探讨在分级诊疗中应用医院社区护理模式对.doc

探讨在分级诊疗中应用医院-社区护理模式对 糖尿病患者的影响 王平 孟晶晶2 徐培3 司冬芹2 梁军2 【摘要】目的：探讨在分级诊疗中应用医院-社区护理模式对糖尿病患者延续性护理的作用。方法：选取在某三级甲等医院内分泌科就诊的糖尿病患者120例并随机分为两组，对照组采取常规糖尿病治疗管理方法，干预组在对照组基础上运用医院-社区护理和糖尿病双向转诊模式进行管理，随访一年后，比较两组患者的血糖控制情况，并采用自制治疗依从性问卷和CSSD70问卷比较两组患者的依从性和糖尿病控制状况。结果：干预组患者在出院后3个月、6个月、12个月的治疗依从性高于对照组，且差异有统计学意义；干预组与对照组患者的血糖代谢指标在干预前后均显著降低，且干预组患者干预后的2hOGTT与HbA1c指标优于对照组；CSSD70评价量表随访发现，干预组的糖尿病控制状况优于对照组。结论：医院-社区护理与糖尿病双向转诊相结合的管理模式，可以提高患者的治疗依从性，改善患者的血糖代谢指标，提高患者的生活质量。 【关键词】医院-社区护理模式；分级诊疗；糖尿病；延续性护理； To discussion the application of hospital-community nursing model in diabetes Classificated Treatment. Wang Ping* Meng Jingjing Xu Pei Si Dongqin Liang Jun * Department of Nursing, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical College; Affiliated Hospital of Southeast University, Xuzhou, Jiangsu, China, 221009 Corresponding author: Liang Jun, Email：.com [Abstract] Objective: Discussion about the application of hospital-community nursing model in diabetes classificated treatment. Methods:Selecting and randomly dividing 120 newly diagnosed diabetic patients in endocrinology department of a first-class tertiary hospital into control group and intervention group. The control group adopts conventional diabetic therapy, while the intervention group utilizes hospital-community nursing model and diabetes two-way referral system on the basis of control group. After one-year follow-up visit, researchers can compare blood glucose control conditions of diabetic patients in two groups and thereafter, compare their compliance and diabetes control conditions by adopting self-made treatment compliance questionnaire and CSSD70 questionnaire.To collect data, measurement data using two independent sample t-test, single order count data using rank and inspection, repetitive measure analysis of variance is used to compare the index difference of blood glucose during the follow-up period. Results: There are differences of compliance embodied in patients respectively discharging fro