| Part ?:Management of Diabetes Patients in a Community in Shanghai[Objective]:To understand the current diabetes patients management in a community.[Methods]:Investigated 220 patients with type 2 diabetes enrolled in a community in shanghai and involved in "Caring Physical Examination",using Summary of Diabetes Self-Care Activities Measure(SDSCA)developed by Toobert and Michigan Diabetes Knowledge Test(MDKT)developed by Fitzgerald,so as to understand the status of diabetes management.[Results]:The management of Community diabetes:(1)Among the 220 diabetic patients under survey,55.6%received health education on dietary guidance,kinesitherapy,medication and blood glucose monitoring,and only 34.4%received health education on diabetes complications.Their diabetes knowledge was mainly obtained through medical staff(68.5%)and the Internet(14.2%).(2)The mean of patients' SDSCA scores was(3.69±1.59).The scores of all self-management dimensions were as follows:dietary behavior(3.92± 1.45),motor behavior(3.96±2.12),blood glucose monitoring(2.86± 1.61),foot care(2.68± 1.71)and medication(5.98± 1.62).(3)The mean of diabetes knowledge scores was(15.78±3.65).The diabetes knowledge score may be below 6(5.9%),12?18(62.5%)or above 20(11.8%).[Conclusion]:The patients don't have a good command of diabetes knowledge,especially the lack of knowledge about diabetes complications.The status of self-management is not optimistic.and does not pay attention to blood glucose monitoring and foot care.Part ?:Applied Research on Comprehensive Management in Community Diabetes Management[Objective]:To investigate the effect of comprehensive management mode of health education,that is,WeChat online health education,online guidance,offline peer education and peer communication on diabetes management and follow-up.[Methods]:Based on the previous baseline survey of 220 patients,The second part divided patients into the control group and the research group,with 110 patients in each group,using a random number table.The control group received routine health management and outpatient follow-up,while the research group received regular knowledge preaching,blood glucose monitoring,individualized health behavior guidance and medication guidance provided by a patients' self-management group composed of doctors,nurses,nutritionists and pharmacists online through WeChat,on the basis of routine health management and outpatient follow-up.In the meantime,major concerns in the WeChat health group were collected,offline peer health education and peer communication were carried out,and problems encountered in follow-up management were solved.Two groups were compared in terms of the levels of blood glucose,blood pressure and blood lipid,blood glucose control rate,blood lipid control rate,blood pressure control rate,Diabetes Specificity Quality of Life(DSQL)scores,the 36-Item Short Form Health Survey(SF-36)scores,the Pittsburgh Sleep Quality Index(PSQI)scores and satisfaction degree with management services 6 months before and after intervention.[Results]:The application of comprehensive management in community diabetes:(1)Before intervention,the comparison between two groups in terms of Hemoglobin Alc(HbA1c),total cholesterol(TC),Triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)showed no statistically significant difference(P>0.05).After intervention,the research group scored lower than the control group in HbA1c,TC,TG and LDL-C,and the differences were statistically significant(P<0.05).(2)Before intervention,the blood glucose control rate,blood pressure control rate and blood lipid control rate were 24.5%,32.7%and 35.5%in the control group,and 25.4%,31.8%and 33.6%in the research group,without statistically significant differences(P>0.05);After intervention,the blood glucose control rate,blood pressure control rate and blood lipid control rate were 45.5%,44.5%and 50.9%in the control group,and 67.3%,69.1%and 75.5%in the research group,with statistically significant differences(P<0.05).(3)Before intervention,the comparison between two groups in terms of physical functioning,role physical,physical functioning,general health perceptions,vitality,social functioning,role emotional and mental health in SF-36 showed no statistically significant difference(P>0.05).After intervention,the research group scored higher than the control group in all dimensions and the differences were statistically significant(P<0.05).(4)Before intervention,the comparison between two groups in terms of physical function,psychology/mind,social relation and influence of treatment in DSQL showed no statistically significant difference(P>0.05).After intervention,the research group scored lower than the control group in all dimensions and the differences were statistically significant(P<0.05).(5)Before intervention,the comparison between two groups in terms of overall sleep quality,sleep-onset latency,duration of sleep,sleep efficiency,sleep disturbance,need for medications to sleep and daytime dysfunction due to sleepiness in PSQI showed no statistically significant difference(P>0.05).After intervention,the research group scored lower than the control group in all dimensions and the differences were statistically significant(P<0.05).(6)The satisfaction degree with management services in the research group was higher than that in the control group(95.5%v.s.73.6%),and the difference was statistically significant(P<0.05).[Conclusion]:Conducting health management on diabetic patients in the community through refined intervention modes,that is,WeChat online health education,online guidance,offline peer education and peer communication can effectively improve the patients'command of relevant diabetes knowledge,increase the involvement of diabetes self-management,help patients control their illness,improve their quality of life and achieve a higher satisfaction degree among patients. |
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