| 【Objective】1.Using phenomenological method-semi-structured interview,we obtained the influencing factors of poor self-management ability and poor blood sugar control in elderly patients with type 2 diabetes,summarized the common characteristics,and provided a basis for elderly patients with type 2 diabetes to develop health education programs.2.Formulate a health education program based on IKAP theory,explore the impact of the program on the knowledge reserve level,self-management ability and blood sugar level of elderly patients with type 2 diabetes,and provide new methods for health education of elderly patients with type 2 diabetes.【Method】1.Fifteen hospitalized elderly patients with type 2 diabetes who met the inclusion and exclusion criteria in a top three Chinese medicine hospital in Yunnan Province from November 2021 to January 2022 were selected as the research objects by the purposive sampling method.The data were collected and analyzed by semi-structured interview and Colaizzi seven step analysis,and the influencing factors of the poor self-management ability and poor blood sugar control of elderly patients with type 2 diabetes were obtained.2.116 hospitalized elderly patients with type 2 diabetes who met the inclusion and exclusion criteria in a top three Chinese medicine hospital in Yunnan Province from February 2022 to September 2022 were selected by convenience sampling method as the research objects.They were divided into intervention group and control group according to the order of admission,with 58 cases in each group.The control group carried out routine health education,and the intervention group carried out health education program based on IKAP theory.The intervention time was the length of the patient’s hospitalization.Before the intervention,on the 7th day of the intervention and after the intervention,the two groups used the diabetes adult knowledge scale,diabetes self-management behavior scale,fasting blood glucose and postprandial blood glucose to collect data and conduct statistical analysis.【Results】1.After the semi-structured interview,the data was analyzed using the Colaizzi seven step analysis method,and the influencing factors of poor self-management ability and poor blood glucose control of elderly patients with type 2 diabetes mellitus were summarized into five: cognitive factors(lack of knowledge about diet management,lack of awareness of sports benefits,lack of awareness of blood glucose monitoring and insulin injection,lack of mastery of techniques for measuring blood glucose and injecting insulin,and information dilemma);Belief factors(lack of perseverance,lack of confidence);Force majeure factors(disease,weather/season,influenza epidemic)social support factors(scientific and technological needs,family economy,lack of peer support);Psychological perception factors(fear,weighing the pros and cons,and individual feeling replacing reality).2.A total of 116 cases were included in this study,including 58 cases in the control group and 58 cases in the intervention group.During the intervention period,2 cases in the control group fell off,1 case in the intervention group fell off,56 cases in the final control group completed,57 cases in the intervention group completed,a total of 113 cases.(1)Before intervention,the general demographic data,knowledge reserve level,self-management ability,fasting blood glucose and postprandial blood glucose of the two groups were compared,and there was no significant difference(P>0.05).The two groups were comparable.(2)After intervention,the level of knowledge reserve in the intervention group was higher than that in the control group(P<0.05);The analysis of variance of repeated measurement showed that the level of knowledge reserve between the two groups was significantly different in time,group and interaction(P<0.05).(3)After intervention,the self-management ability of the intervention group was better than that of the control group(P<0.05);The analysis of variance of repeated measurement showed that there was significant difference in time,group and interaction between the two groups(P<0.05).(4)After intervention,the scores of diet dimension,exercise dimension,blood glucose monitoring dimension and foot nursing dimension in the intervention group were significantly higher than those in the control group(P<0.05);There was no significant difference in the dimension of correct medication between the intervention group and the control group(P>0.05).The repeated measurement analysis of variance showed that there were significant differences between the two groups in terms of time,group and interaction effects in terms of diet dimension,exercise dimension,blood glucose monitoring dimension and foot care dimension in self-management(P<0.05);The repeated measurement analysis of variance showed that there was no significant difference between the two groups in the dimension of correct medication in self-management in terms of time,group and interaction effect(P>0.05).(5)After intervention,the fasting and postprandial blood glucose levels in the intervention group were significantly lower than those in the control group(P>0.05);Repeated measurement analysis of variance showed that there were significant differences in time,group and interaction between fasting and postprandial blood glucose in the two groups(P<0.05).【Conclusion】1.Qualitative research shows that cognitive,belief,force majeure,social support,and psychological perception factors affect the self-management ability and blood sugar control of elderly patients with type 2 diabetes.2.The health education program based on IKAP theory can effectively improve the knowledge reserve level of elderly patients with type 2 diabetes,enhance their self-management ability,and improve fasting and postprandial blood glucose. |
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