The Study On The Health Education Of Dialectic Nursing Combined With Clinical Pathway For Patients With Type2Diabetes Mellitus

ObjectiveTo discuss the effects of health education of dialectic nursing combined with clinical pathway on negative emotion (including anxiety and depression)、the master level of Diabetes knowledge、the level of General self-efficacy、 the level of Self management、the index of Disease(including BMI、FBG、 PBG and HbAlc)、the quality of life and economic indicators(including the length of stay、hospital costs、 and medical expenses) for Patients with type2diabetes mellitusMethods1、This study adopts clinical randomized、controlled study method. Sampling154Patients with type2diabetes who meeting the inclusion criteria and selected in the Endocrine Department of affiliated Hospital of Chengdu University of TCM from September2010to August2011. The subjects were divided into control and experimental groups randomly with DPSv3.01statistical software, control group and experimental group included77cases respectively. Patients of the two groups were treated with the same conventional treatment and rehabilitation care; The control group was provided health education in routine clinical path. The experimental group were provided health education which including dialectical nursing of Traditional Chinese Medicine and routine clinical pathway.2、Information collection:(1) General information:including name, gender, age, occupation, marital status, education level, living conditions, smoking history, alcohol history, family history, course of disease, the Chinese medicine dialectical type, the method of treatment at present, and the history of health education received chronic complications.(2) effective indicators:including the score of Diabetes knowledge scale (DKT)、General Self-Efficacy Scale (GSES)、Type2diabetes self management behavior scale (T2-CSO)、 Hamilton anxiety Rating Scale (HAMA)、 Hamilton Depression Rating Scale (HAMD)、 the quality of life scale for patients with type2diabetes mellitus (DMQLS)、 the index of Disease, including the BMI、 FBG. PBG. HbAlc and Economic indicators, including the length of stay、 hospital costs and medical expenses. All information was collected by the members who were trained specially in the group. The DKT was evaluated first before intervention and second at the discharged. The economic indicators were collected at discharged too. The effect indicators were evaluated first before intervention and second after the follow up which last3months.Results1、 Baseline data:there were no significant statistical differences between two groups in the aspect of General information (P>0.05).And there were no significant statistical differences between two groups in the aspect of DKT、 GSES、 T2-CSO、HAMA、 HAMD. DMQLS、BMI、 FBG、 PBG and HbAlc before nursing intervention (P>0.05).What discussed above shows that the baseline of all the dater were consistent and comparable.2、 Comparison of the degree of negative emotion:After the nursing intervention the differences of the degree of negative emotion (including anxiety and depression) between the two groups were statistically significant (P<0.05).And the degree of negative emotion of experimental group improved better than that of control group after nursing intervention.3、Comparison of the score of Diabetes knowledge:after the intervention, the differences of the score of Diabetes knowledge between the two groups have no statistically significant (P>0.05) after nursing intervention.4、Comparison of the level of General self-efficacy:After the intervention, the differences of the score of GSES between the two groups were statistically significant (P<0.01). And the level of General self-efficacy in the experimental group improved better than that of control group after nursing intervention. 5、Comparison of the level of Self management:after the intervention, In addition to the Aspect of taking the medicine according to the instruction showed no significant difference (P>0.05), the differences of the remaining aspects and the total scores of T2-CSO were statistically significant (P<0.01),and the level of Self management in the experimental group improved better than that in the control group after nursing intervention.6、Comparison of the index of Disease:after the intervention, the differences of FBG、 PBG、 HbAlc and BMI between the two groups were statistically significant (P <0.05).And these indexes in the experimental group were all improved better than that in the control group after nursing intervention.7、Comparison of the quality of life:After the intervention, the differences of the score of DMQIS between the two groups were statistically significant in each aspects and total scores (P<0.01).And the quality of life in the experimental group improved better than that in control group after nursing intervention.8、Comparison of the economic indicators:after the intervention, the differences of the length of stay、hospital costs and medical expenses between the two groups have no statistically significant (P>0.05)after nursing intervention.Conclusions1、The health education of dialectical nursing of TCM combined with clinical pathway for patients with type2diabetes mellitus can improve the negative emotion (including anxiety and depression、the General self-efficacy levels、the Self management level、 the index of Disease(including BMI、FBG、PBG and HbAlc)、the quality of life of Patients with type2diabetes mellitus. And the efficacy of test group is better than that of control group.2、The health education of dialectical nursing of TCM combined with clinical pathway for patients with type2diabetes mellitus can improve the command level of knowledge, Shorten the length of stay、reduced the hospital costs and medical expenses for patients. And the differences between two groups have no statistically significant.