王平,孟晶晶,徐培,司冬芹,梁军.探讨在分级诊疗中应用医院-社区护理模式对糖尿病患者的影响[J].上海护理,2017,17(3):
探讨在分级诊疗中应用医院-社区护理模式对糖尿病患者的影响
DOI:
中文关键词:  医院-社区护理模式  分级诊疗  糖尿病  随访  
英文关键词:hospital-community nursing model  two-way referral system  diabetic  follow-up  
基金项目:江苏省科技厅临床医学科技专项
作者单位E-mail
王平 徐州市中心医院 wp72176@sina.com 
孟晶晶 徐州市中心医院  
徐培 徐州市中心医院  
司冬芹 徐州市中心医院  
梁军* 徐州市中心医院 mwlj521@163.com 
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中文摘要:
      【】目的:探讨在分级诊疗中应用医院-社区护理模式对糖尿病患者治疗依从性的影响。方法:选取在某三级甲等医院内分泌科就诊的糖尿病患者120例并随机分为两组,对照组采取常规糖尿病治疗管理方法,干预组在对照组基础上运用医院-社区护理和糖尿病双向转诊模式进行管理,随访一年后,比较两组患者的血糖控制情况,并采用自制治疗依从性问卷和CSSD70问卷比较两组患者的依从性和糖尿病控制状况。结果:治疗依从性比较:两组患者在出院后3个月、6个月、12个月的依从性存在差别,干预组的依从性高于对照组,且差异有统计学意义。血糖指标比较:随访12个月后干预组2小时餐后血糖、糖化血红蛋白在随访期间均低于同时期的对照组,差异有统计学意义。糖尿病控制状况:运用CSSD70评价量表在出院后3个月、6个月、12个月对两组患者进行随访,结果发现,干预组的糖尿病控制状况明显优于对照组,并且存在统计学差异。结论:医院-社区护理与糖尿病双向转诊相结合的管理模式,可以提高患者的治疗依从性,改善患者的血糖代谢指标,提高患者的生活质量。
英文摘要:
      Objective: Discussion about the application of hospital-community nursing model in diabetes two-way referral system. Methods:Selecting and randomly dividing 120 newly diagnosed diabetic patients in endocrinology department of a first-class tertiary hospital into control group and intervention group. The control group adopts conventional diabetic therapy, while the intervention group utilizes hospital-community nursing model and diabetes two-way referral system on the basis of control group. After one-year follow-up visit, researchers can compare blood glucose control conditions of diabetic patients in two groups and thereafter, compare their compliance and diabetes control conditions by adopting self-made treatment compliance questionnaire and CSSD70 questionnaire.To collect data, measurement data using two independent sample t-test, single order count data using rank and inspection, repetitive measure analysis of variance is used to compare the index difference of blood glucose during the follow-up period. Results:The comparison between treatment compliance: There are differences of compliance embodied in patients respectively discharging from hospital for three months, six months and twelve months, and thereinto, the compliance in intervention group is higher than that in control group with a statistical meaning. The comparison between blood glucose indicators: Fasting blood-glucose, postprandial blood glucose in two hours and glycosylated hemoglobin in follow-up visit term are lower than that of control group at the same time. Similarly, this difference has a statistical meaning.Diabetes controlling conditions: Researchers shall conduct follow-up visits on two groups of post-discharge patients for three months, six months and twelve months by adopting CSSD70 evaluation scale. Research consequences indicate that diabetes controlling conditions in intervention group are obviously superior than that of control group with a statistical meaning. Conclusion: Hospital-community nursing model accompanied by a diabetes two-way referral system can elevate the treatment compliance of patients and thereby improving their blood glucose metabolic indicators and elevating their life quality.
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