刘晓英 张艳玲

[摘要] 目的 探討路径式健康教育对2型糖尿病患者血糖、自我管理行为及情绪的影响。 方法 回顾性分析2016年4月～2017年5月延安市人民医院内分泌科收治的800例2型糖尿病患者的临床资料，依据健康教育方式不同进行分为对照组和观察组，每组各400例。对照组给予常规健康教育，观察组给予路径式健康教育。比较两组患者血糖、情绪及自我管理行为评分。 结果 干预前两组空腹血糖、餐后2 h血糖和糖化血红蛋白比较，差异均无统计学意义（P > 0.05）；干预后两组上述指标均低于干预前，观察组上述指标均明显低于对照组，差异均有统计学意义（P < 0.05）。干预前两组焦虑、抑郁评分比较，差异无统计学意义（P > 0.05）；干预后两组焦虑、抑郁评分均低于干预前，且观察组明显低于对照组，差异有统计学意义（P < 0.05）。干预前两组饮食控制、规律运动、遵医嘱用药、血糖监测、足部护理、血糖异常处理评分比较，差异均无统计学意义（P > 0.05）；干预后两组上述评分均高于干预前，且观察组高于对照组，差异均有统计学意义（P < 0.05）。 结论 路径式健康教育可以降低2型糖尿病患者的血糖，改善心理情绪，提高自我管理水平，值得临床推广应用。

[关键词] 路径式健康教育；2型糖尿病；血糖；自我管理行为；焦虑；抑郁

[中图分类号] R473.2 [文献标识码] A [文章编号] 1673-7210（2018）07（a）-0172-05

Effects of pathway health education on blood glucose， self-management behavior and emotion in patients with type 2 diabetes mellitus

LIU Xiaoying1 ZHANG Yanling2

1.Department of Endocrine， Yan′an People′s Hospital， Shaanxi Province， Yan′an 716000， China；2.Intensive Care Unit， Yan′an People′s Hospital， Shaanxi Province， Yan′an 716000， China

[Abstract] Objective To explore the effects of pathway health education on blood glucose， self-management behavior and emotion in patients with type 2 diabetes mellitus. Methods A total of 800 clinical data of patients with type 2 diabetes mellitus in Department of Endocrine， Yan′an People′s Hospital from April 2016 to May 2017 were retrospectively analyzed and divided into the control group and the observation group by different health education methods， with 400 cases in each group. The control group was given routine health education and the observation group was given pathway health education. The blood glucose， the scores of self-management behavior and the emotions between the two groups were compared. Results Before intervention， there were no statistically significant differences in the fasting plasma glucose， postprandial 2 h blood glucose and glycosylated hemoglobin between the two groups （P > 0.05）； after intervention， the indicators above in the two groups were all lower than those of before intervention， the indicators above in the observation group were significantly lower than those of control group， with statistically significant differences （P < 0.05）. Before intervention， there were no statistically significant differences in the scores of anxiety and depression （P > 0.05）； after intervention， the scores above in the two groups were all lower than those of before intervention and the scores above in the observation group were significantly lower than those of control group， with statistically significant differences （P < 0.05）. Before intervention， there were no statistically significant differences in the scores of diet control， regular exercise， medication following doctor′s advice， blood glucose monitoring， foot care and abnormal blood sugar treatment （P > 0.05）； after intervention， the scores above in the two groups were all higher than those of before intervention and the scores above in the observation group were significantly higher than those of control group， with statistically significant differences （P < 0.05）. Conclusion The application of pathway health education in patients with type 2 diabetes mellitus can decrease the blood sugar， improve the psychological emotions， increase the self-management behavior. It is worthy of promotion and application.

[Key words] Pathway health education； Type 2 diabetes mellitus； Blood glucose； Self-management； Anxiety； Depression

糖尿病各类分型中，2型糖尿病的比例最高，同时也最容易并发糖尿病肾病、脂肪肝、视网膜病变等并发症，严重者危及患者生命安全[1-2]。目前糖尿病不能彻底根治，需要长期服用降糖药物、合理安排饮食才可以保持血糖处于平稳的水平，但是由于患者自我管理意识淡薄，心理上存在不良情绪，造成血糖控制效果不理想，影响了患者正常的治疗[3-4]。健康教育是2型糖尿病常用的宣教方式，有效的健康教育可以提高患者的治疗依从性和自我管理水平，改善患者不良情绪，提高临床疗效[5-6]。路……