The Study About The Effect Of Nursing Case Management On Self-management Ability And Life Quality Of Patients With High Risk Diabetic Foot

Purpose:(1)According to the investigation about self management ability of patients with high risk of diabetic foot in the endocrinology department of a AAA hospital,we can fully know the self-management ability of patients with high risk di abetic foot,and explored its influencing factors.(2)The case nursing intervention was carried out to the patients with high risk of diabetic foot,the high quality nursing service was provided,and the nursing effect was also evaluated.(3)The blood glucose level of patients with high risk of diabetic foot was controlled within the normal range,so that the occurrence of diabetic foot was effectively prevented,so the life quality of patients was improved,and it also provided the reference to help us to fulfill the nursing case management on patients with high risk of diabetic foot.Method:According to the convenient sampling principle,patients with high risk of diabetic foot in the endocrinology department and outpatient department in a AAA hospital were selected,and surveyed by the diabetes self-management behavior scale.Their demographic data,daily behavior,self evaluation,self management ability score in each dimension were analyzed.According to the last digit of hospital number,the hospital ized patients at high risk diabetic foot in the endocrinology department of a AAA hospital were Selected,randomly divided into the intervention group(71 cases)and control group(71 cases),one was treated by the whole nursing case management and the oth er by the routine nursing care.Before the intervention and 6 months after intervention respectively,the patients in two groups were measured about fasting blood glucose(FPG),2h postprandial blood glucose(PG2h),and glycosylated hemoglobin(HBA1c).Also the diabetes specific quality of life scale(DSQL)was fulfilled to evaluate the effect on the life quality of patients who treated by the whole nursing case management.Result:(1)The scores about self management ability of patients with high risk diabeti c foot were low in several aspects: there is average 15.38 ± 10.41 points out of 28 points in the diet scores,and the patients with lower scores than average was 78,about 54.9% of all;Similar,7.04±5.32 points in the excise scores,and the patients with lower scores than average was 63,about 44.3% of all;5.68±4.39 points in the blood glucose monitoring scores,and the patients with lower scores than average was 55,about44.38.7 of all;4.70 ± 3.38 points in the foot care scores,and the patients with lower scores than average was 83,about 58.4% of all;5.80 ± 1.86 points in the drug scores,and the patients with lower scores than average was 59,about 41.5% of all.(2)There were significant differences in the self-management ability,age,gender,education,residence and medical expenses of patients with high risk diabetes foot(P<0.05).(3)The effect of nursing case management on the life quality of patients with diabetic foot:Before the intervention,the difference between the patients with high ris k diabetic foot who treated by nursing case management intervention and those by routine nursing was not statistically different(P>0.05): however it was different after the intervention in FPG,PG2 h,Hb A1 c,and DSQL score between the two groups(P<0.05 or P<0.01).Conclusion:(1)Many patients with high risk of diabetic foot had low self-management ability,especially about the foot care,which should be paid special attention by the clinical care workers;(2)The self-management ability of patients with high risk diabetic foot was influenced by age,gender,education,residence and medical expenses;(3)Nursing case management could reduce the predisposing and potential risk factors of diabetic foot,so as to maintain the healthy blood glucose level,reduce the incidence of diabetic foot ulcers,and also improve the life quality of patients with diabetic foot.