无线通讯短信教育在糖尿病患者自我管理中的应用

目的提高糖尿病患者对糖尿病相关知识的掌握水平,促进行为改变。方法在门诊选择80例2型糖尿病患者,随机分为短信教育组与对照组。短信教育组(下称短信组)首诊时给予常规教育和离院后短信教育;对照组只在首诊时给予常规教育。结果对于糖尿病知识的掌握情况,短信组优于对照组(P0.01);短信组的血糖控制情况亦优于对照组(P0.001)。结论对糖尿病患者进行短信教育有利于帮助他们获得解决问题的知识和技能,而且提高了患者自我管理意识。     

A nurse short message service by cellular phone in type-2 diabetic patients for six months

Aim. To investigate the effectiveness of a nurse short message service (SMS) by cellular phone and wire Internet on plasma glucose levels in people with diabetes for six months. Background. Blood glucose management system using telemedicine approaches may maintain the appropriate blood glucose levels in type‐2 diabetic patients. Design. A control group pre‐test–post‐test design was used to assess the effectiveness of nurse's education. Methods. Twenty‐five patients were randomly assigned to an intervention group and 26 to a control group. The intervention was applied for six months. The goal of the intervention was to keep blood glucose concentrations close to the normal range. Participants were requested to input their blood glucose level, diet and exercise diary everyday in the website by cellular phone or wire Internet. The researcher sends optimal recommendations to each patient using SMS by cellular phone and wire Internet weekly. Results. Glycosylated hemoglobin (HbA₁c) decreased 1·15% points at three months and 1·05% points at six months compared with baseline in the intervention group. Patients in the intervention group had a decrease of two hours post meal glucose (2HPMG) of 85·1 mg/dl at three months and 63·1 mg/dl at six months compared with baseline. Conclusion. This web‐based intervention using SMS of cellular phone improved HbA₁c and 2HPMG for six months in type‐2 diabetic patients. Relevance to clinical practice. An SMS of cellular phone intervention by a nurse can reduce HbA₁c and 2HPMG for six months in type‐2 diabetic patients.     

The effect of short message service intervention on glycemic control in diabetes: a systematic review and meta-analysis

ABSTRACT

Background: Compared with traditional outpatient follow up, short message service (SMS) provides more convenience for diabetes self-management. However, the feasibility, effectiveness, and satisfaction of SMS intervention remain unclear.

Methods: A systematic retrieval of databases, including PubMed, EMBASE, and Cochrane Library, was used to evaluate the effect of SMS on the diabetes glycemic control. Complete quantitative reports on the changes of glycosylated hemoglobin (HbA_1c) before and after intervention were collected. The study type was limited to randomized controlled trials (RCTs).

Results: 13 RCTs were identified as eligible for this subject. Overall result revealed a statistical decline of HbA_1c by -0.62% (95% CI -0.82 to -0.41). The longest intervention duration was 12 months with the noteworthy improvement of HbA_1c by -1.63% (-2.27 to -0.99). Compared with control groups, five trials quantitatively demonstrated a significant decline in fasting plasma glucose (FPG) by -0.45 (95% CI -0.7 to -0.19) and -1.05 (95% CI -1.35 to -0.75) in 2-h postprandial blood glucose (2hPBG).

Conclusions: This meta-analysis demonstrated that text message intervention indeed leads to a decline in HbA_1c and improvement of blood glucose control. No convincing evidence was found on quality of life improvement, satisfaction, body mass index (BMI), blood lipid levels, the frequency of hypoglycemia, self-monitoring of blood glucose or complications reduction.     

社区运动干预对2型糖尿病患者的影响

目的探讨有计划、有针对性的运动干预对社区糖尿病患者改善自身健康状况及血糖控制效果的影响。方法选择社区102例无运动禁忌证、在饮食控制和原有药物治疗的前提下进行有效运动干预的患者。运动治疗6个月、12个月后分别对体重、腹围、血压、空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c),血脂等指标进行测定,并和干预前检查的各项指标比较。结果运动干预6个月后患者的FBG、PBG、HbA1c、舒张压与干预的比较差异有统计意义(P0.01)。体重指数、腹围、甘油三酯(TG)、胆固醇(TC)、收缩压干预12个月后差异有统计学意义(P0.01)。结论运动干预对社区糖尿患者改善自身身体状况、控制血糖效果明显,应引起患者家庭和社区的重视和支持。     

