摘要
目的探讨糖尿病的共同照护模式的管理效果。方法选取2016年10月至2017年6月在北京大学第一医院共同照护门诊规律就诊6个月以上的糖尿病患者作为研究对象，分别在患者初诊及随访6个月后，测定身高、体重、糖化血红蛋白（HbA1c）水平，并使用《糖尿病自我管理行为量表6》、《WHO-5幸福感指数量表》、《患者慢性病评估表DAWN简化版》（PACIC-DSF）、《糖尿病授权评分表DAWN简化版》、《糖尿病相关问题量表5》（PAID-5）评价其疾病自我管理能力及社会心理状态。患者随访前后的数据计量资料比较采用t检验，计数资料比较采用χ2检验。结果符合入选标准并完成数据收集及量表评估的患者共76例。随访6个月与初诊时相比，患者疾病自我管理能力在自我血糖监测[1.0（0.0，3.0）比3.0（1.0，5.0）分，Z=2.978，P=0.003]及自我足部检查方面[0.0（0.0，6.8）比4.5（1.0，7.0）分，Z=3.374，P=0.001]得分较初诊时明显提高，差异有统计学意义，而健康饮食、运动、用药方面得分差异无统计学意义（均P〉0.05）。在社会心理状态方面，从医护人员处获取帮助（PACIC-DSF）得分显著提高[（33±16）比（41±13）分，t=5.475，P〈0.001]、低情绪障碍患者（PAID-5）显著增多[43.4%（33/76）比48.7%（37/76），χ2=11.023，P〈0.05]，而幸福感指数、患者授权能力得分无统计学差异（均P〉0.05）。与初诊时相比，随访6个月后，患者HbA1c水平显著降低（7.3%±1.4%比7.0%±1.2%，t=2.133，P〈0.05），体质指数、低密度脂蛋白胆固醇及单日降糖药物花费差异无统计学意义（均P〉0.05）。结论以共同照护模式管理糖尿病患者，可以提高患者监测血糖及足部自查能力，使患者从医护人员处获得更多帮助，减轻情绪障碍，降低HbA1c。
ObjectiveTo investigate the effectiveness of diabetes shared care model.MethodsFrom October 2016 to June 2017, patients with diabetes mellitus who had been visiting shared care clinic for more than 6 months in Peking University First Hospital were selected. Height, weight and glycated hemoglobin A1c （HbA1c） level were measured at the first visit and 6-month follow-up. Five scales were used to evaluate its disease self-management ability and social psychology, ＂Summary of Diabetes Self Care Activities 6＂ ＂World Health Organization-5 Well-Being Index＂ ＂Patient Assessment of Chronic Illness Care-DAWN Short Form＂ （PACIC-DSF） ＂Diabetes Empowerment Scale-DAWN Short Form＂ and ＂Problem Areas in Diabetes Scale 5＂ （PAID-5）.ResultsA total of 76 patients met the inclusion criteria and completed data collection and scale evaluation. Compared with baseline, scores of disease self-management ability in monitoring the blood sugar [1.0 （0.0, 3.0） vs 3.0 （1.0, 5.0） points, Z=2.978, P=0.003], and self-examination of the foot [0.0 （0.0, 6.8） vs 4.5 （1.0, 7.0） points, Z=3.374, P=0.001] were significantly improved after 6-month follow up, no significant difference was observed in healthy diet, exercise, or medication. Social psychology related index such as getting help from staff （PACIC-DSF） [（33±16） vs （41±13）, t=5.475, P〈0.001] and low mood disorders （PAID-5） [43.4% （33/76） vs 48.7% （37/76）, χ2=11.023, P〈0.05] were significantly increased. No significant difference was found in authorization ability score and the happiness index. Patients achieved greater reduction in HbA1c （7.3%±1.4% vs 7.0%±1.2%, t=2.133, P〈0.05） six months later, with no significant difference in body mass index, low-density lipoprotein-cholesterol, and medication cost （all P〉0.05）.ConclusionShared care model can improve blood glucose monitoring and foot self-examination ability, promote patients getting more help from healthcare professionals, alleviate mood disorders,
作者
张东辉
李昂
井路路
张俊清
郭晓蕙
Zhang Donghui;Li Ang;Jing Lulu;Zhang Junqing;Guo Xiaohui(Department of Endocrinology, Peking University First Hospital, Beijing 100034, China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2018年第5期322-326,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
关键词
糖尿病
疾病管理
共同照护
血糖控制
Diabetes
Disease management
Shared care
Blood glucose control
