The Research About Effects Of Continuing Care On Type 2Diabetes: With Patient’s Clinical Outcome And Quality Of Life

Objective: This paper aims at providing the continue nursing care for patients with type 2 diabetes, to study the effect of continuring care, assess the continuing care impact on the blood glucose 、qualty of life and self-management level of type 2 diabetes. To provide a scientific basis for continuining care carry out in other area; This reach is important to improve type 2 diabetes ’ quality of life, reduce medical costs, reduce the waste of medical resources.Methods: As an quasi-experimental research, this study was carry out from June 2014 to February 2015 in Shen Zhen Nan Shan Hospital.Choose accidental sampling method, Select Endocrinology hospitalized 121 patients with type 2 diabetes, Assess patiant ’ FPG、2h PG、Hb A1 c 、BMI、DSU and SD,while the day before patient discharge、three months after discharge、six months after discharge. Use Diabetes Continuity of Care Questionnaire to assess the lever of continuiting care that paitient had accepte.Use Chinese Normal Audit Of Diabetes Dependent Quality Of Life and Diabetes Self-efficacy Scale to describe or evalut the results.Results: 1、Six months after discharge, Patients in the intervention group in contextual knowledge of the patient score was 77.89±11.11, the diabetes counseling score was 66.19±10.26, personal communicationg score was72.31±10.34,physical exeamination score was69.20±6.04,integration score was63.59±12.92,interpersonal treatment score was77.34±12.90,process of care score was3.00±1.01, trust score was71. 78±5.89. 2、One day before discharge,there are no significant difference between patient’s fasting blood glucose、2hour plasma glucose、glycosylated hemoglobin, body mass index, systolic and diastolic blood pressure, The baseline are the same. Three months after discharge, There are differences between glycated hemoglobin values(t=4.206,P<0.05),other index are the same. Six months after discharge, There are differencesbetween glycated hemoglobin values(t=5.336,P<0.05)and fasting blood glucose(t=1.788,P<0.05), other index are the same. 3、The result of repeated measures analysis in blood glucose shows that time factors is significant(F =33.249,P=0.000),there is interaction effect between time and groups(F=9.070,P=0.001),groups have no diffrenet(F =9.070,P=0.118).Result of repeated measures analysis in 2hour plasma glucose shows that time factors is significant(F=153.694,P=0.000),there have interaction effect between time and intervention(F=7.213,P=0.002), groups have no diffrenet(F=0.000,P=0.994). Result of repeated measures analysis in glycosylated hemoglobin shows that time factors is significant(F=117.066,P=0.000),there have interaction effect between time and intervention(F=13.522,P=0.000), groups also have diffrenet(F=10.992,P=0.001). 4、Patients self-management scores from two groups are the same between the day before discharge and three months after discharge(All P>0.05).Six months after diacharge, There are differences between exercise regular(P=0.000,P<0.05), prescribed medication(P=0.003,P<0.05)and foot care(P=0.000,P<0.05),other index are the same. The result of repeated measures analysis in self-management shows that time factors is significant(F=11170.713,P=0.000), groups also have diffrenet(F=8268.386,P=0.000). 5、Patients qulity of life scores from two groups are the same between the day before discharge and three months after discharge(All P>0.05),but Diet scores were significantly after six months dischager(P=0.003,P<0.05),other scores are the same. Result of repeated measures analysis in glycosylated hemoglobin shows that time factors is significant(F =7456.659,P=0.000),there have interaction effect between time and intervention( F=277.957,P=0.000), groups also have diffrenet(F=12.628,P=0.000). 6、Multiple linear regression analysis showed that duration,and age were the main influencing factors of decrease in blood glucose which could explained 15.4% of the variance; Integration and interpersonal treatment in continuity of care and duration, and age in basic information could explained80.1% of the variance.Conclusion: 1、Patients with type 2 diabetes in this research were accept an higher level,buttheir self-manement and quality of life lever are at low level. 2、Continuing care intervention can improve type 2 diabetes self-management level and their quality of life,the longer it’s carry out,the better effect it cloud be. 3、Duration, age and the level of continuing care can affect blood glucose level, Continuity of care have a positive impact on blood glucose, the longer it’s carry out,the better effect it cloud be.