The "Two In One" Community Care Model For Elderly Patients With Type2Diabetes

Objectives:To investigate the current management of elderly patients with Type2Diabetes in the community; On the basis of the cross-section investigation, we used the methods of theory and literature research and the brain storm of experts in order to get the "Two in One" community care model for elderly patients with Type2diabetes; To validate the effect of the "Two in One" community care model on the patients’diabtetes knowledgement, self-care behaviors and quality of life.Methods:There were two sections in this study. The first section was to build up the "Two in One" community care model:step1, the cross-section investigation. In this step, we recruited about213qualified patients from March to August in2012. In order to assess the effect of management of this Community Health Service Centre, the knowledge of diabetes, the level of self-care behaviors and the quality of their life was investigated and the underlying reason could be ientified. The second step was to build up the "Two in One" community care model for diabetes. This step was based on the results of investigation, the research of theory and literature together with the brain storm of experts. The second section was to evaluate the effect of the "Two in One" community care model for ederly patients with Type2diabetes. We included about203patients took part in both the first section and the second. We placed them into two groups by randomization, an experiment group and a control group. The experiment group was managed following the steps of the "Two in One" care model for elerly patients with Type2diabetes and the control group was managed under the current practice in the community for about6months. Effect of the "Two in One" community care model for elderly patients with Type2diabetes was evaluated in3moths and6months. The statistical software SPSS17.0was used to analyze the collected data, the statistical methods included statistical description, t-test, single factor analysis of variance, Chi-square test, rank sum test, multivariate linear regression analysis, profile analysis, repetitive measure ANOVA, ect. Results:1. There were213patients with type2diabetes took part in the investigation and the results showed that the mean score of diabetes knowledge was52.51±17.05, and the weakest parts was the knowledge about diet; the mean score of diabetes self-care behavior was69.99±12.06and the lowest parts was blood sugar monitoring; the mean score of quality of life was41.90±8.60and the weakest part was social relationship; the blood sugar Achievement Ratio was49.11%for fasting blood glucose and51.59%for the postprandial blood glucose, the Achievement Ratio for glycosylated hemoglobin was43.86%and30.99%for the hypertension, and the Achivement Ratio for BMI was42.28%. This reflected a poor management of the type2diabetes in the community.2. We built up the "Two in One" care model for elderly patients with type2diabetes based on the results of theory, literature and the brain storm of the experts.It was characterised by the management institutions, which are the community health service center and the residents’community committee; the management means, which are combined with the diabetes self-management education and the follow-up visits. We used them together for well management of the diabetes patients.3. About203patients participated in the research of the effect of the "Two in One" care model for type2older diabetes and the results showed that the "Two in One"care model for type2older diabetes could improve the patients knowledge of diabetes (P<0.01), self-care behavior (P<0.01) and mental and social community in quality of life (P<0.05) significantly compared to the current practice model.Conclusion:1. The current manangement of type2diabetes was not as effective as we expected and requests improvement.2. The "Two in One"care model for eldely patients with type2diabetes was better than the model that is used widely in current Community Health Service Centre...