Application Of Swanson’s Care Theory To The Care Model Of Transitional Children And Adolescents With Diabetes

Objectives1.To understand the status quo of the intention to participate in health care among children and adolescents with diabetes mellitus in the transition period.2.To analyze the influencing factors of transitional children and adolescents with diabetes mellitus to participate in health care,and to provide a reference for the later care intervention of this population.3.To explore the effect of nursing intervention based on Swanson’s nursing theory on the intention and behavior of children and adolescents with diabetes in the transition period to participate in health care.MethodsThis study is divided into two parts:1.The first part used a cross-sectional survey.To investigate the status quo of participation in health care intentions of children and adolescents with diabetes mellitus in the transitional period.Convenience sampling was used to select 185 transitional children and adolescents with diabetes mellitus aged 8 to 19 from the endocrinology outpatient and inpatient departments of a Grade-A tertiary hospital in a city in Jiangsu Province from March to October 2021,and the general data questionnaire and patients’ willingness to participate in health care were surveyed.Questionnaire,Chinese version of the Health Literacy Scale(Health Literacy Scale,HLS),Diabetes Self-Management Scale(Diabetes Self-Management Questionnaire,DSMQ)were investigated to understand the status quo of patients’ participation in health care,and the collected data were multi-linear Regression analysis to get the influencing factors.2.The second part adopted quasi-experimental research.Based on Swanson’s nursing theory,an intervention expert group in the hospital was established,and a nursing intervention plan was formulated by consulting domestic and foreign literature.The intervention plan mainly started from "three stages,four elements and five aspects".The three stages include initial admission,during hospitalization,and after discharge;the four elements are "people,environment,health,and nursing";the five aspects are knowing,accompanying(being with),meeting needs(doing for),and empowering(enabling),Maintaining belief.From March 2022 to October 2022,78 transitional children and adolescents with diabetes mellitus aged 8 to 19 who were hospitalized in a Grade-A tertiary hospital in a city in Jiangsu Province were selected as the research subjects,with 39 cases in the control group and 39 cases in the intervention group.The control group used routine nursing measures,and the intervention group used nursing intervention based on Swanson’s nursing theory.The data of patients were collected before the intervention and after 3months of intervention,and the intention(behavior)of participating in health care,patient self-management,general Changes in self-efficacy and quality of life.Results1.In the first part of the research,a total of 182 transitional children and adolescents with diabetes mellitus aged 8 to 19 were included.The survey found that the total score of participation in nursing care of transitional children and adolescents with diabetes was(124.87±16.31),which was at the middle level.After Pearson correlation analysis and multiple linear regression analysis,it was concluded that age,disease duration,disease type,family structure pattern,health literacy,and self-management ability were the main influencing factors of the intention to participate in health care among children and adolescents with diabetes in the transition period(P<0.05).Among them,the level of health literacy was positively correlated with patients’ intention to participate in health care(r=0.250,P<0.05),and the self-management ability of patients was positively correlated with patients’ intention to participate in health care(r=0.232,P<0.05).2.Applied research results: Before the intervention,there was no statistical significance in the basic information and scores of various questionnaires and scales between the two groups of patients(P>0.05),diabetes self-management,general self-efficacy and diabetes-specific quality of life(P<0.05).Conclusions1.The intention of children and adolescents with diabetes to participate in health care in the transition period is at a moderate level,which is affected by many factors.Relevant measures need to be taken against influencing factors to improve patients’ ability to participate in health care.2.Nursing interventions based on Swanson’s nursing theory can effectively improve patients’ intention(behavior)to participate in health care,improve their self-management ability,self-efficacy and quality of life.