| Objective:Based on Donabedian's "three-dimensional quality structure" model theory,this study builds a health management program for elderly patients with diabetes in the old-age care institutions,and applies the program to elderly patients with diabetes in the old-age care institutions.Through the health management of elderly diabetic patients in the old-age care institutions,the patients' self-management behavior are improved,the Diabetes Distress in the old-age care institutions are reduced,and the quality of life of elderly diabetic patients in the old-age care institutions are improved.Methods:1.Study on the construction of health management program for elderly diabetic patients in old-age care institutionsThrough the literature review method and expert panel discussion method,a preliminary letter of inquiry for the health management program for elderly patients with diabetes in the old-age institutions was prepared.After the Delphi method,the items of the health management plan were determined.Through the revision and collation of the expert opinions,the expert consensus was reached to form a health management plan for the elderly patients with diabetes in the old-age care institutions.2.Applied Research on Health Management Program for Elderly Diabetic Patients in Aged Care OrganizationsIn this study,a total of 84 elderly diabetic patients from two nursing institutions were selected by the convenience sampling method,and the two old-age institutions were divided into experimental group and control group randomly.We have developed inclusion and exclusion criteria,and 42 elderly diabetic patients were selected as the study subjects in the experimental group while 42 elderly diabetic patients were selected as the study subjects in the control group.The control group used the routine health education method.In addition to routine health education,the experimental group was developed a health management plan based on Donabedian's "three-dimensional quality structure" model theory.Fasting blood-glucose,two hours postprandial blood glucose,glycosylated hemoglobin,self-management behavior,pain level,and quality of life were evaluated before and 3 months after intervention.Self-management behavior was assessed using the Summary of diabetes self care activities(SDSCA).The Diabetes Distress was assessed using the Diabetes Distress Scale(DDS).The quality of life was assessed using the DiabetesSpecific Quality of Life(DSQL).The data in this study were statistically analyzed,processed and analyzed using SPSS 17.0.Results:1.Based on the theory of Donabedian's "three-dimensional quality structure" model theory,through literature review method,expert discussion method and Delphi method,a scheme suitable for the health management of elderly diabetes in old-age institutions was constructed.2.Baseline data Before the intervention,there were no significant differences in the general data,biochemical indicators,self-management behavior,pain level,and quality of life between the experimental group and the control group(P>0.05).The baseline data of the two groups were comparable.3.Evaluation results of various biochemical indicators After intervention,the fasting blood glucose,two hours postprandial blood glucose and glycosylated hemoglobin in the experimental group were significantly lower than the control group,(P<0.05),suggesting that health management can improve the blood glucose biochemical indicators of elderly patients with diabetes in the old-age care institutions.The effect is better than traditional health education.4.Self-management behavior evaluation results After the intervention,the dietary dimension,exercise dimension,foot care dimension,medication-related medication dimensions and total score of the self-management ability of the experimental group were significantly higher than the control group,(P<0.05),suggesting that health management is better than traditional health education in improving the self-management ability of elderly diabetic patients in old-age care institutions.5.Diabetes Distress evaluation result After the intervention,the emotional burden of pain in the experimental group,the pain associated with the doctor,the pain associated with the law of life,the correlation with the interpersonal relationship and the total score were significantly lower than the control group,(P<0.05),suggesting that health management is better than traditional health education in improving the Diabetes Distress in old-age care institutions.6.Quality of life evaluation results After the intervention,the physiological function,psychological function,social relationship dimension,treatment dimension score and total score of the quality of life of the experimental group were significantly different from the control group(P<0.05),suggesting that health management is better than traditional health education in improving the quality of life of elderly patients with diabetes in elderly care institutions.Conclusion:Based on the Donabedian's "three-dimensional quality structure" model theory,this study constructed a scientific and healthy management plan for elderly diabetic patients with strong scientific and practical facilities,which can provide reference for the health management of elderly patients with diabetes in old-age care institutions.Through the health management practice of elderly diabetic patients in the old-age care institutions,the fasting blood glucose,two hours postprandial blood glucose and glycosylated hemoglobin in the elderly patients with diabetes in the old-age care institutions were effectively reduced,and the blood sugar level of the patients was effectively controlled.After the intervention,the patients were significantly improved in self-management behavior,Diabetes Distress,quality of life,and the improvement effect was better than the regular health education.It has a remarkable clinical practical significance for the health management of elderly patients with diabetes in the old-age care institutions,which is worth to further application and promotion. |
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