基于跨理论模式的健康教育对老年2型糖尿病患者血糖管理及生活质量的影响

目的 探讨跨理论模式的健康教育对老年2型糖尿病患者血糖管理及生活质量的影响.方法选取2014年1~6月在该校第一附属医院内分泌科住院的2型糖尿病患者110例,均确诊时间≥12个月,年龄≥60岁,随机分为对照组和观察组各55例.对照组采取常规内容和模式进行健康教育.观察组在常规护理的基础上实施基于跨理论模式的健康教育.患者住院期间成立专业教育小组,统一进行跨理论模型知识系统培训.入院24 h内完成患者认知特征及健康需求评估后根据系统理论判断行为所处的具体阶段实施针对性的健康教育,20~30 min/次,1~2次/周.出院后每2周面谈1次,并针对不同阶段的具体行为特征进行个体化生活指导.观察干预前后糖代谢指标变化及采用生活质量量表评估患者生活质量.结果干预后6个月观察组的BMI,2 h PBG,FBG,HbA1c,TG,TC水平均明显低于对照组,且生活质量各项评分显著低于对照组,生活质量水平更具优势,组间差异均有统计学意义(均P<0.05).结论基于跨理论模型对老年糖尿病人群的不同行为改变阶段实施个体化健康教育,促进患者行为的改变和保持积极、乐观的情绪,增强患者的健康动机,利于血糖控制及代谢稳定,使依从行为及自护能力显著提升,生活质量显著改善,同时也可潜移默化地改善护患关系,提高对护理工作的满意度,值得进一步推广.

Influence of health education on the blood sugar management and life quality of aged type 2 diabetic patients based on trans theoretical mode

Objective To explore the influence of health education on the blood sugar management and life quality of aged type 2 diabetic patients based on trans theoretical model. Methods A total of 110 type 2 diabetic patients hospitalized in the endocrinology department of the first affiliated hospital of this school were selected in the range of Janu-ary to June 2014. The confirmed diagnosis time was ≥12 months, and the age was ≥60 years old. They were divided into control group and observation group (55 cases each) . Conventional content and mode were conducted to control group to have health education. Health education was conducted to observation group based on trans theoretical model on the ba-sis of conventional nursing. During the hospital stay, a professional education team was formed to have knowledge-based system training uniformly on trans theoretical model. Within 24 of hospital stay, the specific stage of behaviors was judged to implement the specific health education according to the cognitive characteristics and health need evaluation of patients. It was implemented 20 to 30min per time and 1 to 2 times a week. After discharge, interview was conducted once two weeks. In addition, individualized life guidance was conducted aimed at the specific behavior characteristics in different stages. The metabolic index changes before and after intervention were observed. Moreover, life quality scale was used to evaluate the life quality of patients. Results 6 months after intervention, the BMI, 2 h PBG, FBG, HbA1c, TG and TC levels of observation group were significantly lower than control group. In addition, the scores of life quality were sig-nificantly lower than control group. In addition, the level of life quality had more advantages. The between-group differ-ence had statistical significance (P<0. 05). Conclusions Based on the trans theoretical model, with regard to the dif-ferent behavior change stages of the aged diabetes, individualized health education can be implemented to promote pa-tients to change behaviors, keep positive and optimistic mood, strengthen patients' motivation for health, which will be beneficial to control blood sugar and keep metabolism stable. The compliance behaviors and self-care ability can be im-proved significantly. In addition, life quality can be improved obviously. Meanwhile, it can imperceptibly improve nurse-patient relationship and improve the satisfaction with nursing work, which is worth having further promotion.