基于格林模式促进实习护生糖尿病管理能力的效果研究

陈娜; 施冠华; 杨丽娟; 雷婷婷; 周静; 陈永侠

doi:10.16766/j.cnki.issn.1674-4152.003266

基于格林模式促进实习护生糖尿病管理能力的效果研究

doi: 10.16766/j.cnki.issn.1674-4152.003266

蚌埠医学院第一附属医院整形科, 安徽蚌埠 233004

基金项目:

安徽省高等学校质量工程教学研究一般项目 2021jyxm0951

蚌埠医学院自然科学重点项目 BYKY2019072ZD

详细信息

通讯作者:
陈娜，E-mail：candy.cn6658@163.com

中图分类号: R192.6 R587.1
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- 文章访问数: 184
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- PDF下载量: 9
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-08
- 网络出版日期: 2024-01-13

Study on effect of PRECEDE-PROCEED model on improving diabetes management ability of internship nursing students

Department of Plastic Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探索基于格林模式的糖尿病管理教育项目对提高实习护生糖尿病管理能力的效果。方法采用便利抽样法抽取2020年8月—2021年12月在某医院实习的180名护生，采用随机数字表法将实习护生分为格林组和对照组，每组各90人，格林组采用以格林模式为框架构建的培训方案，对照组采用常规的路径式培训方案，对2组实习护生进行糖尿病相关知识以及技能的培训。比较培训前和培训1个月后2组实习护生的糖尿病理论知识、一般自我效能、血糖监测技能、胰岛素注射技能的得分情况。结果培训1个月后2组实习护生的糖尿病理论知识、一般自我效能、血糖监测技能、胰岛素注射技能得分均较培训前提高(均P < 0.01)，格林组实习护生得分高于对照组[糖尿病理论知识得分：(86.91±4.45)分vs. (75.24±7.09)分；一般自我效能得分：(3.14±0.41)分vs. (2.81±0.47)分；血糖监测技能得分：(95.81±1.87)分vs. (92.62±2.95)分；胰岛素注射技能得分：(93.69±4.11)分vs. (90.23±3.90)分]，差异有统计学意义(均P < 0.01)。结论以格林模式为理论框架的糖尿病管理教育项目提高了实习护生的糖尿病理论知识和自我效能水平，规范了血糖监测和胰岛素注射行为，提高了糖尿病管理能力。
- 格林模式 /
- 实习护生 /
- 糖尿病 /
- 自我效能
Abstract: Objective To explore the effects of diabetes management education project based on PRECEDE-PROCEED model on improving the diabetes management ability of internship nursing students. Methods Convenience sampling was used to select 180 internship nursing students who practiced in a hospital as the research object from August 2020 to December 2021. All students were divided into experimental group and control group according to the random number table, with 90 students in each group. The experimental group adopted PRECEDE-PROCEED mode as the framework of the training program, and the control group adopted the conventional path training program. The scores of theoretical knowledges of diabetes, general self-efficacy, blood glucose monitoring skills and insulin injection skills were compared between the two groups before and 1 month after training. Results After 1 month of training, the scores of theoretical knowledge of diabetes, general self-efficacy, blood glucose monitoring skills and insulin injection skills of internship nursing students in both groups were improved compared with those before training (all P < 0.01), and the scores of nursing students in PRECEDE-PROCEED group were higher than those in control group [theoretical knowledge of diabetes: (86.91±4.45) points vs. (75.24±7.09) points; self-efficacy: (3.14±0.41) points vs. (2.81±0.47) points; blood glucose monitoring skills: (95.81±1.87) points vs. (92.62±2.95) points; insulin injection skills: (93.69±4.11) points vs. (90.23±3.90) points], the differences were statistically significant (all P < 0.01). Conclusion The diabetes management education program based on PRECEDE-PROCEED model improves the diabetes theoretical knowledge and self-efficacy of internship nursing students, standardizes their blood glucose monitoring and insulin injection behaviors, and improves their abilities to manage diabetes.
- PRECEDE-PROCEED model /
- Internship nursing students /
- Diabetes /
- Self-efficacy

