链式管理在农村空巢老年糖尿病患者胰岛素注射中的应用研究

doi:10.3761/j.issn.0254-1769.2022.23.013

摘要/Abstract

摘要：

目的评价链式管理对农村空巢老年糖尿病患者胰岛素注射管理能力的影响。方法以村为单位实施整群随机抽样法，2021年1月—12月，选取96例在县域联盟单位接受胰岛素治疗的老年糖尿病患者，使用随机数字表法将患者分为试验组和对照组，各48例。试验组接受链式管理，对照组接受常规管理。干预前及干预后3、6个月，比较两组胰岛素注射管理能力、血糖代谢指标、生存质量及胰岛素注射并发症发生率。结果 91例患者完成了研究。干预后3、6个月，试验组胰岛素注射管理能力总分高于对照组，差异有统计学意义（P<0.05）。2组空腹血糖、餐后2 h血糖在干预前及干预后3、6个月的比较，差异有统计学意义（P_组间<0.001，P_时间=0.002，P_交互=0.002；P_组间<0.001，P_时间=0.015，P_交互=0.016）；2组糖化血红蛋白的组间比较，差异有统计学意义（P_组间<0.001）；干预后6个月，两组生存质量特异性量表各条目及总分的比较，差异均有统计学意义（P<0.05）；干预后6个月，两组皮下脂肪增生及疼痛发生率的比较，差异均有统计学意义（P=0.020，P=0.040）。结论实施链式管理能提升农村空巢老年糖尿病患者的胰岛素注射管理能力，有助于控制血糖，改善患者的生存质量，提高注射的安全性。

关键词: 空巢老年人, 糖尿病, 胰岛素, 链式管理, 护理管理研究

Abstract:

Objective To evaluate the effects of chain management on insulin injection management ability of rural empty nest elderly diabetic patients. Methods The randomized controlled study was conducted to select 96 elderly diabetic patients who started insulin therapy in county alliance units from January 2021 to December 2021 by convenient sampling method. They were divided into an experimental group and a control group by random number table method，with 48 cases in each group. The control group was given routine outpatient care and follow-up management，and the experimental group was given insulin injection chain management. The insulin injection management ability，blood glucose metabolism index，quality of life and incidence of insulin injection complications were compared between the 2 groups after intervention. Results A total of 91 patients completed the study. The scores of insulin injection management ability in the experimental group increased gradually 3 months and 6 months after intervention，and the difference was statistically significant（P<0.05）. There were significant differences in fasting blood-glucose and 2-hour postprandial blood glucose between the 2 groups before intervention，3 months after intervention and 6 months after intervention（P_group<0.001，P_time=0.002，P_interaction=0.002，P_groups<0.001，P_time=0.015，P_interaction=0.016）. There was significant difference in HbA1c between the 2 groups. There were significant differences in DSQL items and total scores between the 2 groups after intervention（P<0.05）. There were significant differences in the incidence of lipohypertrophy and pain between the 2 groups at 6 months after intervention（P=0.020，P=0.040）. Conclusion The implementation of chain management can improve the management ability of insulin injection in rural empty nest elderly diabetic patients，help to control blood glucose smoothly，improve the quality of life of patients，and improve the safety of injection.

Key words: Empty-Nest Elderly, Diabetes, Insulin, Chain Management, Nursing Management Reasearch

吕忠美, 杨小华, 席巍, 葛春燕, 储红梅, 赵杨秋, 王煦, 史爱华. 链式管理在农村空巢老年糖尿病患者胰岛素注射中的应用研究[J]. 中华护理杂志, 2022, 57(23): 2904-2911.

LÜ Zhongmei, YANG Xiaohua, XI Wei, GE Chunyan, CHU Hongmei, ZHAO Yangqiu, WANG Xu, SHI Aihua. Effect of chain management on insulin injection management ability of rural empty nest elderly diabetic patients[J]. Chinese Journal of Nursing, 2022, 57(23): 2904-2911.

图/表 5

表1 两组一般资料的比较

Table 1 Comparison of general data between 2 groups

表2 两组胰岛素注射管理能力的比较[分，M（P25，P75）]

Table 2 Comparison of scores of insulin injection management ability between 2 groups[score，M（P25，P75）]

表3 两组血糖代谢指标的比较（$\bar{x}$±s）

Table 3 Comparison of glucose metabolism indexes between 2 groups before and after intervention（$\bar{x}$±s）

表4 两组生存质量特异性量表得分的比较（分，$\bar{x}$±s）

Table 4 Comparison of DSQL scores between 2 groups before and after intervention（score，$\bar{x}$±s）

表5 两组皮下脂肪增生和疼痛发生率的比较 [例（百分率，%）]

Table 5 Comparison of incidence of Lipohypertrophy and pain between two groups[case（percent，%）]

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