| BackgroundDiabetes retinopathy(DR)is one of the most common and severe microvascular complications of type 2 diabetes.It has become the main cause of preventable vision loss in adults.At present no effective drugs or surgery can be used to completely prevent and control the occurrence and development of diabetic retinopathy,and the important risk factors for the development of the disease include blood glucose,blood lipid and blood pressure.DR patients lack knowledge about this disease,leading to their poor compliance with doctors' advices.When in hospital,the patients exhibited were well controlled indicators.However,After being released,due to the lack of professional supervision and guidance,patients often exhibited poor control on blood sugar and other indicators,which accelerated the course of disease and lost vision.Therefore,mere nursing intervention during hospitalization is not enough for patients.Professional nursing intervention should be extended to the patients after they have been released from hospitals.Continuous nursing intervention to patients with type 2 DR were carried out,and the effects and value are discussed in this thesis.ObjectivesTo explore the value of continuous nursing intervention in type 2 diabetes retinopathy.MethodsA total of 100 patients with type 2 diabetes retinopathy who met the inclusion criteria in June 2015 ~2016 January were selected and randomly divided into intervention group(n=50)and control group(n=50).During the hospitalization of two the groups of patients,nurses with relevant professional knowledge and skills provided routine nursing intervention.Individualized nursing intervention for patients according to different education level,and comprehension capability was provided,including hospital based nursing and drug administration,diet and exercise guidance,matters needing attention,timely referral,and regular fundus examination.The control group was discharged from the hospital in accordance with routine nursing intervention.For the intervention group,the aforementioned nursing interventions was continuously provided in three ways,WeChat follow-up,telephone follow-up,and door-to-door follow-up.When discharging and at the end of the follow-up period,the two groups of patients were surveyed with nursing satisfaction questionnaire as well as diabetes self management scale designed by our hospital.At discharge,1-year and 2-year intervals,we collected and compared fasting blood glucose,postprandial 2 hour blood glucose,glycosylated hemoglobin,visual acuity and other related indicators of the two groups of patients,and the rate of reentry in two groups was compared to evaluate the effect of continuous nursing intervention.Statistical methods: SPSS 25 was used to establish a database.The experimental results of intervention group and control group were statistically analyzed according to the project.The data were measured by two independent sample mean t test,and the number and percentage of counting cases were expressed by chi square or Wilcoxon rank sum test,and P < 0.05 was statistically significantly different.Results1.Changes of visual acuity in the two groups The visual acuity of the two groups of patients at discharge was better than that before treatment(P > 0.05).There was no significant difference in visual acuity between at discharge and 1-year and 2-year intervals in the intervention group(P > 0.05).The visual acuity rate in the control group after 1-year or 2 years follow-up was significantly lower than at discharge(P < 0.05).The decrease rate of visual acuity after 1 year and 2 year in the control group was significantly higher than that in the intervention group(P < 0.05),and is statistically different?2.Changes of blood glucose level in the two groups The fasting blood glucose,postprandial blood glucose and glycosylated hemoglobin level in the intervention group after 1 year and 2 year were significantly better than those in the control group(P < 0.05),the difference was statistically significant(P < 0.05).3.Readmission rate only one patient in the intervention group was admitted to the hospital for the second time,accounting for 2%,and none was hospitalized for more than 2 times,and the total readmission rate was 2%.In the control group,eight patients were admitted to the hospital for the second time,accounting for 16%,and six patients were re-admitted into the hospital for more than two times,accounting for 12%,and the total readmission rate was 28%.In the control group,three patients were admitted to the hospital 2 times,and 3 of them were both binocular.The total readmission rate of the two groups was compared: the intervention group was significantly lower than the control group(P < 0.05),and is statistically different.4.Diabetes self management score At discharge the self management scores of the two groups was not statistically significant(P > 0.05);at the end of the follow-up,the self management score was significantly higher in the intervention group than that in the control group(P < 0.05).5.Two groups of patients' satisfaction survey After the follow-up,46 of the patients in the intervention group were very satisfied,accounting for 92%,4 of them satisfied,8%,0 dissatisfied,with 100% of the total satisfaction.Twenty one patients in the control group were very satisfied,accounting for 42%,18 people were satisfied,36%,11 dissatisfied,22%,and the total satisfaction of patients was 78%.The total satisfaction of the intervention group was significantly better than that of the control group(P < 0.05),and is statistically different.ConclusionsThe continuity of nursing intervention in patients with type 2 DR can help patients and their family on alert with patient care,improve the patient's self-management ability,effectively improve the level of blood glucose,good glycemic control,and maintain good vision after treatment.This intervention can delay diabetes retinopathy in diabetic patients,reduce the incidence of blindness in diabetic retinopathy,lower readmission rates,reduce the economic burden of patients,and improve patient satisfaction with medical application of higher value. |
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