健康行为互动模式在妊娠期糖尿病高危孕妇中的应用

doi:10.3761/j.issn.0254-1769.2022.20.002

摘要/Abstract

摘要：

目的探讨将健康行为互动模式应用于妊娠期糖尿病（gestational diabetes mellitus,GDM）高危孕妇中进行健康管理的效果。方法采用便利抽样法,选取2021年7月—2022年3月在山西省某三级甲等医院规律产检的130例GDM高危孕妇,随机分为试验组和对照组,每组各65例。试验组采取基于健康行为互动模式的护理干预,对照组接受常规的健康教育,比较两组GDM发生率、孕期体重增长合格率、不良妊娠结局、GDM高危人群知信行问卷得分和患者满意度调查表得分。结果干预后,试验组GDM发生率为10.2%,低于对照组的25.0%;巨大儿发生率为3.4%,低于对照组的15.0%;孕期体重增长合格率为79.7%,高于对照组的55.0%,差异均具有统计学意义（P<0.05）。试验组GDM高危人群知信行问卷得分为（77.22±2.37）分,高于对照组的（66.78±2.71）分;患者满意度调查表得分为（50.27±1.95）分,高于对照组的（32.55±1.91）分,两组比较,差异均具有统计学意义（P<0.001）。结论基于健康行为互动模式的护理干预有利于提高GDM高危孕妇的知信行水平,减缓孕期体重增长,降低GDM和巨大儿的发生率,提升护理满意度。

关键词: 妊娠期糖尿病, 高危孕妇, 健康行为互动模式, 护理

Abstract:

Objective To explore the effect of nursing interventions based on the Interaction Model of Client Health Behavior（IMCHB） in health management of high-risk pregnant women with gestational diabetes mellitus （GDM）. Methods The convenience sampling method was adopted to select 130 pregnant women with high risk GDM who received regular obstetric examinations in a tertiary hospital in Shanxi Province from July 2021 to March 2022. They were randomly divided into an experimental group and a control group. The experimental group received nursing interventions based on the IMCHB,and the control group received the routine nursing intervention. The incidence of GDM,pregnancy outcome,diabetes-related knowledge,belief and nursing satisfaction of pregnant women in 2 groups were compared and analyzed. Results After the intervention,the incidence of GDM in the experimental group（10.2%） was lower than that in the control group（25.0%）;the incidence of macrosomia（3.4%） was lower than that in the control group（15.0%）;the qualified rate of weight gain during pregnancy（79.7%） was higher than that in the control group（55.0%）. The GDM questionnaire score of the experimental group was（77.22±2.37）,which was significantly higher than that of the control group（66.78±2.71）. The nursing satisfaction score was （50.27±1.95）,which was significantly higher than that of the control group（32.55±1.91）,and the differences between the 2 groups were statistically significant（P<0.001）. Conclusion Nursing interventions based on the IMCHB is beneficial to improve the level of knowledge,belief,behavior of GDM high-risk pregnant women,to slow down the weight gain during pregnancy,to reduce the incidence of GDM and macrosomia,and to improve nursing satisfaction.

Key words: Gestational Diabetes Mellitus, High-Risk Pregnant Women, Interaction Model of Client Health Behavior, Nursing Care

范洪媛, 燕美琴, 赵希林, 苏杉杉, 冯瑶. 健康行为互动模式在妊娠期糖尿病高危孕妇中的应用[J]. 中华护理杂志, 2022, 57(20): 2445-2451.

FAN Hongyuan, YAN Meiqin, ZHAO Xilin, SU Shanshan, FENG Yao. Effects of Interaction Model of Client Health Behavior in high-risk pregnant women with gestational diabetes mellitus[J]. Chinese Journal of Nursing, 2022, 57(20): 2445-2451.

图/表 4

表1 基于健康行为互动模式的护理干预方案具体内容

Table 1 Specific contents of nursing intervention program based on Interaction Model of Client Health Behavior

表2 两组一般资料比较

Table 2 Comparison of general data between 2 groups

表3 两组不良妊娠结局的比较[例（百分率,%）]

Table 3 Comparison of pregnancy outcomes between 2 groups [case（percentage,%）]

表4 两组干预前后妊娠期糖尿病高危人群知信行问卷和患者满意度调查表得分比较（分,$\bar{x}±s$）

Table 4 Comparison of knowledge, belief, behavior and nursing satisfaction scores of GDM high-risk pregnant women before and after intervention between 2 groups（score,$\bar{x}±s$）

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