Study Of Strengths Model Of Case Management (SMCM) In Improving Self-Management Effectiveness In Community Patients With Diabetes

Objective:Using different self-management intervention model to observe the effectiveness of self-management in noninsulin-dependent diabetes mellitus (NIDDM) patients, in order to find a personalized, happy accepted and obvious effect of NIDDM patient self-management approach.Method:Selected the first time diagnosed patients with NIDDM in Kunshan Affiliated Hospital of Jiangsu University endocrine clinic from July 2013 to December 2013, in line with WHO 1999 diagnostic criteria (age≥18 years; duration ^ 2 years; no DM-related complications; having complete cognitive and behavioral), informed consent, voluntary participation. There were 60 patients enrolled in the study that randomly divided into two groups, namely the implementation of the conventional mode of education control group (conventional group) and Strengths Model of Case Management model (SMCM group),30 cases in each. Two groups of patients with DM-related metabolic parameters were monitored to evaluate the effect after intervention before the intervention, after intervention 6 months and 12 months. Using Michigan Diabetes care profile (DCP) to monitor the level of self-management in two groups of patients before and after the intervention 12 months; Using Chinese version of the Kessler pspsychological distress scale (K10) measure different intervention models on patients with negative emotion. Then analyzed and summarized. SPSS 19.0 statistical software was used to statistical analysis after finishing the data.Results:Self-management DCP measured value after intervention patients were better than before intervention (P<0.05), in which the difference between the terms of the SMCM group were statistically significant (P<0.05); whereas the conventional group only in the diet, exercise there are bars and disease control significant difference (P <0.05), SMCM group was superior to conventional group can improve DM patients improve self-management in comparison of intragroup.Two modes could all reduce the degree of anxious NIDDM patients after the intervention in comparison of intragroup, SMCM group was superior to the conventional group in remission in patients with DM negative emotions in comparison of intergroup, the difference was statistically significant (P<0.05).In DM related metabolic indicators, the result of intragroup comparison showed that FPG of 6 months,12 months and 2hPBG in the experimental group and the control group were significantly reduced after intervention, no significant decline in HbAlc at 6 months, but 12 months decreased significantly (P<0.05), decline in June to 12 months significantly different (P<0.05), however, BMI, triglycerides drop were not obvious, the difference were not statistically significant (P> 0.05), cholesterol decreased 12 months after the onset of the intervention; the result of intergroup comparison showed that the control effect of FPG,2hPBG, HbAlc, LDL cholesterol in SMCM group was better than the conventional group, the difference was statistically significant (P<0.05).Conclusion:Both of the intervention model could improve the self-management of NIDDM patient compliance, ease patient fears, optimization DM related metabolic indicators; Strengths Model of Case Management model (SMCM) more superior than the conventional group to improve patient self-management level, to ease fears and smooth DM-related metabolic parameters, which indicated that SMCM change the cognition to leading and replace the advantage guide to the traditional missing guide, can effectively improve community NIDDM patient self-management efficiency.