HTML全文

表 1 格林模式组实习护生健康教育方案

Table 1. PRECEDE-PROCEED group health education program for internship nursing students

课次	内容	方法
第1次	糖尿病基本知识、糖尿病护理态度和价值观	PPT讲授、视频、案例分析
第2次	糖尿病饮食、运动、药物疗法	PPT讲授、视频、案例分析
第3次	血糖监测及低血糖识别与处理	PPT讲授、示教、分组练习、回示、视频
第4次	胰岛素相关知识及注射技能	PPT讲授、示教、分组练习、回示、视频

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表 2 2组实习护生培训前后理论得分情况(x±s，分)

Table 2. Comparison of theoretical scores between two groups before and after intervention (x±s, points)

组别	人数	总分		基本知识		饮食疗法		运动疗法		药物疗法		低血糖识别及处理
组别	人数	培训前	培训后	培训前	培训后	培训前	培训后	培训前	培训后	培训前	培训后	培训前	培训后
格林组	90	54.93±7.07	86.91±4.45^a	20.11±3.82	31.96±2.24^a	5.67±1.28	9.24±1.06^a	5.69±1.37	9.71±0.70^a	17.27±3.32	26.16±1.65^a	6.20±1.38	9.71±0.71^a
对照组	90	55.68±7.54	75.24±7.09^a	20.78±3.99	26.71±3.55^a	5.80±1.34	8.02±1.21^a	5.76±1.40	8.49±1.32^a	17.18±3.39	23.07±2.04^a	6.18±1.33	8.96±1.21^a
t值		0.793	13.384	1.144	11.845	0.680	7.173	0.323	7.775	0.178	11.180	0.110	5.122
P值		0.489	< 0.001	0.254	< 0.001	0.496	< 0.001	0.747	< 0.001	0.859	< 0.001	0.932	< 0.001
注：与同组培训前比较，^a P < 0.05。

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表 3 2组实习护生培训前后自我效能得分情况(x±s，分)

Table 3. Comparison of self-efficacy scores between two groups before and after intervention (x±s, points)

组别	人数	培训前	培训后
格林组	90	2.43±0.48	3.14±0.41^a
对照组	90	2.46±0.58	2.81±0.47^a
t值		0.376	5.206
P值		0.708	< 0.001
注：与同组培训前比较，^aP < 0.05。

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表 4 2组实习护生培训前后技能考核得分情况(x±s，分)

Table 4. Comparison of skill examination scores between two groups before and after intervention (x±s, points)

组别	人数	血糖监测		胰岛素注射
组别	人数	培训前	培训后	培训前	培训后
格林组	90	84.86±4.30	95.81±1.87^a	77.87±5.62	93.69±4.11^a
对照组	90	85.04±4.34	92.62±2.95^a	76.89±6.91	90.23±3.90^a
t值		0.263	8.657	1.041	4.631
P值		0.770	＜0.001	0.299	＜0.001
注：与同组培训前比较，^aP < 0.05。

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参考文献(22)

