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协同护理管理模式对学龄前1型糖尿病儿童应用效果的观察

Effect of collaborative nursing management model on preschool children with type 1 diabetes

  • 摘要:
    目的  探讨以家庭为中心的协同护理管理模式对学龄前1型糖尿病儿童的临床应用价值,以期为提高患儿遵医行为及血糖控制效果提供参考。
    方法  选取2020年2月 — 2022年2月于河南省儿童医院收治的100例学龄前1型糖尿病儿童及其主要照顾者为研究对象,按照随机数字表法将其分为对照组及观察组,每组各50例患儿及其主要照顾者。对照组采用常规护理管理模式,观察组则施行以家庭为中心的协同护理管理模式,比较两组主要照顾者的疾病相关知识掌握情况、照顾负担水平、积极感受程度以及患儿的遵医行为和血糖控制效果。
    结果  最终入选对照组和观察组各48例患儿及其主要照顾者。两组患儿主要照顾者护理前疾病相关知识掌握度、负担量表(Zarit Burden Interview,ZBI)及积极感受量表(Positive Aspects of Caregiving,PAC)评分的比较差异均无统计学意义(均P > 0.05)。经护理后,两组的疾病相关知识掌握度、PAC评分均有所上升,ZBI则有所下降。观察组患儿主要照顾者的疾病相关知识掌握度、PAC评分均高于对照组,ZBI评分则低于对照组;且观察组患儿的饮食、运动、用药及血糖监测等方面的遵医率均高于对照组,差异均有统计学意义(均P < 0.05)。两组患儿护理前糖化血红蛋白(hemoglobin A1c,HbA1c)、空腹血糖(fasting blood glucose,FBG)的比较差异均无统计学意义(均P > 0.05)。经护理后,两组患儿的HbA1c、FBG均有所降低,观察组低于对照组,且观察组的HbA1c、FBG合格率高于对照组,差异均有统计学意义(均P < 0.05)。
    结论  以家庭为中心的协同护理管理模式可提升学龄前1型糖尿病儿童主要照顾者的疾病相关知识掌握度,减轻其照顾负担,增强其积极感受,且可提高学龄前1型糖尿病儿童的遵医率,有助于血糖控制。

     

    Abstract:
    Objective To explore the clinical application value of family centered collaborative nursing management model on preschool children with type 1 diabetes, so as to provide evidance for improving children’s compliance behavior and blood glucose control effect.
    Methods A total of 100 preschool children with type 1 diabetes who were admitted to Henan Children’s Hospital from February, 2020 to February, 2022 and their main caregivers were recruited as study subjects. They were divided into control group and observational group based on the random number table method, with 50 subjects in each group. The control group received routine care, and the observational group received care based on the family centered collaborative nursing management model. The awaremess of disease, care burden and the degree of positive feeling of care givers, and the compliance behavior and the effect of blood glucose control of the children were compared between 2 groups.
    Results Finally, 48 subjects were recruited in each group. There were no significant differences between two groups in terms of awareness of the disease, ZBI (Zarit Burden Interview) and PAC (Positive Aspects of Caregiving) scores of the main caregivers before intervention (all P > 0.05); After intervention, the awaremess of disease and PAC scores increased, while ZBI scores decreased in both groups; The awareness of disease and PAC scores in observational group were higher than those in control group, while ZBI scores were lower than those in control group (P < 0.05); The rates of compliance bahavior such as diet, exercise, medication use and blood glucose monitoring in observational group were higher than those in control group (all P < 0.05). There were no difference in HbA1c (hemoglobin A1c) and FBG (fasting blood glucose) between the two groups before intervention (all P > 0.05). After intervention, HbA1c and FBG in the two groups all decreased, and those number in observational group were lower than those in control group (P < 0.05), and the rates of HbA1c and FBG drop to normal in the observational group were higher than those in the control group (P < 0.05).
    Conclusion The family centered collaborative nursing management model can improve the awareness of disease among main caregivers of preschool children with type 1 diabetes, reduce their burden of care, enhance positive feelings, and strengthen the compliance behavior of preschool children with type 1 diabetes, which is conducive to blood glocose control.

     

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