视觉和行为干预在糖尿病患者初用胰岛素期间的应用
시각화행위간예재당뇨병환자초용이도소기간적응용
Application of visual and behavioral intervention in diabetics start using insulin period
  • 万方数据
    中华现代护理杂志 중화현대호리잡지
    CHINESE JOURNAL OF MODERN NURSING
    2012年 3期 254-257 ,共4页

    王静%张小群%安珍玉

    왕정%장소군%안진옥

    糖尿病%胰岛素%焦虑%抑郁%社会支持%满意度%视觉和行为干预 糖尿病%胰島素%焦慮%抑鬱%社會支持%滿意度%視覺和行為榦預
    당뇨병%이도소%초필%억욱%사회지지%만의도%시각화행위간예
    Diabetics%Insulin%Anxiety%Depression%Social support%Satisfaction%Visual and behavior intervention
    目的 探讨视觉和行为干预在糖尿病患者初次皮下注射胰岛素期间的应用效果.方法 将158例初次皮下注射胰岛素的糖尿病患者随机分成干预组79例和对照组79例.对照组给予常规的胰岛素笔使用、胰岛素相关知识干预,发放糖尿病干预手册、胰岛素笔使用说明书、血糖监测日记,干预组在此基础上给予视觉和行为干预.两组患者初次注射胰岛素后即刻采用视觉模拟评级法(VAS)进行注射疼痛评分,治疗前及治疗4周后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)和患者满意度量表进行调查,比较两组VAS、SAS、SDS、SSRS评分,干预前后血糖变化及满意度情况.结果 干预组患者初次注射胰岛素VAS评分(0.82±0.72)分明显低于对照组(3.21±1.22)分,差异具有统计学意义(t =2.37,P＜0.01)；干预组患者干预前SAS、SDS、患者满意度、SSRS评分(46.71±13.88),(49.45±12.53),(6.31±0.68),(40.78±1.45)分与对照组患者(47.98±11.06),(48.81±10.29),(6.51±0.63),(41.42±1.63)分比较,差异均无统计学意义(t分别为1.63,3.32,10.87,3.23；P＞0.05)；干预4周后干预组患者SAS、SDS评分(38.68±6.03),(38.35±5.19)分及对照组患者SAS、SDS评分(44.93±8.26),(46.10±8.23)分均低于干预前,差异均有统计学意义(t分别为15.02,24.50,7.71,11.87;P＜0.01),且干预组SAS、SDS评分均低于对照组,差异均有统计学意义(t分别为2.07,2.28;P ＜0.05)；干预4周后干预组患者满意度和SSRS评分(8.50±0.33),(44.31±3.84)分及对照组患者满意度和SSRS评分(6.71±0.59),(42.76±0.76)分均高于干预前,差异均有统计学意义(t分别为16.51,8.81,3.22,2.88;P ＜0.05),且干预组患者满意度和SSRS评分均高于对照组,差异均有统计学意义(t分别为6.50,2.82;P ＜0.05)；两组患者干预前空腹血糖及餐后2h血糖,差异均无统计学意义(P＞0.05)；干预4周后干预组患者空腹血糖(5.99 ±0.92) mmol/L,餐后2h血糖(7.82±1.38) mmol/L,均低于对照组(7.26±1.92),(9.13±1.36) mmol/L,差异均有统计学意义(t分别为5.77,6.12;P＜0.05).结论 应用视觉和行为干预能有效减轻初用胰岛素患者的焦虑、抑郁及痛感,降低空腹及餐后血糖,提高患者的满意度及社会支持度.
    목적 탐토시각화행위간예재당뇨병환자초차피하주사이도소기간적응용효과.방법 장158례초차피하주사이도소적당뇨병환자수궤분성간예조79례화대조조79례.대조조급여상규적이도소필사용、이도소상관지식간예,발방당뇨병간예수책、이도소필사용설명서、혈당감측일기,간예조재차기출상급여시각화행위간예.량조환자초차주사이도소후즉각채용시각모의평급법(VAS)진행주사동통평분,치료전급치료4주후채용초필자평량표(SAS)、억욱자평량표(SDS)、사회지지평정량표(SSRS)화환자만의도량표진행조사,비교량조VAS、SAS、SDS、SSRS평분,간예전후혈당변화급만의도정황.결과 간예조환자초차주사이도소VAS평분(0.82±0.72)분명현저우대조조(3.21±1.22)분,차이구유통계학의의(t =2.37,P＜0.01)；간예조환자간예전SAS、SDS、환자만의도、SSRS평분(46.71±13.88),(49.45±12.53),(6.31±0.68),(40.78±1.45)분여대조조환자(47.98±11.06),(48.81±10.29),(6.51±0.63),(41.42±1.63)분비교,차이균무통계학의의(t분별위1.63,3.32,10.87,3.23；P＞0.05)；간예4주후간예조환자SAS、SDS평분(38.68±6.03),(38.35±5.19)분급대조조환자SAS、SDS평분(44.93±8.26),(46.10±8.23)분균저우간예전,차이균유통계학의의(t분별위15.02,24.50,7.71,11.87;P＜0.01),차간예조SAS、SDS평분균저우대조조,차이균유통계학의의(t분별위2.07,2.28;P ＜0.05)；간예4주후간예조환자만의도화SSRS평분(8.50±0.33),(44.31±3.84)분급대조조환자만의도화SSRS평분(6.71±0.59),(42.76±0.76)분균고우간예전,차이균유통계학의의(t분별위16.51,8.81,3.22,2.88;P ＜0.05),차간예조환자만의도화SSRS평분균고우대조조,차이균유통계학의의(t분별위6.50,2.82;P ＜0.05)；량조환자간예전공복혈당급찬후2h혈당,차이균무통계학의의(P＞0.05)；간예4주후간예조환자공복혈당(5.99 ±0.92) mmol/L,찬후2h혈당(7.82±1.38) mmol/L,균저우대조조(7.26±1.92),(9.13±1.36) mmol/L,차이균유통계학의의(t분별위5.77,6.12;P＜0.05).결론 응용시각화행위간예능유효감경초용이도소환자적초필、억욱급통감,강저공복급찬후혈당,제고환자적만의도급사회지지도.
