Investigation And Analysis Of Self-management Behavior Related Problems Of T2DM Based On Omaha System

Objective:1. On the theory of the Omaha system framework for preparation of T2 DM health questionnaire and investigation in patients with type 2 diabetes mellitus;2. Analysis of general data, Omaha, health problems, and the correlation of T2 DM self-management behavior, to determine the effects of self-management of behavior factors and provide theoretical basis for the further intervention strategy formulation;3. Preparation of T2 DM self-management behavior health problems directory, used to guide clinical/community nursing work.Methods:1. Based on the Omaha question classification system for the theoretical framework,combined with type 2 diabetes self-management behavior influence factor analysis of the literature review of medical records refer to as a result, the formulation of T2 DM Omaha health questionnaire, through expert consultation and investigation, to test reliability and validity of the questionnaire, determine the formal questionnaire;2. Under the mentor and Taiyuan City, a top three hospital endocrinology nurse help,take convenience sampling, in 360 cases of hospitalized patients with type 2 diabetes for a face-to-face questionnaire survey, to establish a database for statistical analysis using SPSS13.0.Results:1. Diabetes self-management behavior of each dimension scores in compliance with medical treatment of 5.96±2.10, the right amount of exercise 2.60±3.41, foot care5.19±3.04, diet control 3.26±2.82, blood glucose monitoring 2.39±2.55. It can be known that the self management behavior is the best, and the blood glucose monitoring is the worst. 360 patients surveyed, smokers in 65 cases, accounting for 18.06%, timely referral consultants of 103 people, accounting for 28.61%.2. With self management behavior related to the Omaha nursing problems involving I, II and psycho social, physiological III, IV health related behaviors in four areas, a total of 23 questions. Among them II-3 contact community resources 2.40±1.81, IV-21.3diabetes knowledge--SMBG 2.61±1.24, IV-21.1 diabetes knowledge-- nutrition3.06±1.32,these problems score lower, more serious. More than half of the patients have the IV-23 diabetes cognitive 91.11%, IV-21.4 diabetes knowledge- foot support 87.50%,IV-21.3diabetes knowledge--SMBG85.28%,IV-21.1diabetes knowledge--nutritional83.06%, III-11.oral health 82.78%, II-3The mental health 73.61%, II-2Contact network community resources 73.33%, III-9Visual 70.56%,III-10 Pain 70%,III-13nerve- muscle-skeletal function 66.39%, III-14 a circular function combination 63.61%, III-18 urinating60.83%, IV-20 Physical activity 60.56%, IV-21.2 diabetes knowledge- the drug 60.28%,III-12 skin 58.61% a total of 15.3. The health problems of patients with self-management behavior: 1) poor as medi--cal medicine behavior: incidence was 17.50%, does not comply with the recommended dose/schedule for the performance of don’t understand the usage of drugs/effect/effects/risk, can’t dozen insulin and folk prescription drug use substitution,etc., and patients of short duration, poor economic conditions, the low degree of culture,lack of diabetes education, diabetes drugs and low level of blood sugar monitoring knowledge, low level of family support and and urinary problems tend to be mild or no.2)Poor diabetes eating behaviors: incidence was 59.16%, the show is not following the recommended nutrition programs, over the established daily dose standards, with younger patients, solitary, high income, physical examination, or because of other illnesses, check out the diabetes diabetes community resources lack, lack of nutrition knowledge, poor mental state, the low degree of family support, hearing and the function of urinary problems tend to be mild or no. 3) poor sports behavior: incidence was 34.72%,as did not follow the recommended amount of movement or type, and women, young,lack of on-the-job, diabetes, community resources, lack of sports venues/no safety,sedentary lifestyle, urinary problems, body mass index, paint and so on. 4) poor blood sugar monitoring behavior: incidence was 78.61%, performance is not carried out in accordance with the recommended time/frequency monitoring, and age, low income,severe urinary tract symptoms, 2 h post-prandial blood glucose value and Hb A1c(%) poorly controlled, do not use insulin treatment. 5) sufficient to protect the poor management behavior: incidence was 60.00%, the performance is not every day to check and correct wash feet, wear appropriate footwear, shoes before check whether there is a sharp objects, avoid walking/sport/when cleaning foot injury, can’t correctly handle callosity/blister/damaged/this foot problems, such as with men, age small, on-the-job,low degree of culture, poor economic conditions,lack of short duration, diabetes,community resources, low degree of diabetic cognitive, severe anxiety, depression, no clear family genetic history and so on. 6) smoking: incidence was 18.06%, of patients after illness is still not to give up smoking, and the patient is male, younger, on-the-job,sedentary, social activity, and diabetes is associated with low cognitive degree of loss of hearing. 7) ill visit/consulting: incidence was 28.61%, show is can’t return on time, can’t accept guidance or health education actively, and the patient’s age, cultural degree is high,2 h postprandial blood glucose value control, without a spouse, solitary, low degree of family support.Conclusion:In this study, the different levels of self-management behavior of patients with diabetes are different, and the situation is not ideal. Omaha question classification system can be on the patients’ body, mind, society, environment and behavior aspects of effective assessment problem, and self-management behavior related to the Omaha nursing problems lack of nutrition knowledge, low levels of blood glucose monitoring skills,diabetes community resources insufficient three problem is more serious. General information as gender, age, living alone, job, education level, economic status, health insurance type, course of disease, complications and complications, treatment, diabetes education, how to discover I diabetes, drinking and Omaha nursing problems.such asⅠ-1Security, II-2 Contact community resources, II-3 The mental health, II–4 Interpersonal relationship, II-5 negligence, II-6 Abuse, II-7 Social, III-8 an auditory, III-18 urinating function, IV–20 Physical activity, IV-21 diabetes knowledge, IV-23 diabetes cognition is the main factors of influencing self-management behavior of patients with. Tips:(1) in strengthening the health education of patients and improve its knowledge, the cognitive level and attach importance to the patient’s psychological nursing;(2) of the family together for education, in order to protect the patients have a good family support;(3) the proposal superior health departments to strengthen to diabetes community service provided resources construction, as far as possible will blood glucose monitoring activities into the scope of medical reimbursement.