基于知识-行动模型的护理干预对2型糖尿病患者足部护理知识与行为状况的影响

严斌娟; 冯梦雪; 赵超英

doi:10.16766/j.cnki.issn.1674-4152.004273

基于知识-行动模型的护理干预对2型糖尿病患者足部护理知识与行为状况的影响

doi: 10.16766/j.cnki.issn.1674-4152.004273

1.
绍兴市中医院内分泌风湿免疫科，浙江绍兴 312000
2.
绍兴市中医院内分泌科

基金项目:

浙江省中医药科技计划项目 2025ZL137

详细信息

通讯作者:
冯梦雪，E-mail：13819582074@163.com

中图分类号: R587.2 R473
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-10
- 网络出版日期: 2026-01-07

Effect of nursing intervention based on the knowledge action model on foot nursing knowledge and behavior of type 2 diabetes patients

1.
Department of Endocrinology, Rheumatology and Immunology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的 2型糖尿病患者存在糖尿病足这一严重并发症的风险, 有效的足部护理知识和行为是预防糖尿病足发生的关键，本研究旨在分析基于知识-行动模型的护理干预对改善2型糖尿病患者足部护理知识水平及行为实践的效果。方法选取2022年9月—2024年9月绍兴市中医院收治的198例2型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(99例)和观察组(99例)。对照组患者应用常规护理，观察组在对照组基础上应用基于知识-行动模型的护理干预。比较2组患者干预前后足部护理知识、足部护理行为及足部护理自我效能水平。结果干预后，观察组患者糖尿病知识量表(ADKnowl)中足部护理知识总分为(20.09±2.35)分，高于对照组[(17.15±3.84)分，P＜0.05]；干预后，观察组患者诺丁汉足部护理功能量表(NAFF)总分为(55.68±6.76)分，高于对照组[(49.97±7.46)分，P＜0.05]；干预后，观察组患者糖尿病自我效能感量表足部护理部分得分为(17.66±2.38)分，高于对照组[(13.25±3.10)分，F=10.967，P＜0.001]。结论基于知识-行动模型的护理干预能有效提高2型糖尿病患者足部护理知识水平，提高患者足部护理自我护理能力及自我效能感。
- 型糖尿病 /
- 糖尿病足 /
- 知识-行动模型 /
- 护理知识与行为
Abstract: Objective Patients suffering from type 2 diabetes are predisposed to severe complications arising from diabetes-related foot problems. Effective foot care knowledge and behavior is the key to prevent diabetes foot. This study analyzed the effect of nursing intervention based on the knowledge action model on improving the level of foot care knowledge and behaviour practice of type 2 diabetes patients. Methods A total of 198 patients diagnosed with type 2 diabetes who received treatment at Shaoxing Hospital of Traditional Chinese Medicine between September 2022 and September 2024, were selected by convenient sampling method. Participants were randomly allocated into two groups, namely the control group and the observation group, each comprising 99 individuals, using a randomized numerical table. The control group received standard nursing procedures; the observation group received additional care interventions grounded in the knowledge-action framework. A comparative analysis was conducted to evaluate the differences in foot care-related knowledge, behavioural practices and self-efficacy scores between the two groups, before and after the intervention. Results Following the intervention, the total score for foot nursing knowledge in the diabetes knowledge scale (ADKnowl) for patients in the observation group was (20.09±2.35) points, which was higher than that in the control group [(17.15±3.84) points, P < 0.05]. The total score for the Nottingham foot care function scale (NAFF) in the observation group was (55.68±6.76) points, which was higher than that in the control group[(49.97±7.46) points, P < 0.05]. Furthermore, the foot care score on the diabetes self-efficacy scale in the observation group was (17.66±2.38) points, which was higher than that in the control group [(13.25±3.10) points, F=10.967, P < 0.05]. Conclusion The nursing intervention, grounded in the knowledge action model can effectively enhance the level of foot nursing knowledge among type 2 diabetes patients, and improve the patients ' foot nursing self-care abilities and self-efficacy.
- Type 2 diabetes /
- Diabetes foot /
- Knowledge action model /
- Nursing knowledge nursing behavior

