| 【 Objective 】 The purpose of this study was to investigate the current situation and influencing factors of self-perceived burden of diabetic retinopathy patients in Yunnan Province.Green model as a theoretical framework for the development of nursing intervention program,to explore the program for diabetic retinopathy patients after self-perceived burden intervention effect,for the healthcare workers in patients with diabetic retinopathy after health education model and content of reference and reference.【Method】The first stage of this study is a cross-sectional study: to investigate the status of self-perceived burden and its influencing factors in patients with diabetic retinopathy after surgery.The method used in this stage is random sampling,using relevant scales to investigate 180 patients with diabetic retinopathy who were hospitalized in a third-class a hospital in Yunnan Province from April to November 2019 and met the inclusion and exclusion criteria.The second stage is a kind of experimental study: In this stage,80 patients with diabetic retinopathy who were hospitalized in an ophthalmology hospital of Yunnan Province from December 2019 to October 2020 and met the inclusion and exclusion criteria were selected as the research object,and the patients were grouped according to the random number table method.Because one patient in the control group was lost to follow-up due to disease,40 patients in the intervention group and 39 patients in the control group were finally treated.In order to avoid the interference of confounding factors,the same number of interventions were carried out in the two groups,and the routine ophthalmic nursing program was implemented in the controlled group.The patients in the intervention group were given nursing intervention under Green model.Before the intervention,one month and three months after the intervention,the status of self-perceived burden,family support,quality of life of visual function impairment and related biochemical indicators were investigated to evaluate the effect of Green model on self-perceived burden of patients with diabetic retinopathy after operation.【Results】The results of the first phase cross-sectional study:1.180 patients after DR self-perceived burden score was 30.07 ± 5.54 points,in the moderate level.Among them,10 people(5.6%)had no self-perceived burden,64 people(35.6%)had mild self-perceived burden,100 people(55.6)had moderate self-perceived burden and 6 people(3.2%)had severe self-perceived burden.The average scores of each dimension from high to low were economic factors,emotional factors and physical factors.2.The average score of family support was 9.29 ± 2.80,which was in the moderate level of support.There were 22 patients(12.2%)with low family support level,94 patients(52.2%)with medium family support level,and 64 patients(35.6%)with high family support level.The average score of quality of life was 93.26 ± 3.27.3.The correlation analysis of self-perceived burden,family support and quality of life showed that the total score of self-perceived burden and the scores of each dimension were negatively correlated with family support(R =-0.365 ～-0.314,p < 0.001);The self-perceived burden and its dimensions were negatively correlated with the quality of life(R =-0.301 ～-0.258,P < 0.001).4.Multivariate linear regression analysis of influencing factors of DR patients’ self-perceived burden: The SPB of DR patients was taken as dependent variable,and there were 5 variables with statistical significance in one-way ANOVA,including working status,educational level,health status of main caregivers,disease cognition,the time from the diagnosis of the disease to the present,and family support and quality of life were taken as independent variables to make multivariate linear analysis.Sex regression analysis,The results showed that the main influencing factors of self-perceived burden were work status,health status of the main caregivers,disease awareness,family support and quality of life.The regression equation was Y = 49.658 + 1.693 × work status + 1.510 × health status of main caregivers + 1.952 × disease cognition +(-0.500)× family support +(-0.274)×quality of life.Results of the second phase of the study:1.before the intervention of the two groups of patients with general information,self-perceived burden,family support level,quality of life scores,FBG,2h PBG,Hb A1 c were compared,the differences were not statistically significant(p > 0.05).2.Two groups of patients after one month,three months after the intervention SPB,family support scores,quality of life level comparison results showed that the difference was statistically significant(P < 0.05).There were significant differences in FBG and 2h PBG between the two groups after one month and three months(P < 0.05).There was no significant difference in Hb A1 c between the two groups one month after intervention(P >0.05),but there was significant difference in Hb A1 c between the two groups three months after intervention(P < 0.05).3.The results of repeated measures analysis of variance before and after intervention showed that after controlling group factors,the scores of self-perceived burden,family support and quality of life in the two groups showed significant differences over time(P <0.01);After controlling the time factor,the two groups had different effects on the scores of self-perceived burden,family support and quality of life(P < 0.05);There was an interaction between time and group(P < 0.001),that is,time and group influenced each other in self-perceived burden,family support and quality of life.As time went on,the changes of self-perceived burden,family support and quality of life were different between the control group and the intervention group.4.The results of repeated measures ANOVA before and after intervention showed that the scores of FBG,2h PBG and Hb A1 c were significantly different between the two groups(P< 0.01);After controlling the time factor,the scores of FBG and 2h PBG were different in the two groups(P < 0.05),but there was no difference in the scores of Hb A1 c between the intervention group and the control group(P > 0.05);There was an interaction between time and group(P < 0.001),that is,time and group influenced each other on the levels of FBG,2h PBG and Hb A1 c.As time went on,the changes of FBG,2h PBG and Hb A1 c scores were different between the control group and the intervention group.【Conclusions】1.94.4% of DR patients had self-perceived burden from mild to severe.2.52.2% of the patients after DR belonged to moderate family support level,and their quality of life score was 93.26 ± 3.27,which should be further improved.3.The self-perceived burden and its dimensions were correlated with family support and quality of life.4.The health status,disease cognition,work status,family support and quality of life of the main caregivers were the main factors affecting the self-perceived burden of the patients.5.This study formed the Green model of nursing intervention program can effectively reduce the DR patients after self-perceived burden,improve the level of family support and quality of life,the control of blood sugar play an effective role,worthy of promotion in clinical use. |
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