Effect of continuous nursing with the emphasis of life style intervention in children and adolescents with type 1 diabetes mellitus
SONG Lili1 WANG Jing2▲ HE Kun3 LENG Yuqing4 LIU Junzhi5 BI Hongbiao6 XIAO Yuan1 QI Yingfei1
1.Department of Digestion and Endocrinology, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
2.Department of Pediatrics, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
3.Department of Cardiology, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
4.Department of Outpatient, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
5.Department of Pharmacy, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
6.Operating Room, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China
Abstract：Objective To explore the effect of intensive lifestyle intervention on type 1 diabetes in children and adolescents Methods A total of 143 childrens and adolescents with type 1 diabetes admitted to the Department of Paediatrics and Endocrinology of the First Affiliated Hospital of Hebei North University from March 2014 to October 2016 were selected by convenient sampling method. According to the admission number of the patients, they were randomly divided into control group (74 cases) and intervention group (69 cases). At discharge, patients in the control group received routine discharge guidance, and the intervention group was combined with a 6 month continuous nursing mode focusing on intensive lifestyle intervention. At discharge, 3 months after intervention and 6 months after intervention, the quality of life scale (DQOLY), diabetes management self-efficacy scale (C-DMSES) and Likert five-level scale were used to evaluate the quality of life, self-management efficacy and compliance of the patients. Meanwhile, the number of readmission in the two groups within 6 months was calculated. Results Three months after discharge and 6 months after discharge, DQOLY evaluation of the intervention group was significantly better than that of the control group (P ＜ 0.05), C-DMSES score was significantly higher than that of the control group (P ＜ 0.05), and C-DMSES score of the two groups was significantly higher than that of the control group (P ＜ 0.05), and compliance of the intervention group was significantly better than that of the control group (P ＜ 0.05). In addition, within 6 months after discharge, the number of patients in the control group who were readmission due to non-compliance with medicine, readmission due to irregular diet, and readmission due to diabetic complications were significantly higher than those in the intervention group (P ＜ 0.05). Conclusion Continuous nursing with the focus of intensive lifestyle intervention can significantly improve the quality of life of patients, improve their satisfaction and compliance, enhance the self-confidence of patients' self-management behavior, and effectively reduce the short-term readmission rate after discharge.
宋莉莉1 王静2▲ 何琨3 冷育清4 刘君致5 毕宏彪6 肖渊1 齐迎菲1. 以强化生活方式干预为重点的延续护理在儿童青少年1型糖尿病中的应用效果[J]. 中国医药导报, 2019, 16(4): 164-168.
SONG Lili1 WANG Jing2▲ HE Kun3 LENG Yuqing4 LIU Junzhi5 BI Hongbiao6 XIAO Yuan1 QI Yingfei1. Effect of continuous nursing with the emphasis of life style intervention in children and adolescents with type 1 diabetes mellitus. 中国医药导报, 2019, 16(4): 164-168.
[1] Demirel F，Tepe D，Kara O，et al. Microvascular complications in adolescents with type 1 diabetes mellitus [J]. J Clin Res Pediatr Endocrinol，2013，5（3）：145-149.
[2] 毛凤星，栗达.儿童青少年1型糖尿病的营养治疗[J].中国临床医生，2015，43（10）：9-12.
[3] 董彦会，王政和，杨忠平，等.中国儿童青少年糖尿病患病率Meta分析[J].中国学校卫生，2016，37（11）：1676-1679.
[4] 黄乐.儿童1型糖尿病并发症及预防[J].开卷有益-求医问药，2017（3）：33-33.
[5] 杨立勇.1型糖尿病微血管并发症特点及应对[J].中国实用内科杂志，2016，36（7）：543-546.
[6] Falkowski B，Rogowicz-Frontczak A，Grzelka A，et al. Higher free triiodothyronine concentration is associated with lower prevalence of microangiopathic complications and better metabolic control in adult euthyroid people with type 1 diabetes [J]. Endocrine，2018，60（3）：458-465.
