糖尿病自我护理的ESE模式研究(1)
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【摘要】 目的 本课题旨在构建糖尿病自我护理的ESE模式(理论教育E-自我护理S -定期检查E),并研究该模式对于提高自我效能和控制血糖水平的临床效果。方法 将已确诊、具有可比性的Ⅱ型糖尿病住院患者分为ESE模式组、对照组,其中ESE模式组通过讲座强化糖尿病疾病理论教育和自我护理常识教育,出院时通知两组患者2月后复查。结果 复查显示,ESE模式组、对照组的自我效能评分分别为(96.2±14.8) mmol/L、(58.3±8.7)mmol/L,P<0.05;空腹血糖分别为(6.8±0.6)mmol/L、(7.6±0.8)mmol/L,P<0.05;糖基化血红蛋白(HbA1c)分别为6.1%±0.5%、6.7%±0.7%,P<0.05。结论 糖尿病自我护理的ESE模式有助于提高自我效能和控制血糖水平,可推广应用于护理工作。
【关键词】糖尿病;自我护理;护理模式
Study on the Diabetic ESE Model of Self-care CHEN Qian, LIU Jiang-hua
Department of Public Health, Logistic Service Group, Hengyang 421001, China
【Abstract】 Objective It was aimed to establish an Education-Self-care-Examination (ESE) skills model of diabetes self-care, as well as to study its clinical effect. Methods Comparable type 2 diabetic inpa-
tients were divided into two groups, that was to say, group of ESE model and group of control. All the patients
in the group of ESE model were requested to learn basic diabetic knowledge and general knowledge of diabetic self-care by listening to lectures, while those in the group of control did not. All the patients were requested to reexamine 2 months later when they left the hospital. Results In the two groups, the remarks of self-efficacy were 96.2±14.8 mmol/L, 58.3±8.7 mmol/L, respectively, and P<0.05; Fasting blood glucose were 6.8±0.6 mmol/L, 7.6±0.8 mmol/L, respectively, and P<0.05; Glycosylated hemoglobin (HbA1c) were 6.1%±0.5%, 6.7%±0.7%, respectively, and P<0.05.Conclusion ESE skills model will contribute to increase self-efficacy and curb blood glucose, and it can be applied to diabetic self-care.
【Key words】 Diabetes; Self-care; Skill model
糖尿病是常见的慢性病,目前中国已确诊的患者已达 4000 万,并以每年 100 万的速度递增。其发生、发展与遗传因素和环境因素密切相关,当胰岛素分泌不足(Ⅰ型糖尿病)或靶细胞对胰岛素敏感性降低(Ⅱ型糖尿病、妊娠期糖尿病)时,即可发生糖尿病。患者常有多饮、多食、多尿、消瘦等“三多一少”症状,临床上出现以高血糖为主要标志的系列征候群。在防治与护理工作中如麻痹大意,可引起或加重系列并发症和多系统器官的损害,出现较高的死亡率。本课题旨在构建糖尿病自我护理的ESE模式(Education-Self-care-Examination skills model, ESE model),并研究该模式对于提高自我效能和控制血糖水平的临床效果。
1 资料与方法
1.1 一般资料
以2009年1月至2009年12月为时间段,在南华大学附属第一医院内分泌科,随机选择已确诊的Ⅱ糖尿病住院患者200人。其中,男114例,女86例;年龄57~84岁,平均71岁;糖尿病病程5~30年,平均17年。患者经检测尿糖、空腹血糖、餐后2 h血糖、糖基化血红蛋白(HbA1c),符合2005年WHO规定的糖尿病诊断标准。患者随机分为ESE模式组、对照组,各组100人,经检验,两组患者在年龄、病程、空腹血糖、餐后2 h血糖、HbA1c、自我效能评分等方面均无显著性差异 ......
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