基于互动达标理论的延续性护理在糖尿病视网膜病变患者中的应用

徐少君; 童毓华; 周梦玲; 刘佳敏; 祝春燕

doi:10.16766/j.cnki.issn.1674-4152.002923

基于互动达标理论的延续性护理在糖尿病视网膜病变患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002923

1.
温州医科大学附属衢州医院(衢州市人民医院)眼科，浙江衢州 324000
2.
温州医科大学附属衢州医院(衢州市人民医院)内分泌科

基金项目:

浙江省基础公益研究项目 LGF18H120002

详细信息

通讯作者:
徐少君，E-mail: hhxsjhyt@163.com

中图分类号: R587.2 R473.58
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- 被引次数: 0
出版历程
- 收稿日期: 2022-09-21
- 网络出版日期: 2023-04-19

Study on the application of continuity nursing in patients with diabetic retinopathy based on the interactive attainment theory

1.
Department of Ophthalmology, Quzhou Hospital of Wenzhou Medical University, Quzhou, Zhejiang 324000, China

摘要

摘要: 目的观察基于互动达标理论的延续性护理对糖尿病视网膜病变(DR)患者血糖水平、自我管理能力及生命质量的影响。方法选择2020年6月—2021年7月在温州医科大学附属衢州医院接受治疗的DR患者92例，依照建档顺序，分为2组，每组46例。对照组采取常规护理，试验组在对照组基础上采取互动达标理论主导的延续性护理，均干预1年。比较2组视力、血糖、自我管理能力及视功能生活质量等指标变化。结果干预后，试验组视力下降率为2.17%(1/46)，明显低于对照组的17.39%(8/46，χ²=4.343, P=0.035)；干预后试验组空腹血糖、餐后2 h血糖水平分别为(5.74±0.66)mmol/L、(9.35±0.92)mmol/L，均低于对照组[(6.79±0.87)mmol/L、(11.41±1.00)mmol/L, t=6.521、10.282，均P＜0.001]。干预后试验组饮食、运动、遵医嘱用药、血糖监测及足部管理得分均高于对照组(均P＜0.01)。干预后，试验组除眼痛、色觉外，其余各项视功能相关生命质量评分均高于对照组(均P＜0.01)。结论基于互动达标理论的延续性护理可提高DR患者的自我管理能力，控制血糖、视力水平，改善患者生活质量。
- 糖尿病 /
- 视网膜病变 /
- 延续性护理 /
- 互动达标理论
Abstract: Objective To observe the effect of continuous nursing based on the interactive attainment theory on blood glucose levels, self-management ability and quality of life in patients with diabetes retinopathy (DR). Methods A total of 92 patients with DR who were treated at the Quzhou Hospital of Wenzhou Medical University from June 2020 to July 2021 were selected and divided into 2 groups of 46 cases each, according to the order of the files. The control group received regular nursing care, and the experimental group received continuity nursing based on the interactive standard theory. Both interventions were continued for 1 year. Changes of visual acuity, blood glucose, self-management ability, visual function and quality of life were compared between the 2 groups. Results After the intervention, the visual acuity decline rate in the experimental group was 2.17% (1/46), which was significantly lower than 17.39% in the control group (8/46, χ²=4.343, P=0.035); After the intervention, the fasting blood glucose and 2 h postprandial blood glucose levels in the experimental group were (5.74±0.66) mmol/L, (9.35±0.92) mmol/L respectively, which were lower than those in the control group [(6.79±0.87) mmol/L, (11.41±1.00) mmol/L, t=6.521, 10.282, both P < 0.001]. After the intervention, scores for diet, exercise, medication according to medical advice, blood glucose monitoring and foot management were higher in the experimental group than those in the control group (all P < 0.01). Except for eye pain and color perception, all quality of life scores related to visual function were higher in the experimental group than in the control group (all P < 0.01). Conclusion The continuity nursing based on the theory of interactive standard can improve self-management ability, blood glucose control and visual acuity and quality of life for patients with DR.
- Diabetes /
- Retinopathy /
- Continuity of Care /
- Interactive standard theory