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表 1 2组2型糖尿病患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with type 2 diabetes

项目	对照组(n=99)	观察组(n=99)	统计量	P值
性别(例)			0.085^a	0.771
男性	59	61
女性	40	38
年龄(x±s，岁)	61.32±7.78	60.75±6.45	0.561^b	0.575
文化程度(例)			0.448^c	0.799
初中及以下	56	60
高中/中专	26	25
大专及以上	17	14
家庭人均月收入(例)			0.979^c	0.613
＜3 000元	38	42
3 000~5 000元	33	35
＞5 000元	28	22
主要照顾者(例)			0.493^a	0.782
配偶	69	70
子女	24	21
其他	6	8
是否吸烟(例)			0.417^a	0.518
是	28	24
否	71	75
是否饮酒(例)			0.092^a	0.761
是	31	33
否	68	66
病程时间(x±s，年)	8.72±2.35	9.10±2.88	1.017^b	0.310
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组2型糖尿病患者糖尿病足护理知识得分比较(x±s，分)

Table 2. Comparison of diabetic foot-care knowledge scores between the two groups of patients with type 2 diabetes (x±s, points)

组别	例数	足部检查		足部日常护理		趾甲修剪		足部问题治疗
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	99	2.50±0.79	3.03±0.80	2.62±0.94	2.90±0.45	1.58±0.33	1.61±0.28	2.71±0.82	3.08±0.51
观察组	99	2.44±0.81	3.47±0.32	2.66±0.87	3.48±0.29	1.60±0.42	1.77±0.13	2.74±0.94	3.57±0.22
统计量		0.528^a	4.638^b	0.311^a	9.722^b	0.373^a	5.063^b	0.239^a	8.673^b
P值		0.598	＜0.001	0.756	＜0.001	0.710	＜0.001	0.811	＜0.001

组别	例数	鞋型选择			足部皮肤干燥处理			总分
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	99	3.33±1.05	3.45±0.88		2.94±0.63	3.15±0.46		15.19±3.02	17.15±3.84
观察组	99	3.28±0.94	4.12±0.50		2.97±0.58	3.87±0.50		14.76±2.98	20.09±2.35
统计量		0.353^a	5.904^b		0.349^a	10.215^b		1.008^a	6.072^b
P值		0.724	＜0.001		0.728	＜0.001		0.314	＜0.001
注：^a为t值，^b为F值。

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表 3 2组2型糖尿病患者糖尿病足护理行为得分比较(x±s，分)

Table 3. Comparison of diabetic foot-care behavior scores between the two groups of patients with type 2 diabetes (x±s, points)

组别	例数	足部检查		足部清洁		足部保护
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	99	4.58±1.02	5.23±1.11	7.45±1.29	8.33±1.46	10.22±1.57	11.18±1.65
观察组	99	4.62±1.17	6.07±1.28	7.51±1.13	9.08±1.54	9.87±1.21	12.33±1.52
统计量		0.256^a	4.826^b	0.348^a	3.263^b	1.757^a	4.895^b
P值		0.798	＜0.001	0.728	0.002	0.081	＜0.001

组别	例数	鞋袜选择		求医行为		总分
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	99	17.28±1.64	18.33±2.23	5.09±1.13	6.13±1.24	45.81±6.42	49.97±7.46
观察组	99	17.21±1.90	21.02±3.16	4.94±1.25	7.00±1.39	44.96±7.18	55.68±6.76
统计量		0.277^a	5.726^b	0.886^a	4.171^b	0.878^a	5.482^b
P值		0.782	＜0.001	0.377	＜0.001	0.381	＜0.001
注：^a为t值，^b为F值。

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表 4 2组2型糖尿病患者足部护理自我效能感比较(x±s，分)

Table 4. Comparison of foot-care self-efficacy between the two groups of patients with type 2 diabetes mellitus(x±s, points)

组别	例数	干预前	干预后
对照组	99	10.68±2.13	13.25±3.10
观察组	99	11.23±2.24	17.66±2.38
统计量		1.770^a	10.967^b
P值		0.078	＜0.001
注：^a为t值，^b为F值。

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