    Objective To explore the application effects of visual and behavioral intervention in diabetics start using insulin period.Methods Totals of 158 diabetics with start using insulin for the first time were randomly divided into intervention group( 79 cases) and control group( 79 cases).Control group received intervention of conventional insulin pen utilization and relative insulin knowledge,and diabetes intervention manual,introduction of insulin pen utilization were provided to patients,and patients wrote blood glucose monitoring diary.On this basic,intervention group received visual and behavioral intervention.Visual simulation rating method (VAS)was used when patients first used insulin to measure injection pain score,before and after four cure four weeks,patients were investigated with self-anxious scale ( SAS),self-depression scale ( SDS),selfsocial support scale (SSRS) and patients' satisfaction degree,then those score,blood glucose change were compared.Results The VAS score of intervention group was (0.82 ± 0.72 ) obviously lower than ( 3.21 ±1.22 ) of control group,and the difference was statistically significant ( t =2.37,P ＜ 0.01 ).Before intervention,the score of SAS、SDS、patients' satisfaction degree and SSRS in intervention group in order was (46.71 ±13.88 ),(49.45 ± 12.53 ),( 6.31 ± 0.68 ),( 40.78 ± 1.45 ) and compared with control group that in order was(47.98 ± 11.06 ),( 48.81 ± 10.29 ),( 6.51 ± 0.63 ),( 41.42 ± 1.63 ),differences was statistically significant( t =1.63,3.32,10.87,3.23 ; P ＞ 0.05 ).After intervention four weeks,the score of SAS、SDS of intervention group respectively was ( 38.68 ± 6.03 ),( 38.35 ± 5.19) and that of control group was (44.93 ±8.26),(46.10 ± 8.23 ),lower than before intervention and the difference was statistically significant (t=15.02,24.50,7.71,11.87,respectively;P ＜0.01 ) ; the score of SAS、SDS of intervention group was lower than that of control group,the difference was statistically significant (t =2.07,2.28;P ＜ 0.05 ).After intervention four weeks,SSPS score and patients' satisfaction degree was(44.31 ±3.84) and (8.50 ±0.33),and that of control group was(42.76 ± 0.76) and (6.71 ± 0.59 ),both higher than before intervention,the difference was statistically significant(t =8.81,16.51,2.88,3.22,respectively; P ＜ 0.05 ),SSPS score and patients'satisfaction degree of intervention group was higher than that of control group,the difference was statistically significant( t =2.82,6.50,respectively;P ＜0.05 ).There was no difference between two groups in fasting blood-glucose(FBG) and two hours after meal( P ＞ 0.05 ).After intervention four weeks,FBG and two hours after meal of intervention group was ( 5.99 ± 0.92 ) mmol/L,( 7.82 ± 1.38 ) mmol/L,both lower than that of control group which was ( 7.26 ± 1.92 ) mmol/L,( 9.13 ± 1.36 ) mmol/L,the difference was statistically significant(t =5.77,6.12,respectively;P＜0.05).Conclusions Adopting visual and behavioral interventions for diabetics in start using insulin period can effectively reduce anxiety,depression,pain,decrease fasting bloodglucose and two hours after meal blood-glucose,and improve patient's satisfaction and social support.
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