糖尿病足截肢患者自我管理方案实施的行动研究

doi:10.3761/j.issn.0254-1769.2024.11.009

摘要/Abstract

摘要：

目的将行动研究法用于前期构建的糖尿病足截肢患者自我管理方案中，不断完善方案，确保方案的顺利实施。方法采用行动研究法，于2023年2月—6月选取北京市某三级甲等综合医院烧伤整形医学部住院的糖尿病足截肢患者为研究对象，通过“计划-行动-观察-反思”的循环过程，不断修订和完善前期构建的糖尿病足截肢患者自我管理方案。结果经过2轮行动研究，完善了糖尿病足截肢患者自我管理方案的施行方式和干预时机，患者自我管理行为水平得到提高（P<0.001）。结论运用行动研究法，研究人员针对糖尿病足截肢患者行为健康干预过程中存在的问题进行综合分析，通过对患者住院期、过渡期和居家期的反馈进行方案调整，确保每个阶段的对应指标能够基本满足患者自我管理需求，促进了糖尿病足截肢患者自我管理方案的顺利实施。

关键词: 糖尿病足, 截肢, 行动研究, 半结构访谈, 自我管理, 护理

Abstract:

Objective Action research methodology was used in a constructed self-management program for diabetic foot amputees to continuously improve the program and ensure the smooth implementation of the program. Methods Using the action research method，from February to June，2023，the self-management program constructed by the author was continuously revised and improved through the cyclic process of “planning-action-observation-reflection” for patients with diabetic foot amputation. Results After 2 rounds of action research，the action research refined the delivery of the program and the timing of the intervention，and the level of patient self-management behaviors increased significantly（P<0.05）. Conclusion Using the action research method，the researchers conducted a comprehensive analysis of the problems that existed in the process of patients’ behavioral health interventions，and adjusted the program through feedback from the patients’ hospitalization period，transition period，and home period，to ensure that the corresponding indexes at each stage could basically satisfy the patients’ self-management needs，and to improve the smooth implementation of the self-management program for patients with diabetic foot amputation.

Key words: Diabetic Foot, Amputation, Action Research, Semi-Structured Interviews, Self-Management, Nursing Care

祝红娟, 余红丽, 王倩, 王利卫, 岳鹏. 糖尿病足截肢患者自我管理方案实施的行动研究[J]. 中华护理杂志, 2024, 59(11): 1346-1352.

ZHU Hongjuan, YU Hongli, WANG Qian, WANG Liwei, YUE Peng. Action research on the implement of a self-management program for patients with diabetic foot amputation[J]. Chinese Journal of Nursing, 2024, 59(11): 1346-1352.

图/表 5

图1 “糖尿病足截肢患者自我管理方案构建的行动研究”的研究过程

Figure 1 “Action research on the construction of self-management program for patients with diabetic foot amputation” research process

表1 糖尿病足截肢患者的一般资料（n=21）

Table 1 General information of patients with diabetic foot amputation（n=21）

表2 2轮行动研究参与性观察结果

Table 2 Participatory observations of 2 rounds of action study

表3 2轮行动研究半结构访谈结果

Table 3 Results of 2 rounds of semi-structured interviews for action research

表4 患者自我管理行为水平比较（分，$\bar{x}±s$）

Table 4 Comparison of self-management behavior level of patients（score，$\bar{x}±s$）

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