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Application Of Nursing Intervention Based On Information-Motivation-Behavioral Skills Model In Gestational Diabetes Mellitus Patients With Subclinical Hypothyroidism

Posted on:2024-05-24Degree:MasterType:Thesis
Country:ChinaCandidate:J J ChenFull Text:PDF
GTID:2544307127490854Subject:Nursing
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Objectives1.The information demands questionnaire of GDM with sub-clinical hypothyroidism patients made by ourselves was prepared to investigate the information demands of GDM with sub-clinical hypothyroidism patients,to provide the basis for the subsequent targeted intervention.2.Based on the information from the survey and the information-motivation-behavioral skills model,we formulated a targeted intervention plan for GDM patients with sub-clinical hypothyroidism and explored whether it could improve the thyroid function and blood glucose status of patients,and reduce the incidence of adverse pregnancy outcomes.Methods1.Based on the literature review,our research team determined the preliminary item pool of the information demands questionnaire for patients with GDM and sub-clinical hypothyroidism.After three rounds of expert consultation,a prior investigation of 10 patients,and a reliability and validity test,we finally formed the final version of the questionnaire.2.The convenience sampling method within the non-probability sampling method was used in our study.Patients who visited the Obstetrics and Endocrinology Department of a Grade-A tertiary hospital in Jiangsu Province from October 2020 to November 2021 were selected as the research objects.The information demands questionnaire was used to investigate the information demands of GDM patients with sub-clinical hypothyroidism.3.72 GDM patients with sub-clinical hypothyroidism treated in the obstetric clinic of a Grade-A tertiary hospital in Jiangsu Province from November 2021 to December 2022 were selected by convenience sampling method and randomly divided into two groups according to random number table,namely,observation group and control group,with 36 patients in each group.The control group received routine follow-up care,and the observation group received nursing intervention based on the information-motivation-behavioral skills model based on the routine follow-up care of the control group,with the intervention time from the group to 6 weeks postpartum.The blood glucose level,serum thyroid-stimulating hormone(TSH)level,Irritability,Depression and Anxiety Scale(IDA)scores,and pregnancy outcome before delivery were compared between the two groups.Results1.The information demands questionnaire of GDM patients with sub-clinical hypothyroidism consists of eight dimensions with 19 items.The total Cronbach’s ɑcoefficient of the questionnaire was 0.890,the Cronbach’s ɑ coefficient of each dimension ranged from 0.790 to 0.898,the test-retest reliability of the total questionnaire was 0.577,the test-retest reliability of each dimension was 0.495~0.679,the total content validity S-CVI/Ave of the questionnaire was 0.98,and the content validity I-CVI of each item was 0.83~1.00.2.Survey results of patients’ information demands: The total score of information demands was 60~89,with an average score of(78.2±5.06).The score of disease information demands was(12.32±1.77);The score of drug information dimension was(8.27±1.63);The score of dietary information was(12.52±1.69);The score of blood glucose monitoring information dimension was(8.31 ± 1.41);The score of blood thyroid stimulating hormone monitoring information dimension was(3.93 ± 1.06);The score of maternal and child monitoring information dimension was(12.12±1.94);The score of motivational information dimension was(7.82 ± 1.29);The score of behavioral skills information dimension was(12.93±1.82).The scoring rates of the eight dimensions were 82.13%,82.70%,83.47%,83.10%,78.60%,80.80%,78.20%,and 86.20%,respectively.The total score rate of information demands was 82.32%.The results showed that the general information demands of patients were strong,especially in the aspects of behavioral skills,diet,blood glucose monitoring,drug information,disease information,and maternal and child monitoring information.3.The observation group finally completed the data collection of 35 patients,while the control group completed the data collection of 36 patients.There was no statistical difference between the two groups(P>0.05).The results of the comparison of blood glucose,serum TSH,adverse pregnancy outcomes,Irritability,Depression,and Anxiety Scale(IDA)scores between the two groups before and after intervention were as follows:(1)Blood glucose and serum TSH levelsAfter the intervention,the levels of FBG,PBG,HbA1 c,and serum TSH in the observation group were decreased(P<0.05),and the levels of FBG,PBG,and HbA1 c in the control group were also decreased(P<0.05).Although the serum TSH level was decreased in the control group,the difference was not statistically significant(P>0.05).After the intervention,the levels of FBG,PBG,HbA1 c,and serum TSH in the observation group were lower than those in the control group(P<0.05).(2)Adverse pregnancy outcomesThere were 94.3% of patients without adverse pregnancy outcomes in the observation group and 66.6% in the control group.In the control group,more people had adverse pregnancy outcomes such as abortion or premature delivery,fetal intrauterine distress,low birth weight infants,and neonatal hypoglycemia.There were significant differences in the distribution of adverse pregnancy outcomes between the two groups(P < 0.05).(3)The scores of Irritability,Depression,and Anxiety Scale(IDA)After the intervention,the scores of anxiety,depression,extroversion,and introversion in the observation group decreased(P<0.05),and the scores of anxiety,depression,extroversion,and introversion in the control group decreased(P<0.05).The scores of anxiety,depression,extroversion,and introversion in the observation group were lower than those in the control group(P<0.05).Conclusions1.The overall information demands of GDM patients with sub-clinical hypothyroidism are relatively high,especially in the behavioral skills information demands,maternal and child monitoring information demands,dietary information demands,and drug information demands.2.Nursing intervention based on the information-motivation-behavioral skills model is beneficial to reduce the blood glucose of patients with GDM and sub-clinical hypothyroidism,improve the thyroid function of patients with GDM and sub-clinical hypothyroidism,relieve the negative emotions of patients with GDM and sub-clinical hypothyroidism,and reduce the incidence of adverse pregnancy outcomes of patients with GDM and sub-clinical hypothyroidism.
Keywords/Search Tags:gestational diabetes mellitus, sub-clinical hypothyroidism, thyroid function, pregnancy outcome, Information-Motivation-Behavioral skills
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