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基于慢性病轨迹框架的目标管理模式在老年糖尿病合并心血管疾病患者中的应用价值。

Application Value of Target Management Mode Based on Chronic Illness Trajectory Framework in Elderly Patients with Diabetes Mellitus and Cardiovascular Diseases.

出版信息

Altern Ther Health Med. 2024 Aug;30(8):136-143.

Abstract

BACKGROUND

Diabetes and cardiovascular diseases represent significant global health challenges, leading to organ dysfunction and increased mortality rates. Managing these conditions is complex, especially in the elderly population. The study addresses this pressing issue by exploring the application of the Chronic Illness Trajectory Framework (CITF), aiming to improve self-care and quality of life in elderly patients with diabetes and cardiovascular diseases.

METHODS

A total of 127 patients with diabetes mellitus and cardiovascular diseases admitted to the hospital were enrolled between January 2020 and January 2022. According to the implementation of CITF management mode, they were divided into a control group (62 cases, non-implementation) and an observation group (65 cases, implementation). The control group was given routine intervention, while the observation group was given CITF-based target management mode for 3 months. The changes in blood glucose, blood lipid, negative emotions, self-efficacy, self-management, compliance, and quality of life before and after intervention in both groups were observed. This study was approved by the Ethics Committee of Zhujiang Hospital.

RESULTS

After intervention, levels of fasting plasma glucose (FPG), 2h plasma glucose (2hPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C), scores of self-rating depression scale (SDS), self-rating anxiety scale (SAS) and Diabetes Specific Quality of Life Scale (DSQL) were decreased (P < .05), while scores of General Self-Efficacy Scale (GSES) and Scale of the Diabetes Self-Care Activities Chinese version (SDSCA), and compliance rate were increased in both groups (P < .05). The levels of FPG, 2hPG, HbA1c, TC, TG, and LDL-C, scores of SDS, SAS, and DSQL in the observation group were lower than those in the control group (P < .001), and scores of GSES and SDSCA, and compliance rate were higher than those in the control group (P < .001). These results highlight the positive role of comprehensive intervention in improving the physical and mental health of patients with diabetes and provide strong support for the application of comprehensive intervention strategies in diabetes management.

CONCLUSION

CITF-based target management mode can alleviate negative emotions in patients with diabetes mellitus and cardiovascular diseases, improve self-management, self-efficacy, and compliance, effectively control blood glucose and lipids, and improve quality of life. The study conclusions highlight the importance of CITF management models in improving the management of patients with diabetes and cardiovascular disease. This comprehensive intervention helps reduce negative emotions, improve self-management and compliance, effectively control blood sugar and blood lipids, and improve quality of life. These results have important clinical implications and provide strong support for better care of patients with chronic diseases.

摘要

背景

糖尿病和心血管疾病是全球性的重大健康挑战,导致器官功能障碍和死亡率上升。管理这些疾病的难度较大,尤其在老年人群中更为复杂。本研究通过探讨慢性疾病轨迹框架(Chronic Illness Trajectory Framework,CITF)的应用,旨在改善老年糖尿病和心血管疾病患者的自我护理和生活质量。

方法

2020 年 1 月至 2022 年 1 月,共纳入 127 例糖尿病合并心血管疾病住院患者。根据 CITF 管理模式的实施情况,将其分为对照组(62 例,未实施)和观察组(65 例,实施)。对照组给予常规干预,观察组给予基于 CITF 的目标管理模式,干预时间为 3 个月。观察两组患者干预前后血糖、血脂、负性情绪、自我效能、自我管理、依从性和生活质量的变化。本研究经珠江医院伦理委员会批准。

结果

干预后,两组空腹血糖(FPG)、餐后 2 小时血糖(2hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均降低(P<0.05),抑郁自评量表(SDS)、焦虑自评量表(SAS)和糖尿病特异性生存质量量表(DSQL)评分降低(P<0.05),一般自我效能感量表(GSES)和糖尿病自我管理行为量表中文版(SDSCA)评分升高(P<0.05),依从率升高(P<0.05)。观察组 FPG、2hPG、HbA1c、TC、TG、LDL-C 水平低于对照组(P<0.001),GSES 和 SDSCA 评分及依从率高于对照组(P<0.001)。这些结果强调了综合干预在改善糖尿病患者身心健康方面的积极作用,为糖尿病管理中应用综合干预策略提供了有力支持。

结论

基于 CITF 的目标管理模式可缓解糖尿病合并心血管疾病患者的负性情绪,提高自我管理、自我效能和依从性,有效控制血糖和血脂,改善生活质量。本研究结论突出了 CITF 管理模式在改善糖尿病和心血管疾病患者管理中的重要性。这种综合干预有助于减轻负性情绪,提高自我管理和依从性,有效控制血糖和血脂,改善生活质量。这些结果具有重要的临床意义,为慢性病患者的更好护理提供了有力支持。

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