李燕江 李小娜

【摘要】 目的：探讨提升希望感的护理干预对提高2型糖尿病合并冠心病患者自我管理行为与希望水平的效果。方法：选择2017年5月1日-2019年10月30日于笔者所在医院心内科和内分泌科住院的2型糖尿病合并冠心病患者88例，等分为对照组和观察组。对照组采取常规护理，包括健康生活方式指导及心理辅导等。观察组在对照组基础上采取提升希望感的护理干预。两组均干预4周。干预前后分别采用糖尿病自我管理行为量表和Herth希望量表对两组进行自我管理水平和希望水平评估。结果：干预前，两组糖尿病自我管理行为量表和Herth希望量表各维度评分比较，差异均无统计学意义（P>0.05）;干预后，观察组糖尿病自我管理行为量表和Herth希望量表各维度评分均高于对照组，差异均有统计学意义（P<0.05）。结论：提升希望感的护理干预可提高2型糖尿病合并冠心病患者的自我管理行為与希望水平。

【关键词】 希望感 护理干预 2型糖尿病合并冠心病 自我管理 希望水平

doi：10.14033/j.cnki.cfmr.2020.20.025 文献标识码 B 文章编号 1674-6805（2020）20-00-03

Effect of Nursing Intervention to Enhance the Sense of Hope on Self-management Behavior and Level of Hope of Patients with Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease/LI Yanjiang， LI Xiaona. //Chinese and Foreign Medical Research， 2020， 18（20）： -67

[Abstract] Objective： To explore the effect of nursing intervention on improving self-management behavior and level of hope of patients with type 2 diabetes mellitus complicated with coronary heart disease. Method： From May 1， 2017 to October 30， 2019， 88 patients with type 2 diabetes mellitus with coronary heart disease who were hospitalized in the department of cardiology and endocrinology of our hospital were selected. They were divided into the control group and the observation group. The control group received routine nursing， including healthy lifestyle guidance and psychological guidance. The observation group received nursing intervention to enhance the sense of hope on the basis of the control group. Both groups were treated for 4 weeks. Before and after intervention， diabetic self-management behavior scale and Herth hope scale were used to evaluate the levels of self-management and hope of the two groups. Result： Before intervention， the scores of each dimension of diabetic self-management behavior scale and Herth hope scale were compared between the two groups， and the differences were not statistically significant （P>0.05）. After intervention， the scores of each dimension of diabetic self-management behavior scale and Herth hope scale in the observation group were higher than those of the control group， and the differences were statistically significant （P<0.05）. Conclusion： The nursing intervention to enhance the sense of hope can improve the levels of self-management behavior and hope of patients with type 2 diabetes mellitus complicated with coronary heart disease.

[Key words] Sense of hope Nursing intervention Type 2 diabetes mellitus complicated with coronary heart disease Self-management Level of hope

First-authors address： Wuchuan Peoples Hospital， Wuchuan 524500， China

文献[1-4]报道，2型糖尿病（T2DM）与冠心病关系密切，T2DM是冠心病患者的独立危险因素之一，被视为冠心病的“等危症”，具有高致残、致死率，一旦并发心肌梗死极易出现心力衰竭、休克，甚至猝死。近年来，我国2型糖尿病合并冠心病发病率和病死率呈上升趋势[5]。在临床治疗的同时，需稳定患者的情绪，提高配合度，才能保证治疗效果。希望感是心理学研究的一个新领域，属于一种积极的心理品质[6]。本研究通过提升希望感的护理干预提升患者的希望感，以促进患者的自我管理行为，稳定情绪、增加自信，达到恢复健康的目的。