引导式教育训练对青少年1型糖尿病患者自我管理能力的影响

王素; 张丽; 裘金绿

doi:10.16766/j.cnki.issn.1674-4152.003506

引导式教育训练对青少年1型糖尿病患者自我管理能力的影响

doi: 10.16766/j.cnki.issn.1674-4152.003506

杭州市儿童医院内分泌科，浙江杭州 310005

基金项目:

浙江省中医药科技计划项目 2023ZL125

详细信息

通讯作者:
张丽，E-mail：wszl830115@163.com

中图分类号: R587.1 R163
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出版历程
- 收稿日期: 2024-02-05
- 网络出版日期: 2024-07-20

Influence of guided education and training on self-management ability of adolescents with type 1 diabetes

Cardiovascular Department of Hangzhou Children' s Hospital, Hangzhou, Zhejiang 310005, China

摘要

摘要: 目的分析引导式教育训练在青少年1型糖尿病患者中的应用效果，探讨其对患者自我管理能力的影响，为临床青少年1型糖尿病患者自我管理提供新思路。方法选取2021年1月—2023年10月杭州市儿童医院收治的116例青少年1型糖尿病患者，采用随机数字表法将其分为对照组(58例)和观察组(58例)。对照组患者应用常规教育，观察组在对照组基础上应用引导式教育训练。比较2组患者血糖水平、自我管理能力及心理韧性。结果干预后，观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别为(6.65±0.84)mmol/L、(7.58±0.67)mmol/L、(6.50±0.67)%，均低于对照组[(7.12±1.33)mmol/L、(9.66±1.14)mmol/L、(7.82±1.03)%，P<0.05]。干预后，观察组青少年1型糖尿病自我管理量表(SMOD-A)各分量表得分均高于对照组(P<0.05)。干预后，观察组患者青少年糖尿病优势与韧性量表(DSTAR-Teen)总分为(48.90±5.72)分，高于对照组[(36.52±6.46)分，P<0.05]。结论引导式教育训练有利于控制青少年1型糖尿病患者血糖水平，提高自我管理能力及心理韧性，值得推广应用。
- 青少年1型糖尿病 /
- 引导式教育训练 /
- 自我管理能力 /
- 心理韧性
Abstract: Objective To analyze the application effect of guided education and training in adolescents with type 1 diabetes, explore its impact on patients ' self-management ability, and provide new ideas for clinical adolescents with type 1 diabetes in self-management. Methods A total of 116 adolescents with type 1 diabetes who were admitted to Hangzhou Children ' s Hospital from 2021 to October 2023 were selected, and they were randomly divided into control team and by random number table method. The control team received routine education, while the observation team received guided education and training on the basis of the control team. Blood glucose levels, self-management abilities, and psychological resilience of patients were compared between the two teams. Results After the intervention, the fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels in the observation team were (6.65±0.84) mmol/L, (7.58±0.67) mmol/L, and (6.50±0.67)%, respectively, which were lower than those in the control team [(7.12±1.33) mmol/L, (9.66±1.14) mmol/L, and (7.82±1.03)%, respectively], with statistical differences (P<0.05). Furthermore, the scores of self-report measure of self-management of type 1 diabetes for adolescents (SMOD-A) in the observation team were higher than those in the control team (P<0.05). Additionally, the total score of diabetes strengths and resilience measure for adolescents (DSTAR-Teen) in the observation team was (48.90±5.72) scores, higher than that of the control team [(36.52±6.46) scores, P<0.05]. Conclusion Guided education and training is beneficial to control the blood sugar level of adolescents with type 1 diabetes, improve their self-management ability and psychological resilience, and is worth popularizing.
- Adolescents with type 1 diabetes /
- Guided education and training /
- Self management ability /
- Psychological resilience

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表 1 2组T1DM患者及家长一般资料比较

Table 1. Comparison of general information between two groups of T1DM patients and their parents

项目	对照组(n=58)	观察组(n=58)	统计量	P值
性别(例)			0.139^a	0.711
男	28	26
女	30	32
年龄(x±s，岁)	13.22±2.13	13.51±1.87	0.779^b	0.437
身高(x±s，cm)	158.72±13.96	158.14±12.17	0.239^b	0.812
体重(x±s，kg)	51.52±6.77	50.98±7.20	0.416^b	0.678
文化程度(例)			0.337^a	0.562
小学	22	19
中学	36	39
病程时间(x±s，月)	6.77±1.54	6.61±1.49	0.569^b	0.571
胰岛素治疗方案(例)			0.439^a	0.803
三速一长	31	30
短中比	23	22
三短一长	4	6
家长年龄(x±s，岁)	40.88±4.65	41.50±4.83	0.704^b	0.483
与患者关系(例)			0.837^a	0.658
父亲	16	20
母亲	35	33
其他	7	5
文化程度(例)			0.685^a	0.408
中学及以下	18	14
大专及以上	40	44
注：^a为χ²值，^b为t值。

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表 2 2组T1DM患者血糖水平比较(x±s)

Table 2. Comparison of blood glucose levels in two groups of T1DM patients (x±s)

组别	例数	FBG(mmol/L)		2hPBG(mmol/L)		HbA1c(%)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	58	10.77±1.86	7.12±1.33	14.28±3.26	9.66±1.14	13.77±1.81	7.82±1.03
观察组	58	11.04±2.25	6.65±0.84	14.65±3.31	7.58±0.67	13.54±1.66	6.50±0.67
统计量		0.704^a	2.486^b	0.607^a	9.731^b	0.713^a	7.973^b
P值		0.483	0.025	0.545	<0.001	0.477	<0.001
注：^a为t值，^b为F值。

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表 3 2组T1DM患者自我管理能力比较(x±s，分)

Table 3. Comparison of self-management abilities in two groups of T1DM patients (x±s, points)

组别	例数	青少年与父母在糖尿病管理上的协作		糖尿病日常照护行为		与糖尿病相关问题的解决		与糖尿病相关的沟通		糖尿病管理目标
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	58	20.11±3.18	23.81±3.38	24.35±3.24	27.42±3.67	14.37±1.61	15.82±2.10	18.72±2.15	20.33±2.44	13.35±1.42	14.78±1.37
观察组	58	20.23±2.96	30.17±3.59	25.18±3.73	33.55±3.86	13.95±1.58	17.52±2.41	18.04±2.44	24.03±2.65	13.42±1.50	16.87±1.54
统计量		0.210^a	7.506^b	1.279^a	6.832^b	1.418^a	3.562^b	1.592^a	7.300^b	0.256^a	5.898^b
P值		0.834	<0.001	0.213	<0.001	0.158	<0.001	0.114	<0.001	0.798	<0.001
注：^a为t值，^b为F值。

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表 4 2组T1DM患者心理韧性比较(x±s，分)

Table 4. Comparison of psychological resilience between two groups of T1DM patients (x±s, points)

组别	例数	寻求帮助		自我照护信心		外部资源		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	58	10.82±2.11	12.43±2.74	9.64±1.58	12.11±2.30	9.15±1.01	10.67±1.85	31.77±5.11	36.52±6.46
观察组	58	11.36±1.89	15.67±1.06	9.21±1.24	16.78±0.72	8.97±0.83	14.53±2.46	30.89±4.58	48.90±5.72
统计量		1.452^a	7.137^b	1.630^a	11.285^b	1.049^a	7.356^b	0.977^a	8.972^b
P值		0.149	<0.001	0.106	<0.001	0.297	<0.001	0.311	<0.001
注：^a为t值，^b为F值。

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