[7] Sumida Y，Yoneda M. Glycogen Hepatopathy：An Under-recognized Hepatic Complication of Uncontrolled Type 1 Diabetes Mellitus [J]. Intern Med，2018，57（8）：1063-1064.
[8] 孙冰，王守磊.多学科团队信息化支持与冬夏令营活动的联合延续护理对1型糖尿病青少年患者的影响[J].护理实践与研究，2017，14（4）：12-14.
[9] 刘延迪，王红艳，李梅，等.陪伴教育对提高青少年1型糖尿病患者生活质量及家庭亲密度和适应性的效果[J].解放军护理杂志，2016，33（2）：26-28.
[10] 向蓉，程昕然，何卫兰，等.以家庭为中心的护理对青少年1型糖尿病患者家庭亲密度和适应性及血糖控制的影响[J].医药卫生：文摘版，2017，2（6）：00229-00230.
[11] 王坤，仇爱珍.家庭陪伴护理对糖尿病患儿家庭亲密度适应性及血糖控制的影响分析[J].川北医学院学报，2017，32（5）：794-797.
[12] 张红，王燕，唐云.奥瑞姆自我护理模式对1型糖尿病患儿的临床应用分析[J].实用临床护理学电子杂志，2016， 1（7）：115-116.
[13] International C. Diagnosis and classification of diabetes mellitus [J]. Diabetes Care，2010，33（Suppl 1）：S62-S69.
[14] 邱翠竹，王明珠，罗少荘，等.青少年1型糖尿病患者生存质量及影响因素的调查研究[J].护士进修杂志，2015（16）：1467-1469.
[15] Otto C，Barthel D，Klasen F，et al. Predictors of self-reported health-related quality of life according to the EQ-5D-Y in chronically ill children and adolescents with asthma，diabetes，and juvenile arthritis：longitudinal results [J]. Qual Life Res，2018，27（4）：879-890.
[16] 郑侠，张宁.青少年1型糖尿病患者出院后延续护理的效果研究[J].中华现代护理杂志，2016，22（9）：1289-1292.
[17] Oyarzun A，Lera L，Codner E，et al. High concentrations of anti-caspase-8 antibodies in Chilean patients with type 1 diabetes [J]. Immunobiology，2011，216（2）：208-212.
[18] Vendrame F，Cataldo D，Ciarlo L，et al. In Type 1 Diabetes Immunocompetent cells are defective in IL-16 secretion [J]. Scand J Immunol，2012，75（1）：127-128.
[19] Badami E，Sorini C，Coccia M，et al. Defective Differentiation of regulatory FoxP3（+） T Cells by small-intestinal dendritic cells in patients with type 1 diabetes [J]. Diabetes，2011，60（8）：2120-2124.
[20] 罗灿明，戴霞，何燕玲，等.强化生活方式干预对空腹血糖受损人群抑郁及血糖影响的研究[J].护理研究，2014，28（2）：196-197.
[21] Ikramuddin S，Korner J，Lee WJ，et al. Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c，LDL Cholesterol，and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study [J]. JAMA，2018， 319（3）：266-278.
[22] Johansen MY，MacDonald CS，Hansen KB，et al. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes：A Randomized Clinical Trial [J]. JAMA，2017，318（7）：637-646.
[23] 杨锡翠，王文平.护理干预在提高1型糖尿病患儿依从性中的作用[J].医药前沿，2017，7（18）：238-239.
[24] 李乃适，张念荣，李光伟.生活方式干预是预防2型糖尿病的重要举措[J].中华健康管理学杂志，2013，7（5）：289-291.
[25] 王晓林，蔡尚郎，郑淑芳，等.对社区代谢综合征患者进行强化生活方式干预的效果观察[J].山东医药，2010， 50（17）：60-61.
[26] 李琼，李雨露，胡乾配，等.药物与强化生活方式治疗糖尿病前期疗效的Meta分析[J].重庆医学，2016，45（25）：3508-3513.
[27] 郑侠，张宁.青少年1型糖尿病患者出院后延续护理的效果研究[J].中华现代护理杂志，2016，22（9）：1289-1292.
2019, Vol. 16 
京公网安备 11010502046598号