Abstract:

Objective　To investigate the impact of phased comprehensive management intervention on blood glucose control in patients with diabetes. Methods　This study was a randomized controlled trial. A total of 120 diabetic patients who visited the Department of Nephrology and Endocrinology, The Second Affiliated Hospital of Xi'an Medical University from January 2022 to November 2023 were selected as the research objects. The patients were divided into a control group (60 cases) and an observation group (60 cases) by the random number table method. There were 43 males and 17 females in the control group, aged (47.62±6.35) years, and the course of disease was (6.31±3.57) years. There were 39 males and 21 females in the observation group, aged (47.39±6.14) years, and the course of disease was (6.65±3.74) years. The control group received standard care, and the observation group received phased comprehensive management nursing intervention based on the control group for 3 months. Blood glucose levels [glycated hemoglobin (HbA1c) and fasting blood glucose (FBG)], self-management ability [Diabetes Self-Management Questionnaire (DSMQ)], medication compliance [Eight-item Morisky Medication Adherence Scale (MMAS-8)], and quality of life [Diabetes Quality of Life Questionnaire (DQOL)] were compared between the two groups before and after intervention. Independent sample t test, paired t test, and χ² test were used. Results　After intervention, the levels of HbA1c [(50.72±0.92) mmol/mol] and FBG [(7.15±0.46) mmol/L] in the observation group were lower than those in the control group [(53.47±1.06) mmol/mol and (7.68±0.57) mmol/L] (both P<0.05). The scores of diet control [(5.85±1.93) points], physical activity [(5.12±1.66) points], blood glucose monitoring [(4.05±1.08) points], and medication adherence [(4.47±1.28) points] of the DSMQ in the observation group were all higher than those in the control group [(4.85±1.38) points, (4.25±1.19) points, (2.94±0.72) points, and (3.52±1.09) points] (all P<0.05). The MMAS-8 score of the observation group [(8.54±0.52) points] was higher than that of the control group [(7.31±0.58) points] (P<0.05). The scores of satisfaction [(32.25±4.75) points], impact [(43.82±7.04) points], disease-related anxiety [(9.14±1.41) points], and social concern [(9.25±1.53) points] of the DQOL in the observation group were lower than those in the control group [(36.19±5.28) points, (51.46±7.63) points, (12.59±1.85) points, and (12.93±1.97) points] (all P<0.05). Conclusion　The phased comprehensive management nursing intervention significantly improves the blood glucose level, self-management ability, medication adherence, and quality of life in diabetic patients.

Key words:

Diabetes, Phased comprehensive management, Blood glucose level, Medication adherence, Quality of life

摘要：

目的　探讨分阶段综合管理护理干预对糖尿病患者血糖控制效果的影响。方法　本研究为随机对照试验。选取2022年1月至2023年11月西安医学院第二附属医院肾脏内分泌科收治的120例糖尿病患者作为研究对象。采用随机数字表法，将患者分为对照组（60例）和观察组（60例）。对照组男43例，女17例；年龄（47.62±6.35）岁；病程（6.31±3.57）年。观察组男39例，女21例；年龄（47.39±6.14）岁；病程（6.65±3.74）年。对照组采用常规护理干预，观察组在对照组基础上采用分阶段综合管理护理干预。两组均干预3个月。比较两组干预前后血糖水平［糖化血红蛋白（HbA1c）、空腹血糖（FBG）］、自我管理能力［糖尿病自我管理问卷（DSMQ）］、用药依从性［8项目版Morisky药物依从性量表（MMAS-8）］、生活质量［糖尿病生活质量问卷（DQOL）］。采用独立样本t检验、配对t检验和χ²检验。结果　干预后，观察组HbA1c［（50.72±0.92）mmol/mol］、FBG［（7.15±0.46）mmol/L］水平均低于对照组［（53.47±1.06）mmol/mol、（7.68±0.57）mmol/L］（均P<0.05）；观察组DSMQ中的饮食控制［（5.85±1.93）分］、身体活动［（5.12±1.66）分］、血糖监测［（4.05±1.08）分］、遵医用药［（4.47±1.28）分］评分均高于对照组［（4.85±1.38）分、（4.25±1.19）分、（2.94±0.72）分、（3.52±1.09）分］（均P<0.05）；观察组MMAS-8评分［（8.54±0.52）分］高于对照组［（7.31±0.58）分］（P<0.05）；观察组DQOL中的满意度［（32.25±4.75）分］、影响度［（43.82±7.04）分］、疾病忧虑［（9.14±1.41）分］、社会担忧［（9.25±1.53）分］评分均低于对照组［（36.19±5.28）分、（51.46±7.63）分、（12.59±1.85）分、（12.93±1.97）分］（均P<0.05）。结论　分阶段综合管理护理干预可改善糖尿病患者血糖水平、自我管理能力、用药依从性和生活质量。

关键词:

糖尿病, 分阶段综合管理, 血糖水平, 用药依从性, 生活质量