Abstract:

Objective　To explore the application effect of 5A nursing model based on Internet platform in patients with gestational diabetes mellitus (GDM). Methods　A total of one hundred and fifteen pregnant women with GDM who underwent birth examination in Binzhou Central Hospital between July 2019 and February 2022 were prospectively selected as subjects in this study, and were divided into control and study groups by the random number table method. Fifty-eight patients in the control group, aged 22-33 years, were given clinical routine care intervention, and 57 patients in the study group, aged 22-35 years, were given 5A nursing model based on Internet platform based on routine care. The control of blood glucose [fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)], self-efficacy [Diabetes Management Self-Efficacy Scale (DMSES) and General Self-Efficacy Scale (GSES)], psychological status [Pregnancy-Specific Anxiety Questionnaire (PAQ), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS)], self-management ability [modified version of Summary of Diabetes Self Care Activities (SDSCA)], and pregnancy outcomes of the two groups were compared. Statistical methods used were t test and χ² test. Results　After nursing, the levels of FBG and HbA1c in the study group were lower than those in the control group [(5.11±1.02) mmol/L vs. (5.62±1.12) mmol/L, (5.21±1.04)% vs. (5.74±1.15)%], with statistically significant differences (t=2.55 and 2.59, both P<0.05). The DMSES and GSES scores of the study group were higher than those of the control group [(168.47±18.72) points vs. (154.32±17.15) points, (35.27±3.92) points vs. (31.48±3.51) points], with statistically significant differences (t=4.23 and 5.46, both P<0.05). The scores of PAQ, SAS, and SDS in the study group were lower than those in the control group [(18.51±3.70) points vs. (21.42±4.28) points, (41.32±6.88) points vs. (45.51±7.58) points, (42.33±7.05) points vs. (45.62±7.61) points], with statistically significant differences (t=3.90, 3.10, and 2.40, all P<0.05). The scores of diet, exercise, blood glucose monitoring, and foot care of the SDSCA in the study group were higher than those in the control group [(22.15±3.69) points vs. (20.41±3.40) points, (10.87±2.17) points vs. (9.43±1.89) points, (11.12±2.22) points vs. (10.21±2.04) points, (11.45±2.29) points vs. (10.31±2.06) points], with statistically significant differences (t=2.63, 3.80, 2.29, and 2.81, all P<0.05). The incidences of polyhydramnios and macrosomia in the study group were lower than those in the control group [5.26% (3/57) vs. 18.97% (11/58), 7.02% (4/57) vs. 24.13% (14/58)], with statistically significant differences (χ²=5.05 and 6.38, both P<0.05). Conclusion　The 5A nursing model intervention based on Internet platform was applied to GDM patients, the blood glucose level during pregnancy was obviously controlled, and the self-efficacy, psychological status, and self-management ability were significantly improved, with good pregnancy outcomes.

Key words:

Gestational diabetes mellitus, Pregnant woman, 5A nursing model, Internet platform, Self-management

摘要：

目的　探究基于互联网平台的5A护理模式在妊娠糖尿病（GDM）患者中的应用效果。方法　选取2019年7月至2022年2月在滨州市中心医院进行产检的115例GDM患者进行前瞻性研究，采用随机数字表法将其分为对照组和研究组。对照组58例，年龄22～33岁，予以临床常规护理干预；研究组57例，年龄22～35岁，予以常规护理增加基于互联网平台的5A护理模式干预。比较两组患者血糖［空腹血糖（FBG）、糖化血红蛋白（HbA1c）］控制情况、自我效能感［糖尿病管理自我效能量表（DMSES）、一般自我效能感量表（GSES）］、心理状态［妊娠相关焦虑量表（PAQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）］、自我管理能力［改良版糖尿病自我管理行为量表（SDSCA）］及妊娠结局情况。统计学方法采用t检验、χ²检验。结果　护理后，研究组FBG、HbA1c水平均低于对照组［（5.11±1.02）mmol/L比（5.62±1.12）mmol/L、（5.21±1.04）%比（5.74±1.15）%］，差异均有统计学意义（t=2.55、2.59，均P<0.05）；研究组DMSES、GSES评分均高于对照组［（168.47±18.72）分比（154.32±17.15）分、（35.27±3.92）分比（31.48±3.51）分］，差异均有统计学意义（t=4.23、5.46，均P<0.05）；研究组PAQ、SAS、SDS评分均低于对照组［（18.51±3.70）分比（21.42±4.28）分、（41.32±6.88）分比（45.51±7.58）分、（42.33±7.05）分比（45.62±7.61）分］，差异均有统计学意义（t=3.90、3.10、2.40，均P<0.05）；研究组SDSCA中饮食、运动、血糖监测、足部护理评分均高于对照组［（22.15±3.69）分比（20.41±3.40）分、（10.87±2.17）分比（9.43±1.89）分、（11.12±2.22）分比（10.21±2.04）分、（11.45±2.29）分比（10.31±2.06）分］，差异均有统计学意义（t=2.63、3.80、2.29、2.81，均P<0.05）。研究组羊水过多、巨大儿发生率均低于对照组［5.26%（3/57）比18.97%（11/58）、7.02%（4/57）比24.13%（14/58）］，差异均有统计学意义（χ²=5.05、6.38，均P<0.05）。结论　对GDM患者应用基于互联网平台的5A护理模式干预，孕期血糖水平得到明显控制，且自我效能感、心理状态及自我管理能力均有改善，有较好妊娠结局。

关键词:

妊娠糖尿病, 孕妇, 5A护理模式, 互联网平台, 自我管理