The Impact Of Nursing Intervention Based On Empowerment Theory On Self-management Ability Of Type 2 Diabetes Patients

ObjectivesThis study aims to investigate the status quo of self-management,psychological distress and quality of life in patients with Type 2 Diabetes Mellitus(T2DM);To analyze the influencing factors of self-management in patients with T2 DM and the correlation between self-management and psychological distress and quality of life;To explore the effect of nursing intervention based on the empowerment theory on the self-management and quality of life of patients with T2 DM,and lay a practical foundation for the extensive application of the empowerment theory in the field of Nursing.Methods(1)Using the method of convenient sampling,eligible endocrinology inpatients with T2 DM in 3 tertiary A hospitals were selected in a certain city as the survey subjects,the general information questionnaire,the self-management behavior scale,pain scale and survival quality specific scale of diabetic patients were applied as a research tool.A total of 450 T2 DM inpatients were surveyed to understand the status of self-management,distress and quality of life of T2 DM inpatients,and to analyze the influencing factors of self-management of T2 DM patients.In addition,to explore the relationship between self-management,psychological distress and quality of life.(2)A lottery method was used to determine a hospital from the three surveyed hospitals in a certain city.According to the inclusion and exclusion criteria,a total of 84 T2 DM inpatients were randomly selected as the research objects.The included objects were divided into the intervention group and the control group by the random number table method.The control group received regular health education and issued a health education handbook on diabetes-related knowledge.The intervention group implemented nursing intervention based on the empowerment theory.Then compared the changes in self-management,psychological distress,quality of life,and glucose metabolism indexes between the two groups.SPSS 24.0 software was used for statistical analysis of the data.Independent sample t-test,analysis of variance,chi-square test,Fisher’s exact probability method,Pearson’s method and multi-factor logistics regression were used for statistical analysis.Results(1)The total score of self-management for patients with T2 DM was(34.23±14.21)points,with a scoring rate of 44.45% which was at a moderately low level.The scores of each dimension are smoking,exercise,diet,blood sugar monitoring,and foot care in descending order.Older age(OR=1.484,95% Cl: 1.081-1.894)was a risk factor for better self-management status,while high school education or above(OR=0.927,95% Cl: 0.904-0.986)was a protective factor for self-management status.(2)The total score of painful psychological in patients with T2 DM was(38.93±7.80)points,which was at a moderate pain level.The scores of each dimension from high to low were emotional burden,life pattern,interpersonal relationship,and doctor-related pain.(3)The total score of the Quality of Life Specificity Scale for T2 DM patients was(63.95±7.21)points,which was at a moderate level.The scores of each dimension,from high to low,were physiological function,mentality,social relationship,and treatment.(4)The total score of self-management behavior scale was negatively correlated with the total score of psychological distress scale in T2 DM patients(r=-0.286,P<0.001),the pain dimension related to emotional burden(r=-0.249,P<0.001),and the pain dimension related to the law of life(r=-0.245,P<0.001).(5)The total score of the self-management behavior scale was negatively correlated with the total score of the quality of life scale for patients with type 2 diabetes(r=-0.295,P<0.001),physical function dimensions(r=-0.246,P<0.001),mental and spiritual dimensions(r=-0.287,P<0.001),the social relationship dimension(r=-0.321,P<0.001),and the treatment dimension(r=-0.249,P<0.001).(6)Before the intervention,there was no significant statistic difference between the two groups of patients with T2 DM in general information,total self-management scores,scores of various dimensions,total painful psychology and scores of various dimensions,total quality of life scores,scores of various dimensions,and glucose metabolism indicators.(P>0.05);(7)After 1 month and 3 months of the intervention,the blood glucose at 2 hours postprandial and glycosylated hemoglobin of the intervention group were lower than those in the control group(P<0.05),but there was no significant statistic difference in fasting blood glucose between the two group(P>0.05);(8)After 1 month and 3 months of the intervention,the total score of self-management and the scores of all dimensions in the intervention group were higher than those in the control group(P<0.05),and the total scores of the patient’s psychological pain,all dimensions,quality of life and all dimensions in the intervention group were lower than the control group,the difference was statistically significant(P<0.05).Conclusions(1)The psychological distress and quality of life of T2 DM patients were at a moderate level,while the self-management was at a moderate low level.The main influencing factors of self-management for patients with T2 DM were age and education level.Self-management was negatively correlated with psychological distress and quality of life in patients with T2 DM.(2)Nursing intervention based on the empowerment theory can effectively improve the glucose metabolism indicators of patients with T2 DM,and improve the self-management level and quality of life.