| Objectives Establish the continuous nursing intervention model of gestational diabetes mellitus,and explore the influence of the network interactive continuous nursing intervention model on GDM patients' quality of life.Methods From December 2012 to December 2014,172 primipara were included in this study.All patients have been diagnosed of GDM by OGTT and have given written informed consents.The 172 primipara received normolized prenatal examination and deliver in this hospital by will.They were divided into two groups at random:the intervention group have 86 patients,while the comparison group have 86 patients.The intervention period was stipulated since pregnancy 24-28 weeks to 42 days after diliverd.The control group adopted routine nursing period of diabetes care in pregnancy.These patients' informations was recorded in Electronic health records which were estabilished by Tianjin Maternal and child health management system,They received gestational diabetes education,exercise,and diet guidance,close monitoring of blood glucose during hospitalization,positive adjustment of diet,treatment at hospital if necessary.They also were encouraged to take part in GDM lecture,receive health education after discharge and come back to hospital to have examination.The intervention group based on routine nursing care has been given network interactive continuous nursing program,combined with the modern cyber source.We Chat communication group with GDM patients electronic health records was established to implement health education and psychological intervention,dietary intervention for GDM patients,incluiding moderate exercise intervention during pregnancy,postpartum blood glucose monitoring and continuous nursing program.Through the implementation of We Chat feedback every time we found and solved the problems timely and the patients were followed up 2 times a week regularly after discharge.They have been send real-time push related intervention,implement once every 2 weeks for each patient guidance personality continued to postpartum 42 days clinic review.To achieve the whole process of continuous care and ensure the effect of the intervention,we guided GDM patients to carry out nursing intervention program effectively.The pregnancy outcome of the two groups of GDM patients with the implementation of network interactive continuous nursing intervention were analyzed,by collecting the data about postpartum 42 days blood glucose control satisfaction degree,self-management level factor,General Well-Being index and the quality of life.The difference about these data were analyzed to evaluate the influence of the network interactive and continuous nursing intervention to GDM patients' quality of life.The independent-T test,chi-square test,and Repeated data of variance analysis were used to do the statistical analysis,and explore the application value of network interactive continuous nursing intervention mode in improving the GDM patients' quality of life.Results 1.The two groups puerperas' general data,FPG and PBG,general well-being index and the related factor of self-management level showed no statistically significance(P>0.05),and the baseline data compareability.2.The intervention group revealed statistically significance compared with the control group at the pregnancy outcome,satisfaction degree of blood glucose control in the postpartum 42 days,the related factor of self-management level,a number of indicators of general well-being index and score of quality of life(P<0.05).(1)Outcome of pregnancy: The intervention group GDM patients' delivery index(preeclampsia,postpartum hemorrhage,wound undesirable healing rate),delivery outcome index(the rate of cesarean section and the natural labour rate),newborn outcome(macrosomia,low blood glucose of newborn and the change department rate of newborn)were better than the control group and the difference shows statistical significance(P<0.05).The other index(like polyhydramnios,FGR co.)showed no statistical significance(P>0.05).(2)The intervention group GDM patients' blood glucose control degree in the postpartum 42 days were lower than the control group.The difference showed statistical significance(P<0.05).The intervention group disasatisfaction rate of FPB was 11.6% and the PBG' s disasatisfaction rate was 6.98%.(3)The intervention group patients' self-management index(attitude and capabillity of self-management,exercise,diet obedience,supervise of blood glucose and urine glucose)were better than the control group and the difference showed statistical significance(P<0.05).(4)The intervention group patients showed statistical significance with the control group at evaluation in GWB scale,worried about health,satisfaction and interesting of life,glommy or happy state of mood,the control of emotional and behavior and relax or nervous.(P<0.05).The intervention group was better than the control group.(5)The intervention group patients' scores were higher than the control group patients at quality of life scores,Influence to work and prospect,physical condition self evaluation score,and the difference showed statistical significance(P<0.05).The intervention group patients score were lower than control group at social relationship score and daily activity restriction,but the difference showed no statistical significance(P>0.05).Conclusions Implemention of network interactive and continuous nursing to GDM patients at 24-28 gestational week till postpoartum 42 days can increase patients and their majar caregivers' acknowledge and attach importance to the GDM,improving the patients positivity of joining and the management about the disease and making patients insist therapy andsupervise the relation situation about disease.In conclusion,network interactive and continuous nursing to GDM patients can improve the outcome of pregnancy and their self-management capability after delivery,and it also makes GDM patients control the blood glucose when delivery or after delivery effectively.Besides,the implemention can increase the happiness of GDM patients after delivery.It has a positive influence on improving the GDM patients' quality of life and has good clinical generalized value. |
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