Study On The Construction And Effect Of Community Type 2 Diabetes Care Management Model

Part ?INVESTIGATE ON THE MANAGEMENT LEVELOF TYPE 2 DIABETES IN COMMUNITYObjectiveIn order to understand the management mode,level and influencing factors of the patients with type 2 diabetes,on the basis of literature research,then the investigation of the current situation to provide theoretical basis for the construction of diabetes management model.MethodsIn order to further understand the current situation and influencing factors of community diabetes in this study,We select 360 Type 2 diabetes patients who met the inclusion criteria of Tai'an and Ji'nan city of belonging to the office of the community health service center to take part in investigation.The questionnaire including General information,Chronic Illness Resource Survey,Community management satisfaction questionnaire,Diabetes self-efficacy scale(PDSMS),Diabetes self-management behavior scale(DSCS).And who after a preliminary investigation and on the basis of Bandura's social learning theory and Self-efficacy theory,that has good reliability and validity.Statistical methodEpidata 3.1 was used for logging data and statistical analysis was performed using SPSS 20.Including descriptive analysis,t test,variance analysis,x~2 test,rank test and multiple linear stepwise regression analysis,analysis of variance of repeated measurement,the test level of?=0.05.Result1.The current community diabetes management mode is:Community Health Service Center for T2DM patients to establish a health record and provide four free glucose monitoring.At the same time invite experienced experts for one or two health lectures.2.Results show that the level of diabetes self-management was(2.39±0.85),with the lowest score of foot care,the community management satisfaction score was(24.06±9.23),with the lowest score of the willingness to participate in diabetes health management;the level of diabetes self-management was(2.39±0.85),with the lowest score of foot care and the level of self-efficacy was(23.42±2.98).The compliance rate of fasting blood glucose,glycosylated hemoglobin and physical fitness index was 13.6%,15.6%,43.6%,respectively.3.Per monthly income,lifestyle,education level,chronic disease resource utilization,s elf-efficacy,and community management satisfaction were the influencing factors of self-management ability.ConclusionThe current management model of community type 2 diabetes is unsatisfactory because of the level of type 2 diabetes patients is very low manifested in chronic disease resource utilization level,community management satisfaction,and self-efficacy level.We can build a new type 2 diabetes management model through improve the patient's life style,chronic disease resource utilization,self-efficacy,community management satisfaction and other controllable factors.Part ?CONSTRUCTION OF COMMUNITY SHARED CARE MANAGEMENT MODEL FOR TYPE 2 DIABETES MELLITUSObjectiveAfter the expert group meeting agreed to form Community type 2 diabetes shared care management model finalize a manuscript,in this study constructs the management mode suitable for the patients with type 2 diabetes,based on the investigation of current situation to provide practical basis for the management of patients with type 2 diabetes mellitus.MethodsConstruction of community care management model for type 2 diabetes mellitus based on the survey results of the reference,draw lessons from the merits of different models at home and abroad,format the draft model combined according to China's national conditions,and ultimately build a community health service center,day care centers,neighborhood committees,community health volunteers and the patients themselves to participate in a set of health education,telephone follow-up,outpatient follow-up,self management as one of the one by expert group meeting to further revise and improve the model.ResultThe construction of"community type 2 diabetes shared care management model"is the models,which are community health service center,day care centers,neighborhood committees,community health volunteers and the patients themselves to participate in a set of health education,telephone follow-up,outpatient follow-up and self management.ConclusionThe management model can fully reflect the following characteristics that patients centered,continuity,integrity.So it can be used to improve the current situation of community type 2 diabetes management.PART?EVALUATION OF COMMUNITY TYPE 2 DIABETES CARE MANAGEMENT MODELObjectiveEvaluation of the effect of community nursing care for type 2 diabetes mellitus,Through the questionnaire survey with the community type 2 diabetes management level questionnaire to verify the effectiveness of its implementation.MethodsRandomly selected 80 patients who participated in the current phase of the investigation and met the following criteria whose course of disease is greater than 1 years and no plans to go out in the past six months.The patients were randomly divided into intervention group and control group by the means of random number table.The intervention group was managed by the community type 2 diabetes care management mode,and the control group was managed by the community management mode for a period of 6months.The self-efficacy level evaluation of two groups of patients with chronic disease community resource utilization levels,community management satisfaction,diabetes self management ability and analysis of the effect of community nursing care for type 2diabetes mellitus after the intervention of at the end of 3 and the end of the 6 month.Statistical methodEpidata 3.1 was used for logging data and statistical analysis was performed using SPSS 20.Including descriptive analysis,t test,variance analysis,x~2 test,rank test,profile analysis,analysis of variance of repeated measurement,the test level of?=0.05.Result1.The resources of patients with chronic diseases,community management satisfaction,the level of self-efficacy,diabetes self-management level of the intervention group and the control group were showed that there was no significant difference between the two groups(P>0.05).2.After 3 and 6 months,the intervention group and control group,chronic disease score,community management satisfaction score,self-efficacy score,self-management score differences were statistically significant(P<0.05),the intervention group was significantly higher than the control group,and 6 months to 3 months to score high score(P<0.05).Conclusion1.Compared with the current"type 2 diabetes management of community type 2diabetes shared care management model"can significantly improve the ability to use the resources of patients with chronic diseases,community management satisfaction,the level of self-efficacy,diabetes self-management level and the long-term effect is better than the recent effect.It is worthy of popularization and application.2.To provide a new management model for the patients with type 2 diabetes mellitus in our country and to improve the blood glucose control and self-management ability of patients with type 2 diabetes.