Tang Yaling, Liu Li, Xu Weiwei, Luo Yunqiu, Sun Hang
Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2025 Aug 29;104(35):e43832. doi: 10.1097/MD.0000000000043832.
This study investigates the impact of a timing theory-based case management model on inpatient management efficiency, self-management capacity, and complication rates in patients with type 2 diabetes mellitus (T2DM). We retrospectively analyzed 120 inpatients with T2DM admitted between December 2023 and March 2024. Patients were divided into 2 groups based on the type of nursing care they received: an observation group (n = 60), which received a timing theory-based case management model, and a control group (n = 60), which received routine nursing care. The timing theory-based model structured nursing interventions into 5 progressive stages - diagnosis, stabilization, preparation, implementation, and adaptation - designed to align with patients' physical and psychological needs throughout the disease course. Primary outcomes included length of hospital stay, HbA1c target achievement rate, diabetes self-management questionnaire scores, psychological status (depression-anxiety-stress scale), and incidence of complications. Compared with the control group, the observation group had a shorter average hospital stay (8.56 ± 3.45 vs 10.34 ± 3.84 days, P < .001) and a 16.67% higher rate of achieving HbA1c goals (66.67% vs 50.00%, P = .041). Total diabetes self-management questionnaire scores (40.70 ± 3.50 vs 33.00 ± 3.80) and subscale scores - such as medication adherence and dietary control - were significantly better in the observation group (all P < .001). Post-intervention, scores for depression (10.46 ± 3.84 vs 15.51 ± 3.93) and anxiety (9.78 ± 3.73 vs 13.37 ± 3.96) were notably lower (both P < .001). The overall complication rate decreased by 26.66% (16.67% vs 43.33%, P = .007), while complete treatment adherence improved by 13.3% (50.0% vs 36.7%, P = .013). A timing theory-based case management model can significantly shorten hospital stays, enhance self-management and psychological well-being, and reduce the risk of complications in T2DM patients. These findings provide practical evidence for comprehensive diabetes care and offer new perspectives for long-term T2DM management.
本研究探讨基于时机理论的个案管理模式对2型糖尿病（T2DM）患者住院管理效率、自我管理能力及并发症发生率的影响。我们回顾性分析了2023年12月至2024年3月期间收治的120例T2DM住院患者。根据所接受的护理类型将患者分为两组：观察组（n = 60），接受基于时机理论的个案管理模式；对照组（n = 60），接受常规护理。基于时机理论的模式将护理干预分为5个递进阶段——诊断、稳定、准备、实施和适应——旨在在疾病全过程中与患者的生理和心理需求相匹配。主要结局指标包括住院时间、糖化血红蛋白（HbA1c）目标达成率、糖尿病自我管理问卷得分、心理状态（抑郁-焦虑-压力量表）及并发症发生率。与对照组相比，观察组平均住院时间更短（8.56 ± 3.45天 vs 10.34 ± 3.84天，P <.001），HbA1c目标达成率高出16.67%（66.67% vs 50.00%，P =.041）。观察组糖尿病自我管理问卷总分（40.70 ± 3.50 vs 33.00 ± 3.80）及各子量表得分——如用药依从性和饮食控制——均显著更好（均P <.001）。干预后，抑郁得分（10.46 ± 3.84 vs 15.51 ± 3.93）和焦虑得分（9.78 ± 3.73 vs 13.37 ± 3.96）显著降低（均P <.001）。总体并发症发生率降低了26.66%（16.67% vs 43.33%，P =.007），而完全治疗依从性提高了13.3%（50.0% vs 36.7%，P =.013）。基于时机理论的个案管理模式可显著缩短T2DM患者的住院时间，增强自我管理能力和心理健康水平，并降低并发症风险。这些研究结果为糖尿病综合护理提供了实践依据，并为T2DM的长期管理提供了新的视角。
