Abstract:

Objective　To explore the effect of integrated medical care management on gestational diabetes mellitus. Methods　A total of 103 patients with gestational diabetes mellitus treated in Sanshui District Maternal and Child Health Hospital, Foshan City from January 2020 to December 2022 were divided into two groups by the random number table method. In the 51 cases of the control group, the age was (27.32±2.12) years old, the gestational week was (26.53±2.09) weeks, and the times of pregnancy was 1.39±0.31. In the 52 cases of the experimental group, the age was (28.36±2.14) years old, the gestational week was (26.35±3.11) weeks, and the times of pregnancy was 1.21±0.25. The control group was given conventional management, and the experimental group was given integrated medical care management. The intervention time was 8 weeks. The self-health management ability, blood glucose control, mood improvement, nursing satisfaction, and clinical outcomes were compared between the two groups. Independent sample t test, χ² test, and Fisher exact probability method were used for statistical analysis. Results　After intervention, the scores of blood glucose monitoring and management [(8.51±0.53) points vs. (6.49±0.49) points], exercise management [(8.23±0.56) points vs. (6.98±0.52) points], and diet management [(22.69±0.76) points vs. (16.48±0.71) points] of the experimental group were higher than those of the control group (all P<0.05); the fasting blood glucose [(5.38±0.28) mmol/L vs. (6.42±0.31) mmol/L] and 2 h postprandial blood glucose [(5.99±0.35) mmol/L vs. (9.23±0.38) mmol/L] were lower than those of the control group (both P<0.05); the depression score [(45.92±3.92) points vs. (50.55±4.23) points] and anxiety score [(45.33±4.45) points vs. (50.32±5.11) points] were lower than those of the control group (both P<0.05). The nursing satisfaction of the experimental group was higher than that of the control group [100.00% (52/52) vs. 84.31% (44/51), P=0.006]. The cesarean section rate of the experimental group was lower than that of the control group [23.08% (12/52) vs. 43.14% (22/51), χ²=4.456, P=0.035], and the incidence of total adverse pregnancy outcomes was lower than that of the control group [3.85% (2/52) vs. 19.61% (10/51), χ²=6.061. P=0.014]. Conclusion　Integrated medical care management improves the self-health management ability in patients with gestational diabetes mellitus, effectively controls their blood glucose, relieves their anxiety and depression, and improves their satisfaction with management.

Key words:

Gestational diabetes mellitus, Integrated medical care management, Self-health management ability, Clinical outcomes

摘要：

目的　探讨医护一体化管理对妊娠期糖尿病的效果。方法　以2020年1月至2022年12月期间于佛山市三水区妇幼保健院就诊的103例妊娠期糖尿病患者为研究对象，以随机数字表法分为两组。对照组51例，年龄（27.32±2.12）岁，孕周（26.53±2.09）周，妊娠次数（1.39±0.31）次；试验组52例，年龄（28.36±2.14）岁，孕周（26.35±3.11）周，妊娠次数（1.21±0.25）次。对照组患者给予常规管理，试验组患者给予医护一体化管理，干预时间均为8周。对比两组患者自我健康管理能力、血糖控制、情绪改善、护理满意度以及临床结局。采用独立样本t检验、χ²检验、Fisher确切概率法进行统计学分析。结果　干预后，试验组患者血糖监测管理评分［（8.51±0.53）分比（6.49±0.49）分］、运动管理评分［（8.23±0.56）分比（6.98±0.52）分］、饮食管理评分［（22.69±0.76）分比（16.48±0.71）分］均高于对照组（均P<0.05）；空腹血糖［（5.38±0.28）mmol/L比（6.42±0.31）mmol/L］、餐后2 h血糖［（5.99±0.35）mmol/L比（9.23±0.38）mmol/L］均低于对照组（均P<0.05）；抑郁评分［（45.92±3.92）分比（50.55±4.23）分］、焦虑评分［（45.33±4.45）分比（50.32±5.11）分］均低于对照组（均P<0.05）。试验组患者的护理满意度高于对照组［100.00%（52/52）比84.31%（44/51），P=0.006］。试验组患者剖宫产率低于对照组［23.08%（12/52）比43.14%（22/51），χ²=4.456，P=0.035］，总不良妊娠结局发生率低于对照组［3.85%（2/52）比19.61%（10/51），χ²=6.061，P=0.014］。结论　医护一体化管理提升了妊娠期糖尿病患者的自我健康管理能力，使血糖得到有效控制，焦虑、抑郁情绪得到缓解，患者对管理满意度较佳。

关键词:

妊娠期糖尿病, 医护一体化管理, 自我健康管理能力, 临床结局