Application Of Teach-back In Initial Injection Of Insulin Patients

Objective:To analyze the cognitive impairment of insulin in patients with initial insulin injection in Shihezi City,and to explore the application of Teach-back method in the education of insulin cognition,knowledge and injection behavior in patients with insulin for the first time and to provide Teach-back education for clinical nurses for reference.Methods:1.Teach-back interventional research: A total of 101 patients who were admitted to hospital during the period of January to July 2017 in the Department of Endocrinology and Metabolism of a top-three hospital were selected to investigate the level of insulin awareness and knowledge of the patients.According to endocrinology,the intervention group(51 cases)and the control group(50 cases)were divided into two groups of responsibility.The intervention group used Teach-back education method to carry out insulin injection related knowledge and skills education,and the control group used traditional education methods for education.At the time of admission,the patient was assigned to any responsibility group according to the order of admission.The intervention time was the day before the start of insulin treatment to discharge,and a telephone follow-up survey was conducted one month and three months after discharge to investigate patient’s insulin cognition,knowledge of use,and injection behavior.2.Statistical methods: Data was entered using EpiData 3.1 software,and SPSS 19.0 software was used to analyze the data.General information uses descriptive analysis.Chi-square test was used for count data,and t-test and paired t-test for normal distribution were adopted for measurement data,and rank sum test for normal distribution was not used.The test was P<0.05 for the difference was statistically significant.Results:1.The initial injection of insulin in the patient’s "My opinion on insulin" scale score: The median score is90 points,the median score in each dimension is: 11 points for insulin benefit,18 points for insulin cognition,life management 17 points,10 points for use,16 points for injection,9 points for side effects,and 7 points for expenses.The median score for insulin use knowledge is 4 points.2.There was no significant difference in general data,disease-related data,insulin cognition and use knowledge between the Teach-back group and the traditional group before intervention(P>0.05).3.One month after the intervention,the Teach-back group and the traditional group had statistically significant differences in the scores of the “My Views on Insulin” scale,the injection-related dimensions and cost dimensions,and insulin use knowledge(P<0.05);There was no significant difference in behavioral scores(P>0.05).The difference between the Teach-back group and the traditional group in the three months after the intervention was statistically significant(P<0.05)in the “My Views on Insulin” scale,the use attitude dimension,the knowledge of insulin use,and the injection behavior scores.).5.The statistics of educational times in this study were: 2.3±0.77 intervention groups and 2.1±0.71 control groups,the difference was not statistically significant(P=0.269).There was a statistically significant difference in total time spent on education among patients with the same number of education(P<0.05).6.The Top 5 in the Teach-back Group Recurrent Education in the “Insulin Infusion Education Record Sheet” is: Insulin injection process,Insulin preservation,Hazard of repeated use of needles and Discarded needles The treatment,insulin pen installation,injection site selection and rotation.The frequency of use of assistive devices was:insulin injection 9-step card,injection site rotation card,needle reuse hazard card.7.The “Insulin Injection Assessment Criteria” statistically shows that the frequency of major unqualified items in the insulin injection process is: do not wash hands before injection,do not check insulin dosage forms and expiration date,pinch skin methods,and needle insertion angle Correct,disposal of discarded needles was incorrect.Conclusions:1.First-time insulin-injected diabetic patients have different levels of cognitive impairment of insulin,need to strengthen education.2.The Teach-back group was better than the regular education method in terms of insulin knowledge,injection-related,cost,and use attitudes in the “I think about insulin” scale,and the normative aspects of late injection.3.Insulin injection education should emphasize the proper preservation of insulin,needle repeated use hazards,selection and rotation of the injection site;injection process to strengthen the injection before injection,check the effective period of insulin,the correct shaking method,pinching skin and needle angle,Disposal of education for correct disposal.