Abstract:

Objective To evaluate the effectiveness of the shared medical appointments (SMA) in the management of type 2 diabetes mellitus (T2DM) and its impact on self-management behavior and efficacy and quality of life led by specialist nurses. Methods 30 patients with T2DM going to the endocrine clinic of a hospital from September to December 2020 were selected to participate in the SMA. The body mass index,Summary of Diabetes Self-care Activities (SDSCA) scale and Diabetes Management Self-efficacy Scale (DMSES) and Diabetes Specific Quality of Life (DSQL) scale were compared before the intervention and 3 months after the intervention. Results After 3 months of intervention,there was no statistical significance in the control rate of blood glucose compared with that before intervention (P=0.310). Waist circumference,total cholesterol and triglycerides of the patients after the intervention were significantly lower than those before the intervention (P<0.05). The total scores and the score of each dimension (diet,foot care) in SDSCA,and the DMSES score after the intervention were higher than those before (P<0.05). After the intervention,the total scores of DSQL and the scores of physiological dimension,psychological dimension and social relationship dimension were significantly lower than those before the intervention (P<0.05). Conclusion The SMA can effectively improve the waist circumference,total cholesterol and triglycerides of diabetic patients,improve the self-management ability,self-management efficiency,and the quality of life of patients with type 2 diabetes.

Key words: Shared Medical Appointments, Type 2 Diabetes, Self-Management, Care Model, Nursing Care

摘要：

目的 建立专科护士主导的2型糖尿病患者共享门诊,分析其对患者代谢指标、自我管理行为、自我管理效能及生活质量的影响。方法 构建专科护士主导的2型糖尿病患者共享门诊,并应用于2020年9月—12月在某三级甲等医院内分泌门诊就诊的30例2型糖尿病患者中。比较干预前和干预3个月后血糖达标率、各项生化指标、糖尿病患者自我管理行为量表得分、糖尿病患者管理自我效能量表得分及生存质量特异性量表得分的差异。 结果 干预3个月后,患者的血糖达标率与干预前相比,差异无统计学意义 (P=0.310) 。干预3个月后患者的腰围、总胆固醇、甘油三酯低于干预前 (P<0.05) ;患者的自我管理行为量表总分以及饮食管理和足部管理2个维度得分及自我效能量表得分高于干预前 (P<0.05) ;患者的糖尿病生存质量特异性量表总分及生理维度、心理维度、社会关系维度3个维度得分较干预前降低 (P<0.05) 。 结论 由专科护士主导的共享门诊能够有效降低2型糖尿病患者的腰围、总胆固醇和甘油三酯,提高患者的自我管理行为和自我管理效能,改善患者的生存质量。

关键词: 共享门诊, 2型糖尿病, 自我管理能力, 管理模式, 护理