问题导向式护理干预对老年2型糖尿病患者自护能力及疾病感知能力的影响

目的探究问题导向式护理干预对老年2型糖尿病（T2DM）患者自护能力和疾病感知能力的影响。 方法选择2016年11月至2018年11月海军第九七一医院的老年T2DM患者42例，进行为期6个月的问题导向式护理干预。对比护理干预前后患者的血糖控制情况、自护能力和疾病感知能力。自护能力使用糖尿病自护行为量表进行评价，疾病感知能力使用糖尿病疾病感知问卷简表进行评价。干预前后各指标的比较采用t检验。 结果与干预前比较，护理干预后患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均明显下降（t=5.183、14.188、4.926，P<0.05），自护能力各项目（总体饮食、具体饮食、运动、血糖测试、足部护理、吸烟）和疾病感知能力各项目（认知描绘、情绪描绘、综合理解）评分均明显提高（t=14.730、12.965、6.414、10.995、10.525、10.502、9.879、10.926、23.662，P<0.05）。 结论问题导向式护理干预能够通过提高老年T2DM患者的自护能力和疾病感知能力，达到更好地控制血糖的目的。

Effect of problem-oriented nursing intervention on self-care ability and disease perception ability of elderly patients with type 2 diabetes mellitus

ObjectiveTo investigate the effect of problem-oriented nursing intervention on self-care ability and disease perception ability of elderly patients with type 2 diabetes mellitus (T2DM). MethodsTotally 42 elderly patients with T2DM in the No.971 Hospital of Chinese PLA Navy from November 2016 to November 2018 were selected for 6 months of problem-oriented nursing intervention. The blood glucose control, self-care ability and disease perception ability of patients before and after nursing intervention were compared. The self-care ability was evaluated by the summary of diabetes self-care activities questionnaire, and the disease perception ability was evaluated by brief illness perception questionnaire. T test was used to compare the indexes before and after intervention. ResultsAfter nursing intervention, the levels of fasting blood glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin of patients decreased (t=5.138, 14.188, 4.926, P < 0.05), and the scores of self-care ability (including general diet, specific diet, exercise, blood sugar testing, foot care and smoking) and disease perception ability (including cognitive representation, emotional representation, illness coherence) were improved (t=14.730, 12.965, 6.414, 10.995, 10.525, 10.502, 9.879, 10.926, 23.622, P < 0.05). ConclusionProblem-oriented nursing intervention can better control blood glucose in elderly patients with T2DM by improving their self-care ability and disease perception ability.