心内科,上海市200120 [4]上海交通大学公共卫生学院,上海市200025

出　　处：《护理管理杂志》2024年第2期98-102,共5页Journal of Nursing Administration

基　　金：国家重点研发计划项目(2022YFC3601500);国家自然科学基金青年项目(72204187);上海市中西医结合学会社区医学与健康管理科研项目(2021-42)。

摘　　要：目的探讨基于叙事护理改善社区老年2型糖尿病患者胰岛素注射痛苦的效果。方法采用随机分组方法将140例社区老年2型糖尿病患者分为观察组和对照组,各70例。对照组采用常规糖尿病护理管理模式,观察组在常规护理模式基础上,通过组建叙事护理小组、制订叙事护理干预方案并实施,比较两组患者在入组第1天和入组第8周的血糖指标达标情况、糖尿病痛苦评分和胰岛素抵抗评分。结果干预后观察组空腹血糖达标率、餐后2 h血糖达标率、糖化血红蛋白达标率均明显高于干预前,差异有统计学意义(P<0.05),但与对照组比较差异无统计学意义;干预后观察组糖尿病痛苦总分明显低于对照组,差异有统计学意义(P<0.05);干预后观察组胰岛素抵抗评分明显低于对照组,差异有统计学意义(P<0.05)。结论叙事护理能提高社区老年2型糖尿病胰岛素注射患者血糖控制水平,缓解糖尿病痛苦,有效降降低心理性胰岛素抵抗。Objective To explore the effect of narrative nursing in alleviating the pain of insulin injection in elderly patients with type 2 diabetes mellitus in community.Methods A total of 140 elderly patients with type 2 diabetes mellitus in community were divided into observation group and control group by random sampling method,with 70 cases in each group.The patients in the control group were managed by routine diabetes nursing management mode.On the basis of routine nursing mode,the observation group established a narrative nursing group,formulated a narrative nursing intervention program and implemented it.The compliance of the blood glucose index,the diabetes pain score and psychological insulin resistance score were compared between the two groups on the first day and the eighth week of enrollment.Results After intervention,the fasting blood glucose compliance rate,postprandial 2 h blood glucose compliance rate and glycosylated hemoglobin compliance rate in the observation group were significantly higher than those before intervention,and the differences were statistically significant(P<0.05),but there was no statistical difference compared with the control group.After intervention,the total score of diabetes pain in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).After intervention,the psychological insulin resistance score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Narrative nursing can improve the blood glucose control level of elderly patients with insulin injection,relieve the pain of diabetes,and effectively reduce the psychological insulin resistance.

关 键 词：叙事护理 胰岛素注射 糖尿病痛苦 老年患者 2型糖尿病 

分 类 号：R473.5[医药卫生—护理学]