"短信服务+防护技能培训"健康促进干预模式的建立及应用

目的 建立短信服务+防护技能培训健康促进干预模式, 并观察其应用效果。 方法 选择江西省南昌市西湖区某社区360名社区居民作为研究对象。随机分为两个实验组和一个对照组,各120人。一个实验组(A组)应用短信服务+防护技能培训 健康教育干预模式,另一个实验组(B组)进行防护技能培训,2个月后比较2个模式的干预效果。 结果 干预前三组知晓率、健康态度持有率、健康行为实践率比较差异无统计学意义(P0.05)。干预后A组、B组5个知识点知晓率、4种健康态度持有率、5种健康行为实践率较对照组明显提高(P0.05)。干预后A组在知晓率、健康态度持有率、健康行为实践率较B组高,且差异有统计学意义(P0.05)。 结论 短信服务+防护技能培训健康促进干预模式是一种有效的社区传染病防制干预方式,可推广应用。     

Impact of a multidisciplinary intervention for diabetes in Eritrea

BACKGROUND: When hemoglobin A1c (HbA1c) testing was made available to diabetic patients in the nation of Eritrea, the majority of values were markedly increased. As a result, a multidisciplinary clinical education program was instituted in Eritrea and the rate of HbA1c testing was increased to monitor progress. METHODS: In February 2003, a cooperative diabetes project was initiated in Eritrea to train diabetes educators, enhance physician education, create patient-teaching materials, and promote glucose monitoring. Two additional visits were made in 2003 and 2004. HbA1c values from January 2003 to November 2004 (n = 3606) were reviewed to assess diabetic control for the population and for a subset of individual patients (n = 350). A cohort of 209 diabetic persons were evaluated for demographics, treatment, and prevalence of complications. RESULTS: The cohort of 209 patients was 34% female and had a mean (SD) age of 50.5 (15.5) years and diabetes duration of 8.6 (6.3) years. Prevalence of hypertension was 37% and proteinuria 6%. For diabetes treatment, 59% received insulin therapy, 35% received oral agents, and 6% received nonpharmacologic treatment. HbA1c values improved significantly between the 1st 6 months of 2003 (median 10.9%) and the last 6 months of 2004 (median 8.5%; P <0.001). Individual patients in whom 2 HbA1c values were measured > or =3 months apart showed a significant mean decrease of 0.5% (P <0.001). CONCLUSIONS: Our experience suggests that the combination of sustainable upgraded laboratory services and training in clinical management leads to sustainable improvement in diabetes care in developing countries.     

A randomized controlled trial of a nurse short-message service by cellular phone for people with diabetes

BACKGROUND: Nurse's education using telemedicine results in a decrease in blood glucose levels in patients with type 2 diabetes. OBJECTIVE: To investigate the effectiveness of an educational intervention that used both the cellular phone and the Internet to provide a short-messaging service (SMS) relating to plasma glucose levels. METHODS: Twenty-five patients were randomly assigned to an intervention group and 26 to a control group. The intervention was applied for 12 weeks. The goal of the intervention was to keep blood glucose concentrations close to the normal range. Patients in the intervention group were asked to access a website by using a cellular phone or to wiring the Internet and input their blood glucose levels every day. Participants were sent the optimal recommendations by both cellular phone and the Internet weekly. RESULTS: Patients in the intervention group had a mean decrease in glycosylated haemoglobin (HbA(1)c) levels of 1.15% and those in the control group had a mean increase of HbA(1)c levels of 0.07% (p=0.005). There was a significant mean change in the 2hrs post-meal glucose (2HPMG) level for the intervention group (p<0.05), with a mean change of -4.7mmol/l. The mean change in the control group was not significant. CONCLUSION: This educational intervention using the Internet and an SMS by cellular phone improved levels of HbA(1)c and 2HPMG.     

