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[护士主导的团队管理对社区2型糖尿病患者的影响]

[Effects of Nurse-Led Team Management on Type 2 Diabetes Patients in the Community].

作者信息

Ni Yun-Xia, Liu Su-Zhen, Li Ji-Ping, Diao Yong-Shu, Dong Ting, Tao Lin

机构信息

Department of Nursing, West China Hospital of Sichuan University, Taiwan, ROC.

Postgraduate Student, School of Nursing, Sichuan University, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2017 Apr;64(2):76-87. doi: 10.6224/JN.000028.

Abstract

BACKGROUND

Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care.

PURPOSE

To explore the effects of community-nurse-led team management on diabetes patients.

METHODS

An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram.

RESULTS

The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p < .01; F = 4.065, p < .01; F = 5.540, p < .01). The other outcome variables remained statistically similar between both groups throughout the study period.

CONCLUSIONS

Community nurse-led team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.

摘要

背景

糖尿病患者数量不断增加,给医疗服务提供者,尤其是通常承担多种角色的全科医生带来了越来越大的压力。这种情况导致糖尿病管理的总体效果不佳。然而,一些国家的社区护士已成功且有效地控制了患者的慢性病。因此,护士主导的管理效果值得进一步探索,以便更好地理解和推广这种护理模式。

目的

探讨社区护士主导的团队管理对糖尿病患者的影响。

方法

采用实验研究设计。从中国成都市武侯区的两个社区卫生中心招募2型糖尿病患者(第一个社区卫生中心的患者为干预组,第二个社区卫生中心的患者为对照组)。干预组接受护士主导的团队管理护理2年,而对照组接受标准护理。在干预前以及干预后的6个月、12个月和24个月进行评估。评估指标包括糖化血红蛋白(HbA1c)水平、体重指数、腰围、视力、踝臂指数、肾功能指标、尿蛋白水平和心电图。

结果

179名参与者中,干预组有88人,对照组有91人。干预后,干预组的HbA1c水平、踝臂指数和腰围均显著优于对照组(F = 28.894,p <.01;F = 4.065,p <.01;F = 5.540,p <.01)。在整个研究期间,两组的其他评估指标在统计学上仍相似。

结论

社区护士主导的团队管理在控制血糖和预防糖尿病相关并发症方面是一种有效的护理模式。

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