| Objective: To investigate the status of knowledge,self-management,and life quality of patients with type 2 diabetes mellitus(T2DM)in a tertiary grade hospital in Guizhou province.To explore the application of the Information-Motivation-Behavioral model of transitional care for patients with T2DM effects.Methods: From January 2018 to March 2018,a cross-sectional survey was carried out among 210 patients with T2DM that met the study criteria in a tertiary grade hospital in Guizhou province.Using the Audit of Diabetes Knowledge,the Summary of Diabetes Self-Care Activities Measure,the Revised Quality of Life Scale for Type 2 Diabetes Mellitus,and a self-designed general information questionnaire to investigate the status of knowledge,self-management and life quality of patients with T2DM among hospitalized patients.The clinical randomized controlled trial method was used to within the endocrine department in a tertiary grade hospital in Guizhou province from May 2018 to June 2018.76 patients with T2DM who met the study criteria were randomly divided into an intervention group and a control group with 38 in each group.Both groups received routine care during hospitalization and received regular follow-ups after discharge.On the basis of this,transitional care intervene was implemented among the intervention group based on the IMB model by trained nurses,which included diabetes information delivery,personal and social motivation construction,and behavioral skills training.Fasting plasma glucose(FPG),2-hour Postprandial Plasma Glucose(2hPG),Hemoglobin A1c(HbA1c)and self-management levels were observed at 3 months and 6 months after the intervention.The statistic analyzed was performed with SPSS18.0.Results:1.Survey results:a total of 210 questionnaires was distributed in this survey,201 were recovered,and the effective recovery rate was 95.71%.(1)In the questionnaire of the Audit of Diabetes Knowledge(ADKnowl),there were 61 patients in the oral group,the average score of ADKnowl was(53.07 ± 18.06);53patients in the insulin group,the average score of ADKnowl was(50.81 ± 20.75);87patients in the oral drug and insulin group,the average score of ADKnowl was(60.75± 16.07).The correct rate of response to each dimension of the ADKnowl scale of 201 patients with T2DM include: reduction in the risk of complications(63.34%),foot care(60.53%),sick days(54.86%),hypoglycemia(53.45%),the effects of physical activity(52.19%),diet /food(49.81%),and the effects of smoking or alcohol(41.17%).(2)The total scores of the Summary of Diabetes Self-Care Activities of 201 T2DM hospitalized patients were(24.81±11.09)and the overall score of patients was 29.54%.The scores of each dimension are listed from the highest to the lowest: diet(39.73%),medication according to the doctor's advice(35.86%),exercise(27.83%),plasma glucose monitoring(17.34%),and foot care(16.49%).(3)The total scores of the Revised Quality of Life Scale of 201 T2DM hospitalized patients were(143.75±20.11),and the overall score was 73.72%.The rankings of the remaining dimensions from high to low as follows: society(80.52%),physiology(78.58%),psychology(72.99%),disease(72.21%),and satisfaction(66.60%).2.Intervention study results: a total of 76 patients with T2DM were examined in the study.Four patients did not participate in the follow-ups because of moving,going abroad,loss of contact,and voluntary withdrawal.72 patients completed the study,the intervention group and the control group consisted of 36 people each.(1)There was no significant difference in general information,the total scores of SDSCA and plasma glucose indexes(FPG,2hPG,HbA1c)between the two groups before the intervention(P>0.05).(2)After 3 months and 6 months of intervention,the aggregate scores of SDSCA in the intervention group were better than the control group,and the difference was statistically significant(P<0.05).The scores of each dimension of the SDSCA scale were statistically significant,except for smoking(smoking count)(P<0.05).(3)After 3 months and 6 months of intervention,plasma glucose levels of FPG,2hPG,and Hb A1 c in the intervention group were less than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:1.In this area,T2DM inpatients have insufficient knowledge of diabetes,and their self-management level is relatively low.The quality of life of patients needs to be further enhanced.2.Transitional care intervention based on the IMB model can improve the self-management behavior of patients with T2DM and improve glycemic control. |
PDF Full Text Request