Applied Research Of Psychological Empowerment Model In Self-glucose Management Of Young And Middle-aged Patients With Type 2 Diabetes Mellitus

Objective:(1)To construct an intervention program on self-glucose management in young and middle-aged patients with type 2 diabetes based on psychological empowerment model.(2)To verify the effect of this intervention program on self-glucose management in young and middle-aged patients with type 2 diabetes.Methods:(1)The literature review method was used to search the Chinese and English databases,and then we screened,extracted and evaluated the quality of the literatures that met the inclusion criteria to obtain qualified literature.The content analysis method was used to extract the literature title,first author,nationality,publication time,sample size,interveners,intervention forms,intervention frequency and intervention time,and then we analyzed data above.After group discussion,the first draft of the intervention program was formed.Then,the intervention program was revised and the final intervention program was formed by letter inquiry of experts who are selected from the third-grade class-A hospitals and universities in 11 provinces and cities.(2)Convenience sampling method was used to selected 120 patients as the research objects,who met the research conditions and were admitted to a third-grade class-A hospital in Qingdao from May 2021 to January 2022.They were randomly divided into the intervention group and the control group,which were respectively given the intervention program based on psychological empowerment model and diabetes routine nursing intervention.The intervention time of two groups was 6 months.The China Diabetes Empowerment scale(CM-DES),the Summary of Diabetes Self-Cale Activities(SDSCA),Diabetes Pain Scale-DDS was used to measure the empowerment,selfmanagement,psychological distress of patients with diabetes,and at the same time,we measured glycosylated hemoglobin value,fasting blood glucose value,2-hour post-dinner blood glucose value and BMI value of the two groups,which were compared between the two groups before intervention,3 months after intervention and 6 months after intervention,respectively.SPSS 25.0 statistical software was used for statistical analysis of the results,including T test,Chi-square test,rank sum test,repeated measurement variance analysis,etc.Result:(1)The effective recoveries of the two rounds of expert questionnaire were 81.8% and83.3%,the expert authority coefficients were 0.817 and 0.924,Kendall harmony coefficients were 0.287 and 0.244,respectively,and their significance test P<0.05.The final intervention program constructed includes 19 specific plans,including curriculum and time arrangement,intervention theme,intervention purpose and intervention content.(2)Effect of intervention program based on psychological empowerment model in self-glucose management in young and middle-aged patients with type 2 diabetes:①Before intervention,there were no significant differences in total scores and scores of empowerment,self-management,psychological distress,and clinical values of fasting blood glucose,2-hour post-dinner blood glucose,glycosylated hemoglobin,BMI,Etc.between the two groups(P > 0.05).②After 3 months of intervention,the scores of each dimension and total scores of empowerment of the intervention group were higher than those of the control group except the self-cognition dimension,and the difference was statistically significant(P < 0.05).The scores of each dimension and total scores of self-management in the intervention group were higher than those in the control group except for the medication dimension,and the difference was statistically significant(P < 0.05).The scores of each dimension and total scores of diabetic psychological distress,and values of fasting blood glucose,2-hour postdinner blood glucose and glycosylated hemoglobin of the intervention group were lower than those of the control group,and the difference was statistical significance(P < 0.05),but there was no significant difference in BMI level(P > 0.05).Intra-group comparison showed that after 3 months of intervention,the scores of each dimension and total scores of empowerment and self-management of the intervention group were higher than before intervention,while the scores of each dimension and total scores of diabetes psychological distress and clinical indicators of the intervention group were lower than before intervention,and the difference was statistical significance(P < 0.05),but there was no significant difference in BMI of the control group(P > 0.05).③After 6 months of intervention,the scores of each dimension and total score of empowerment and self-management of the intervention group were higher than those of the control group,while the scores of each dimensions and total scores of diabetes psychological distress and clinical values were lower than those of the control group,and the difference was statistically significant(P< 0.05).Intra-group comparison showed that at the end of 6 months after intervention,the scores of each dimension and total scores of empowerment of the intervention group were increased compared with those in 3rd months,and the differences were statistically significant(P < 0.05),while the dimensions of selfadjustment and self-decision making of the control group were decreased,and the differences were not statistically significant(P > 0.05).The scores of each dimension and total scores of self-management of the intervention group were improved compared with3 rd months,and the difference was statistically significant(P < 0.05),while the blood glucose monitoring and foot care dimensions of the control group were decreased,and the difference was not statistically significant(P > 0.05).The scores of each dimension and total score of diabetic psychological distress of the intervention group were decreased compared with 3rd months,and the difference was statistically significant(P < 0.05),while the score of emotional burden of the control group was not significantly changed compared with 3rd months,and the difference was not statistically significant(P > 0.05).Fasting blood glucose and 2-hour post-dinner blood glucose of the intervention group were still decreased compared with 3rd months,the difference was statistically significant(P < 0.05),and there was no significantly difference between glycosylated hemoglobin and BMI(P >0.05),while the values of clinical indicators of the control group showed an increasing trend,the difference was not statistically significant(P > 0.05).④After 3 months and 6 months intervention,the intervention group and the control group were respectively subjected to two-factor multi-level repeated measurement variance analysis for empowering ability,self-management,diabetes psychological distress total scores and scores of each dimension,and fasting blood glucose values and other clinical indicators.The results showed that the scores of each scale and clinical values had statistical differences among intervention main effect,within time main effect and interaction effects(P<0.05).Conclusions:(1)The intervention program based on psychological empowerment model is scientific and reasonable,which was formed by literature review and Delphi expert correspondence consultation,and this intervention program can be used for the self-glucose management of young and middle-aged patients with type 2 diabetes.(2)The intervention program is beneficial to improve the diabetes empowerment ability and self-glucose management level of young and middle-aged patients with type 2diabetes,and is beneficial to improve the psychological distress and related clinical indicators of patients with diabetes.