The effect of family participatory case management combined with remote guidance on the self-management ability of first-diagnosed type 2 diabetic patients / 中国实用护理杂志

ABSTRACT

Objective:To explore the influence of family participatory case management combined with the Internet remote health guidance model on the self-management behavior and self-efficacy of patients with type 2 diabetes who are first diagnosed in physical examination, in order to provide reference for early blood glucose management of diabetic.Methods:A total of 200 patients who were newly diagnosed as type 2 diabetes in Beijing Friendship Hospital Affiliated to Capital Medical University from October 2017 to June 2018 were selected and divided into observation group and control group according to the random number table method, with 100 cases in each group. Patients in the control group were treated with routine management methods, while patients in the observation group were treated with family participatory case management combined with internet nursing mode. The blood glucose index, self-management level, self-efficacy and cognition of basic knowledge were compared between the two groups after intervention.Results:After the intervention, the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were (6.52±1.34) mmol/L, (8.24±1.25) mmol/L, (6.35±1.24)%, which were lower than those in the control group(6.94±1.45) mmol/L, (8.70±1.40) mmol/L, (6.75±1.18)%, the differences were statistically significant ( t values were -2.127, -2.451, -2.337, P<0.05); the scores of self-management of diet self-management, regular exercise, medication self-management, blood glucose monitoring, foot care, high and low blood glucose prevention and treatment in the observation group were (22.58±4.24), (15.38±2.45), (13.23±1.10), (18.66±1.15), (19.56±3.14), (17.35±1.87) points respectively, which were higher than those in the control group [(18.56±3.87), (11.64±2.82), (11.26±1.82), (15.38±2.49), (15.82±3.56), (15.34±2.14) points], the differences were statistically significant ( t values were 7.003-11.959, P<0.01); the scores of self-efficacy of emotion control, reasonable rest, pain and discomfort control, self-care, medication compliance management, health problems in the observation group were (9.12±0.45), (8.56±0.62), (8.86±0.72), (8.46±0.68), (9.26±0.39), (8.76±0.46) points respectively, which were higher than those in the control group [(8.14±0.82), (7.14±0.85), (7.58±0.93), (7.16±0.85), (8.14±0.42), (7.48±0.79) points], the differences were statistically significant( t values were 10.477-19.541, P<0.01). The cognitive level of basic knowledge in the observation group was (17.45±2.48) points, which was higher than (13.12±3.14) points in the control group, the differences was statistically significant ( t value was 10.822, P<0.01). Conclusions:Family participatory case management combined with the Internet-based nursing model can significantly improve the self-management ability, self-efficacy and disease awareness of type 2 diabetes patients, and have a positive effect on improving patients' blood glucose metabolism indicators.