行动体验式心理健康教育对老年糖尿病合并心力衰竭患者心理应激的影响

目的：探讨行动体验式心理健康教育对老年糖尿病合并心力衰竭患者的效果及对心理应激的影响。方法：选取152例老年糖尿病合并心力衰竭患者，按随机数字表分为观察组与对照组，各76例。对照组采取常规健康教育，观察组采取行动体验式心理健康教育，干预时间2个月。比较2组干预前后的血清空腹血糖（FPG）、餐后2 h血糖（PG2h）、糖化血红蛋白（HbA1c）、去甲肾上腺素（NE）、肾上腺素（E）、皮质醇（Cr）及自我管理效能。结果：两组干预2个月后，2组的FPG、PG2h与HbA1c均较干预前降低（P<0.05）。观察组干预后的FPG、PG2h与HbA1c低于对照组（P<0.05）。2组干预2个月后的KAB疾病知识与行为评分均较干预前升高、KAB态度评分较干预前降低（P<0.05）。观察组干预后的KAB疾病知识与行为评分高于对照组，态度评分低于对照组（P<0.05）。干预2个月后，2组的血清NE、E、Cr均较干预前降低，且观察组低于对照组（P< 0.05）。结论：与常规健康教育相比，行动体验式心理健康教育可有效强化老年糖尿病合并心力衰竭患者的血糖控制效果，提高患者自我管理能力，减轻心理应激。

Effect of mental health education of action-experience model on psychological stress in elderly patients with diabetes mellitus complicated with heart failure

Objective: To explore the effect of mental health education of action-experience model on elderly patients with diabetes mellitus complicated with heart failure and its impact on psychological stress.Methods: A total of 152 elderly patients with diabetes mellitus complicated with heart failure were enrolled in the observation group and the control group according to the random number table (76 cases each).The control group received routine health education, while the observation group took mental health education of action-experienced model for 2 months.The serum fasting blood glucose (FPG), 2 h postprandial blood glucose (PG2h), HbA1c, norepinephrine (NE), epinephrine(E), cortisol(Cor) and self-management efficacywere compared between the two groups of before and after interventions.Results:After 2 months of intervention, FPG, PG2 h and HbA1c in both groups were lower than those before intervention （P<0.05）.FPG, PG2h and HbA1c in the observation group were lower than those in the control group(P<0.05). The score of KAB disease knowledge and behavior in both groups were higher than before intervention, while the score of KAB attitude was lower (P<0.05).The score of KAB disease knowledge and behavior after intervention was higher in the observation group, and score of KABattitude was lower （P<0.05）. After 2 months of intervention, the levels of NE, E and Cr in serum of the two groups were lower than those before intervention, and those in the observation group were lower than those in the control group(P<0.05).Conclusion:Compared with regular health education, action-experience model can effectivelycontrol the blood sugar for elderly patients with diabetes and heart failure, improve patients’ self-management ability, and reduce the psychological stress in the hospital.