短信教育在冠心病患者中的应用

目的 探讨短信教育对冠心病(CHD)患者进行干预的临床效果.方法 选取56例CHD患者,按随机数字表法随机分为对照组和实验组,各28例.对照组采用常规护理,实验组在对照组的基础上加用短信提醒,观察两组患者疾病相关知识的掌握、服药的依从性及生活方式的改变情况.结果 干预前两组患者服药依从性、疾病相关知识掌握情况及生活方式情况比较差异均无统计学意义(P＞0.05);干预后实验组服药依从得分为(4.55±0.48)分,低于干预前得分(6.25±0.56)分,也低于对照组得分(5.85±0.43)分,差异均有统计学意义(t值分别为12.196,12.266;P＜0.01);对照组服药依从性干预前后比较差异有统计学意义(t=5.032,P＜0.01);实验组干预后疾病相关知识的掌握优于对照组,差异有统计学意义(x2值分别为4.77,4.91,5.54;P ＜0.05);生活方式改善优于对照组,差异均有统计学意义(x2值分别为6.79,14.67,4.67,4.98;P ＜0.05).结论 短信教育能有效地提高CHD患者服药的依从性及对疾病相关知识的掌握,改变患者的生活方式.     

短信教育对血液透析间期患者体质量的影响

目的探讨短信教育对血液透析间期患者体质量的影响。方法将92例行维持性血液透析(MHD)>3个月的患者按透析单双日分组,单日治疗的患者为短信教育组(46例),双日为对照组(46例)。短信教育组在常规教育的基础上,患者在透析间期每天7:00～7:15接收护士发的教育短信;19:30～20:00护士接收患者反馈的信息。对照组进行常规教育。结果透析间期体质量增加,短信教育组低于对照组(P<0.01);液体摄入依从性,短信教育组优于对照组(P<0.05)。结论对血液透析间期的患者进行短信教育,有利于提高MHD患者限制液体摄入的依从性,使透析间期体质量增加值控制在规定范围。     

糖尿病患者饮食疗法的护理干预

目的探讨护理干预对糖尿病患者饮食疗法的影响。方法结合临床资料，将80例2型糖尿病患者随机分为干预组40例和对照组40例，干预组接受饮食治疗的护理干预，对照组只接受常规健康教育，两组均配合同等强度的运动疗法，连续观察3个月。通过监测空腹和餐后2h血糖值，进行干预前后比较。结果经护理干预，干预组空腹和餐后2h血糖值与对照组比较均明显降低，有统计学意义（P〈0．05）。结论接受饮食治疗的护理干预能显著降低糖尿病患者血糖，提高患者的生存质量。     

社区老年高血压患者服药短信与电话干预的对比研究

目的探索短信与电话干预对社区老年高血压患者的服药效果的影响。方法以年龄、性别、高血压等级及病程为配对条件,筛选282例(94区组)满足配对条件的老年高血压患者,每个区组3例,随机分到短信组、电话组和常规组,3组分别为短信干预、电话干预和常规社区干预,共干预6个月。对其服药依从性、按时服药、血压值、患者满意度进行比较。结果短信组和电话组在干预3个月和6个月后与常规组的服药依从性、按时服药、血压值和满意度比较差异具有统计学意义(P0.05)。干预后3个月和6个月短信组的按时服药及满意度均高于电话组(P0.05)。结论短信和电话干预均可以提高社区老年高血压患者的服药依从性、按时服药行为和改善血压控制,短信组的患者按时服药得分及满意度优于电话组。     

Technological intervention for obese patients with type 2 diabetes

This study applied a 6-month educational intervention that used the technology of the short message service (via cellular phones) and the Internet for obese patients with type 2 diabetes. Eighteen patients were randomly assigned to an intervention group and 16 were assigned to a control group (N = 34). Patients in the intervention group were asked to access a web site by using personal cellular phones or computer Internet services to input their blood glucose levels daily. Participants were then sent optimal recommendations via cellular phone and the Internet weekly. After 6 months, the intervention group had a statistically significant decrease in glycosylated hemoglobin, fasting plasma glucose, 2-hour postmeal glucose, and total cholesterol, as compared with the control group.     

