陈婕 赵春艳 朱媛媛 王燕贤 郝晓妹

[摘要] 目的 探讨案例教学法对提高社区护士糖尿病运动管理的影响。 方法 选取2017年11月～2018年1月上海市各家社区卫生中心筛选出参加培养实践的80名社区护士，运用案例教学法对其进行培训，采用糖尿病知识问卷和糖尿病运动管理计划问卷，对培训前后社区护士进行调查。 结果 糖尿病基础知识、运动适应证与禁忌证、运动频率、运动时间、运动强度、运动方式评分和总评分培训后均高于培训前，差异有统计学意义（P < 0.05）；糖尿病专科护士糖尿病知识、态度、行为评分培训后均高于培训前，差异有统计学意义（P < 0.05）。 结论 通过案例教学法在专科培训中的应用，使社区糖尿病专科护士在专科理论知识、沟通技巧、运动方案的制订能力明显提升，为社区护士在糖尿病运动管理工作中奠定了扎实的基础。

[关键词] 案例教学法；社区护士；糖尿病运动；案例教学法

[中图分类号] R47；G642 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0149-04

[Abstract] Objective To explore the effect of case teaching method on improving the management of diabetes in community nurses. Methods From November 2017 to January 2018， 80 community nurses from community health centers in Shanghai and participated in the training practice were selected. They were trained with the case teaching method， and surveyed the community nurses before and after the training with diabetes knowledge questionnaire and the diabetes sports management plan questionnaire. Results The scores of basic knowledge of diabetes mellitus， sports adaptation and contraindications， exercise frequency， exercise time， exercise intensity， exercise mode， and total scores after training were higher than before training， the differences were statistically significant （P < 0.05）； the scores of diabetes mellitus specialist nurses diabetic knowledge， attitude， behavior after training were higher than before training， the differences were statistically significant （P < 0.05）. Conclusion Through the application of case teaching method in the specialty training， in the specialty theory knowledge， the communication skill， the exercise plan establishment ability of the community diabetes specialist nurses are obvious enhancement， it has laid the solid foundation for the community nurse in the diabetes movement management work.

[Key words] Case teaching method； Community nurses； Diabetes sports； Case teaching method

2型糖尿病是终身性代谢性疾病，与糖尿病饮食及运动密切相关[1]。我国现有的社区医疗服务模式下，对糖尿病患者进行长期、有针对性的专业指导已成为该病护理的重要环节，社区护士在提高糖尿病管理水平、糖尿病患者生活质量等方面起着引领和指导的作用[2]。目前临床上，社区护士对糖尿病运动管理方法不一[3]，患者难以理解并且持久的实施。谭月辉等[4]通过应用专题研讨方式对社区护士进行培训，它是以授课和听课为共同教育主体，实现参与者最大限度地就某一研究主题进行认识互动的一种交互式培训路径，但单一的专题研讨培训由于没有典型案例为载体，缺乏实践性。本研究探讨以案例教学（case-based learning，CBL）为基本培训模式，为改善社区护士对糖尿病运动管理能力提供参考依据。

1 对象与方法

1.1 研究对象