Intervention Study Of Health Education Based On PRECEDE-PROCEED Model On Self-management Of Elderly Patients With Empty Nest Diabetes In Lanzhou Community

Objective:This study investigated the status quo of self-management knowledge,attitude and behavior of empty-nest elderly diabetic patients in Lanzhou community,and analyzed their existing health problems.Under the guidance of the theoretical framework of PRECEDE-PROCEED Model,targeted community health education was formulated and implemented,and the intervention effect was evaluated,so as to improve the self-management ability of empty-nest elderly diabetic patients in Lanzhou community,improve the level of blood glucose control of patients,and delay or avoid the occurrence of diabetic complications.Methods:In this study,a multi-stage random sampling method was adopted to randomly select 2 streets from 5 municipal districts in Lanzhou,and 2 communities were randomly selected from each street,a total of 4 communities were studied.The first stage of cross-sectional survey: Questionnaire survey was adopted to investigate the status quo of self-management knowledge attitude and behavior of 280 empty-nest elderly diabetic patients in 4 communities of Lanzhou.The second phase of intervention study: Two communities were selected from the four communities as the experimental group and the control group,with 50 subjects in each community.The control group was given routine community health education combined with acupoint massage for diabetes,and the experimental group was given health education and acupoint massage based on the control group,and then PRECEDE-PROCEED Model was used for intervention.Questionnaire scores and blood glucose values were compared before intervention,3 months after intervention and 6 months after intervention,and the intervention effect was evaluated.Using SPSS25.0 statistical software to deal with the data analysis,method includes:descriptive statistics analysis,chi-square,two sample t test,repeated measurement analysis of variance,etc.Results:1.Cross-sectional survey results: The total score of self-management knowledge attitude and behavior of empty-nest elderly diabetic patients in Lanzhou community was(62.68±10.72),the overall level of self-management was lower than the average,and the score of behavioral dimension was the lowest.Moreover,most patients have blind spots and misunderstandings in diet,medication,monitoring and complication prevention of diabetes mellitus,and the attitude of selfmanagement is not positive.2.Results of intervention studies:(1)Before intervention,there were no statistically significant differences in general information,self-management knowledge attitude and behavior scores and diabetes-related metabolic indicators between the two groups(P > 0.05),indicating comparability.(2)Results of ANOVA of repeated measurements: The self-management knowledge,attitude and behavior scores and total scores of the two groups showed statistically significant differences at different time and among different groups(P<0.05),and there was an interaction between time and grouping.T-test results of independent samples: after 3 months and at the end of 6 months after intervention,the scores of knowledge,attitude and behavior in each dimension and the total scores in the experimental group were higher than those in the control group,with statistical significance(P<0.05).(3)At the end of 6 months after intervention,the Hb A1 c,FBG and 2h postprandibular blood glucose of the subjects in the experimental group were significantly lower than those in the control group,and the blood glucose level tended to be stable,with statistical significance(P < 0.05).Waist circumference,body mass index and other indexes were slightly decreased,but there was no statistical significance(P > 0.05).Conclusions:1.The scores of all dimensions and total scores of self-management knowledge,attitude and behavior of empty-nest elderly diabetic patients in Lanzhou community were lower than the medium level,and the score of behavioral dimension was the lowest.2.The health education based on PRECEDE-PROCEED Model has a good effect on the selfmanagement of the empty-nest elderly diabetic patients in Lanzhou community,which stabilizes the blood glucose level of the patients and improves their quality of life,reflecting the thought of "treating the disease without disease" in traditional Chinese medicine.