护理信息的网络交流

建立医院计算机局域网与广域网连接,实现护理信息的交流,是护理学科向高科技迈进的标志。本阐述了局域网和广域网护理信息交流的含义和方法;概述了网络技术革新交流、新业务和新技术的推广、临床护理科研信息介绍、重病人的会诊和讨论,护理管理信息交流5个方面的内容和临床意义;并从推广计算机网络护理信息交流对护理学科发展的促进,网络信息交流的效果和开发前景,强化护理人员高科技意识,加强计算机技术培训,建立相关的管理制度,维护网络安全等方面进行了讨论。     

Evaluation of a diabetes referral pathway for the management of hypoglycaemia following emergency contact with the ambulance service to a diabetes specialist nurse team

Objectives

To evaluate the effectiveness of ambulance crew referral of patients treated for acute hypoglycaemia, to a diabetes specialist nurse (DSN) team. Patients were assessed by the ambulance service and did not attend an emergency department.

Methods

For a 3 month period patients were referred from two areas of West Yorkshire by the ambulance service to specialist diabetes teams. The DSNs contacted the patients within 7 days by telephone and arranged further review if necessary. Satisfaction questionnaires were sent to patients.

Results

Thirty eight patients were referred and all were reviewed by telephone; 30 (79%) also required a clinic review appointment. Warning signs of hypoglycaemia were identified by 21 (55%) patients, but 14 (37%) had none (three had incomplete data). Twelve patients had had a self‐treated episode in the previous 6 months; nine patients had had three or more. Fifteen (39%) patients had called an emergency ambulance for similar reasons in the previous 6 months (27 “999” calls). Twenty patients (53%) had their drug treatment altered at a clinic appointment and 14 (37%) required ongoing review. Twenty six patients returned the satisfaction questionnaire; of these 88% agreed or strongly agreed that they had improved their understanding of hypoglycaemia and 73% felt more able to treat a hypoglycaemic episode in the future. Patient satisfaction with this care pathway was high.

Conclusions

The ambulance service can coordinate successful referral of patients with episodes of acute hypoglycaemia to a DSN‐led service. Patients often required treatment review. They valued this service and felt more confident managing their diabetes.     

商务短信在护理信息管理中的应用与效果

目的:探讨商务短信在护理信息管理中的应用效果。方法:该院护理部通过订购商务短信服务,创建护理部自己的账号密码及联系人组,按需要编辑短信内容后发送至所需联系人组内各个用户,并比较使用商务短信前的2009年(使用前)和使用后的2010年(使用后),护理部用于护理管理信息发送方面的费用、时间及护理人员对护理部工作的满意度情况。结果:使用后,护理部在送发管理信息耗时及办公费用方面均低于使用前,护理人员对护理部工作的满意度高于使用前(P<0.01)。结论:使用商务短信传递护理信息,促进了护理管理信息传递的及时性、有效性与准确性,提高了护理管理效率。     

Promoting nurse interventionist fidelity to motivational interviewing in a diabetes self-care intervention

We describe interventionist training procedures for a pilot intervention study that tested the effects of a nurse-delivered Motivational Interviewing (MI) intervention on diabetes self-care among adults diagnosed with type 2 diabetes mellitus. It reports on findings from MI fidelity assessments. Training consisted of didactic workshops plus practicum. Fidelity of MI was assessed using the MI Treatment Integrity (MITI) Scale. Fidelity assessments were conducted on 18 (25%) audiotaped MI sessions, which were randomly selected from a total of 72 sessions with 26 participants. Scores of the MITI were in the proficient and competent range. Results suggest that training strategies were sufficient to promote satisfactory interventionist fidelity to MI.     

糖尿病联络护士个体化出院随访在非内分泌科糖尿病患者中的应用效果

目的 探讨糖尿病联络护士(diabetes liaison nurse,DLN)个体化出院随访在改善非内分泌科糖尿病患者自我管理行为及提高患者糖尿病相关知识、态度及自我管理行为的效果。 方法 将纳入的74例非内分泌科住院的2型糖尿病患者随机分为实验组和对照组,每组各37例,对照组出院后接受病区随访护士提供的3个月常规出院随访,实验组出院后接受DLN提供的3个月个体化出院随访。比较2组干预前及干预6个月后糖尿病相关知识、态度、自我管理行为及糖化血红蛋白的改善效果。结果 干预后2组糖尿病相关知识、态度、自我管理行为在时间效应和交互效应上差异有统计学意义,糖化血红蛋白水平在主效应及时间效应上差异有统计学意义。结论 糖尿病联络护士个体化出院随访能显著提高非内分泌科糖尿病患者的糖尿病相关知识、态度、自我管理行为,降低非内分泌科糖尿病患者的糖化血红蛋白水平。