[1]	李娟, 李乐之, 杨玲凤, 等. 长沙市三级甲等综合医院非内分泌科护士糖尿病护理知信行的调查研究[J]. 中国护理管理, 2013, 13(6): 91-94. LI J, LI L Z, YANG L F, et al. The status research of non-endocrine nurses' diabetes KAP of tertiary general hospital in Changsha[J]. Chinese Nursing Management, 2013, 13(6): 91-94.
[2]	汪晓凤, 王伟群, 李蕊, 等. 糖尿病联络护士院内培训效果评价[J]. 当代护士(中旬刊), 2020, 27(2): 154-156. WANG X F, WANG W Q, LI R, et al. Training and effect analysis of diabetes liaison nurses[J]. Modern Nurse, 2020, 27(2): 154-156.
[3]	杜赟, 周佩如, 陈伟菊, 等. 临床实习护生糖尿病知识掌握现状及学习需求调查[J]. 护理学报, 2010, 17(10): 12-14. doi: 10.3969/j.issn.1008-9969.2010.10.004 DU Y, ZHOU P R, CHEN W J, et al. Survey on status of diabetic knowledge and learning need of practical nurses[J]. Journal of Nursing(China), 2010, 17(10): 12-14. doi: 10.3969/j.issn.1008-9969.2010.10.004
[4]	苏小燕, 林丽娜, 蒋天. 本科实习护生对胰岛素知识掌握情况的调查[J]. 齐齐哈尔医学院学报, 2017, 38(16): 1934-1936. doi: 10.3969/j.issn.1002-1256.2017.16.037 SU X Y, LIN L N, JIANG T, et al. Investigation on knowledge of insulin among undergraduate nursing students[J]. Journal of Qiqihar Medical University, 2017, 38(16): 1934-1936. doi: 10.3969/j.issn.1002-1256.2017.16.037
[5]	MOSAVI F, ALIAKBARI F, RABIEI L. Effect of education based on "PRECEDE" model on self-care behavior in hemodialysis patients[J]. J Educ Health Promot, 2020, 9: 69.
[6]	LIN H, WANG X Y, LUO X H, et al. A management program for preventing occupational blood-borne infectious exposure among operating room nurses: an application of the PRECEDE-PROCEED model[J]. J Int Med Res, 2020, 48(1): 300060519895670. DOI: 10.1177/0300060519895670.
[7]	邱小丹, 王乐洁, 张敏, 等. 基于格林模式的手术烟雾干预策略在手术室医护人员中的应用效果[J]. 中华全科医学, 2022, 20(11): 1960-1964. doi: 10.16766/j.cnki.issn.1674-4152.002746 QIU X D, WANG L J, ZHANG M, et al. Effect of surgical smoke intervention strategy based on Green model on medical staff in operating room[J]. Chinese Journal of General Practice, 2022, 20(11): 1960-1964. doi: 10.16766/j.cnki.issn.1674-4152.002746
[8]	王筱筱, 段宏为, 林航, 等. 格林模式在健康教育中的应用进展[J]. 中国护理管理, 2018, 18(4): 570-574. doi: 10.3969/j.issn.1672-1756.2018.04.030 WANG X X, DUAN H W, LIN H, et al. Application of the PRECEDE-PROCEED model in health education: a literature review[J]. Chinese Nursing Management, 2018, 18(4): 570--574. doi: 10.3969/j.issn.1672-1756.2018.04.030
[9]	SCHWARZER R, ARISTI B. Optimistic self-beliefs: assessment of general perceived self-efficacy in thirteen cultures[J]. Word Psychology, 1997, 3(1-2): 177-190.
[10]	王才康, 胡中锋, 刘勇. 一般自我效能感量表的信度和效度研究[J]. 应用心理学, 2001(1): 37-40. WANG C K, HU Z F, LIU Y. Evidences for reliability and validity of the Chinese version of general self efficacy scale[J]. Chinese Journal of Applied Psychology, 2001(1): 37-40.
[11]	蒋燕, 史齐, 郭兰青, 等. 格林健康教育模式在本科护生职业防护干预中应用效果研究[J]. 护理研究, 2017, 31(34): 4434-4437. doi: 10.3969/j.issn.1009-6493.2017.34.038 JIANG Y, SHI Q, GUO L Q, et al. Application effects research on PRECEDE-PROCEED health education model in occupational protection intervention among undergraduate nursing students[J]. Nursing Research, 2017, 31(34): 4434-4437. doi: 10.3969/j.issn.1009-6493.2017.34.038
