陈玉莹 姚映彩

【摘要】 目的：探討Teach-back健康宣教模式在门诊妊娠糖尿病患者中的应用效果，为患者临床护理提供相关指导。方法：选取2018年10月-2019年10月笔者所在医院妇保科门诊接收诊治的126例妊娠糖尿病患者为研究对象。按照随机单双数法将其分为对照组和研究组，各63例。对照组予以常规健康宣教模式，研究组予以Teach-back健康宣教模式。比较两组宣教前后血糖水平变化及自我管理能力，并分析两组患者不良妊娠结局发生情况。结果：宣教后，两组空腹血糖（FGP）、餐后2 h血糖（2 h FGP）水平均较宣教前明显降低（P<0.05）。宣教后研究组FGP、2 h FGP为（4.34±0.53）mmol/L、（5.21±0.69）mmol/L，均明显低于对照组的（5.05±0.64）mmol/L、（6.79±1.07）mmol/L，差异有统计学意义（P<0.05）。宣教后，两组自我管理能力总分均明显提高，且研究组自我管理能力总分（84.82±12.32）分，明显高于对照组的（63.63±12.15）分，差异有统计学意义（P<0.05）。研究组不良妊娠结局发生率为14.29%，明显低于对照组的33.33%，差异有统计学意义（P<0.05）。结论：Teach-back健康宣教模式在门诊妊娠糖尿病患者中的应用效果显著，明显改善患者血糖水平及自我管理能力，且减少患者不良妊娠结局的发生，值得推广应用于临床。

【关键词】 妊娠糖尿病 Teach-back模式 健康宣教 空腹血糖 自我管理能力 妊娠结局

doi：10.14033/j.cnki.cfmr.2020.24.044 文献标识码 B 文章编号 1674-6805（2020）24-0-03

[Abstract] Objective： To investigate the application effect of Teach-back health education model in outpatient gestational diabetes patients， and to provide relevant guidance for clinical nursing of patients. Method： From October 2018 to October 2019， 126 patients with gestational diabetes received and treated in the outpatient department of gynecology of our hospital were selected as the study subjects. They were divided into the control group and the study group according to the random single and double number method， with 63 cases in each group. The control group adopted the conventional health education model， while the study group adopted the Teach-back health education model. The changes of blood glucose level and self-management ability before and after education were compared between the two groups， and the occurrence of adverse pregnancy outcomes in the two groups was analyzed. Result： After education， the levels of fasting blood glucose （FGP） and 2 h postprandial blood glucose （2 h FGP） in the two groups were significantly reduced （P<0.05）. After education， the FGP and 2 h FGP of the study group were （4.34±0.53）， （5.21±0.69） mmol/L， which were significantly lower than （5.05±0.64） mmol/L and （6.79±1.07） mmol/L of the control group， and the differences were statistically significant （P<0.05）. After education， the total scores of self-management ability in both groups were significantly improved （P<0.05）. After education， the total score of the self-management ability of the study group was （84.82±12.32） points， which was significantly higher than （63.63±12.15） points of the control group， the difference was statistically significant （P<0.05）. The incidence of adverse pregnancy outcomes in the study group was 14.29%， which was significantly lower than 33.33% in the control group， and the difference was statistically significant （P<0.05）. Conclusion： The application of the Teach-back health education model in outpatient gestational diabetes patients has a significant effect， which can significantly improve patients blood glucose level and self-management ability， and reduce the occurrence of adverse pregnancy outcomes of patients， which is worthy of promotion and application in clinical practice.

[Key words] Gestational diabetes Teach-back model Health education Fasting blood glucose Self-management ability Pregnancy outcome

First-authors address： The Childrens Hospital of Quanzhou City， Quanzhou 362000， China

妊娠糖尿病是指患者在妊娠期间发现的因糖耐量异常导致血糖异常升高的疾病，是妊娠期较为多见的代谢紊乱疾病[1]。妊娠糖尿病多见于妊娠中晚期，长期处于糖尿病环境对孕妇及胎儿均会造成极大影响，患有代谢性疾病的风险显著增加，且极易导致早产、缺氧、新生儿窒息等不良妊娠结局的发生，对母婴健康造成严重威胁，积极进行血糖控制，能够显著改善母婴预后[2]。对于血糖的控制需要多方面配合，其中健康宣教对于提高患者专业疾病知识、改善患者预后起到积极作用，所以选择何种方式进行健康宣教变得尤为重要[3]。Teach-back健康宣教模式是指对患者进行健康宣教后，患者通过理解以自己的语言和行为进行信息解读，若患者存在解读不清晰的知识，需要宣教人员进行重复强调，直至受教患者完全掌握信息为止[4]。……