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表 1 2组DR患者一般资料比较

Table 1. Comparison of general data between the two groups of DR Patients

组别	例数	性别(例)		年龄(x±s，岁)	合并疾病(例)		病程(x±s，年)	DR类型(例)
组别	例数	男性	女性	年龄(x±s，岁)	高血压	冠心病	病程(x±s，年)	单纯型	增殖型
对照组	46	19	27	54.84±6.15	19	14	10.60±3.41	7	39
试验组	46	22	24	55.23±6.37	21	11	10.29±3.35	5	41
统计量		0.396^a		0.299^b	0.177^a	0.494^a	0.440^b	0.383^a
P值		0.529		0.766	0.674	0.482	0.661	0.536
注：^a为χ²值，^b为t值。

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表 2 2组DR患者血糖水平变化比较(x±s, mmol/L)

Table 2. Comparison of blood glucose level changes between the two groups of DR Patients(x±s, mmol/L)

组别	例数	FBG		2h-PBG
组别	例数	干预前	干预后	干预前	干预后
对照组	46	6.07±1.01	6.79±0.87^a	9.82±0.93	11.41±1.00^a
试验组	46	6.09±1.03	5.74±0.66^a	9.75±0.88	9.35±0.92^a
t值		0.094	6.521	0.371	10.282
P值		0.925	＜0.001	0.712	＜0.001
注：与同组干预前比较，^aP < 0.05。

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表 3 2组DR患者自我管理能力比较(x±s，分)

Table 3. Comparison of self-management ability between the two groups of DR Patients(x±s, 分)

组别	例数	饮食		运动		遵医嘱用药		血糖监测		足部管理
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	46	4.37±1.09	5.38±1.14^a	3.72±1.04	4.58±1.15^a	5.26±0.86	6.14±0.66^a	2.33±0.64	4.09±0.95^a	2.39±0.61	4.30±0.81^a
试验组	46	4.26±1.11	6.20±1.09^a	3.65±1.10	5.44±1.02^a	5.13±0.72	6.78±0.51^a	2.42±0.58	5.63±0.98^a	2.46±0.74	5.87±0.85^a
t值		0.480	3.526	0.314	3.795	0.786	5.204	0.707	7.653	0.495	9.069
P值		0.633	＜0.001	0.755	＜0.001	0.434	＜0.001	0.482	＜0.001	0.622	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 4 2组DR患者视功能相关生命质量比较(x±s，分)

Table 4. Comparison of visual function-related quality of life between the two groups of DR Patients(x±s, points)

项目	干预前		t值	P值	干预后		t值	P值
项目	对照组(n=46)	试验组(n=46)	t值	P值	对照组(n=46)	试验组(n=46)	t值	P值
总分	52.53±17.12	53.42±16.84	0.251	0.802	65.74±14.61^a	75.57±10.93^a	3.654	＜0.001
整体健康	28.72±7.09	29.25±7.18	0.356	0.723	42.29±10.16^a	55.87±10.25^a	6.382	＜0.001
总体视力	38.45±8.02	38.81±8.33	0.211	0.833	51.26±9.14^a	63.33±10.34^a	5.932	＜0.001
眼痛	75.32±10.16	76.69±10.07	0.650	0.518	77.38±12.23	78.99±13.17	0.608	0.545
近距离运动	54.61±11.25	55.06±11.24	0.192	0.848	64.36±12.22^a	71.62±11.75^a	2.905	0.005
远距离运动	53.38±10.33	53.17±10.61	0.096	0.924	62.14±11.57^a	72.11±12.08^a	4.043	＜0.001
社会功能	66.51±9.43	66.15±9.51	0.182	0.856	72.12±13.03^a	79.10±13.42^a	2.531	0.013
精神健康	54.08±11.15	55.18±11.57	0.464	0.644	62.36±10.38^a	75.82±12.31^a	5.669	＜0.001
角色限制	51.42±9.69	52.04±9.39	0.312	0.756	62.39±10.22^a	76.53±11.26^a	6.307	＜0.001
依赖程度	48.79±11.24	50.15±11.47	0.574	0.567	60.35±13.35^a	72.78±13.16^a	4.497	＜0.001
驾车	66.55±15.83	65.94±15.34	0.188	0.852	68.31±14.41^a	76.24±13.15^a	2.757	0.004
色觉	63.28±14.91	63.51±14.49	0.075	0.940	65.25±12.18	65.83±12.06	0.229	0.819
周边视力	72.23±20.59	71.62±20.80	0.141	0.888	77.84±21.23^a	86.82±21.09^a	2.035	0.022
注：与同组干预前比较，^aP＜0.05。

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