[12]	曾华, 殷彩欣, 徐芳, 等. 格林模式教学对提高实习护生人文关怀能力的效果研究[J]. 护理实践与研究, 2021, 18(22): 3462-3465. doi: 10.3969/j.issn.1672-9676.2021.22.037 ZENG H, YING C X, XU F, et al. The effect of PRECEDE-PROCEED model on improving the humanistic care ability of nursing students[J]. Nursing Practice and Research, 2021, 18(22): 3462-3465. doi: 10.3969/j.issn.1672-9676.2021.22.037
[13]	周宏珍, 朱亚芳, 雷清梅, 等. 格林模式在本科护生临床实习中的应用[J]. 齐鲁护理杂志, 2018, 24(1): 94-96. ZHOU H Z, ZHU Y F, LEI Q M, et al. Application of PRECEDE-PROCEED health education model in Clinical practice among undergraduate nursing students[J]. Journal of Qilu Nursing, 2018, 24(1): 94-96.
[14]	颜丽芳, 金红梅, 朱春燕, 等. 粤北地区1 131名高职护生自我效能感现状及影响因素分析[J]. 护理学报, 2022, 29(18): 59-62. YAN L F, JIN H M, ZHU C Y, et al. Current status of general self-efficacy and its influencing factors: a 1 131 case study[J]. Journal of Nursing(China), 2022, 29(18): 59-62.
[15]	康子华. 实习期护生完成能力现状及其与专业认同、自我效能的相关性分析[D]. 济南: 山东大学, 2021. KANG Z H. Status of nursing students' competence and correlation analysis with professional identity and efficacy in internship period[D]. Jinan: Shandong University, 2021.
[16]	刘凯, 张小满, 郑素素, 等. 护理本科生自我效能在人格特质与学习投入间的中介效应分析[J]. 中华现代护理杂志, 2021, 27(26): 3622-3627. doi: 10.3760/cma.j.cn115682-20210125-00395 LIU K, ZHANG X M, ZHENG S S, et al. Mediating effect of self-efficacy between personality traits and learning engagement in nursing undergraduates[J]. Chinese Journal of Modern Nursing, 2021, 27(26): 3622-3627. doi: 10.3760/cma.j.cn115682-20210125-00395
[17]	KAN W, YANG R, TANG M F. Application research of chronic disease health management in an urban community based on the PRECEDE-PROCEED model in the long-term management of diabetes mellitus[J]. Am J Transl Res, 2021, 13(7): 8142-8149.
[18]	MOSHKI M, YAGHUBI R, PARIAFSAI F. Comparing the effect of education based on PRECEDE-PROCEED model in person-centered and supportive group methods on women ' s psychological well-being in the menopausal periods[J]. J Educ Health Promot, 2022, 11: 68.
[19]	NEJHADDADGAR N, DARABI F, ROHBAN A, et al. The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model[J]. Diabetes Metab Syndr, 2019, 13(1): 440-443.
[20]	梁志金, 刘晓芳, 黄艳, 等. 格林模式培训促进低年资护士胰岛素规范化注射行为[J]. 护理学杂志, 2014, 29(23): 55-57, 74. LIANG Z J, LIU X F, HUANG Y, et al. Standardizing insulin injection practice in junior nurses using the PRECEDE-PROCEED model[J]. Journal of Nursing Science, 2014, 29(23): 55-57, 74.
[21]	李敏, 胡小磊. 住院患者血糖管理的研究进展[J]. 齐齐哈尔医学院学报, 2021, 42(22): 2006-2010. LI M, HU X L. Research progress of blood glucose management in inpatients[J]. Journal of Qiqihar Medical University, 2021, 42(22): 2006-2010.
[22]	周滋霞, 孙海燕, 孙静, 等. 实习护生使用便携式血糖仪的操作行为调查与分析[J]. 重庆医学, 2014, 43(22): 2963-2965. ZHOU Z X, SUN H Y, SUN J, et al. Investigation and analysis on the operation behavior of nursing students using portable blood glucose meter[J]. Chongqing Medicine, 2014, 43(22): 2963-2965.