Effects Of Comprehensive Nursing Intervention With Protection Motivation Theory On Self Efficacy And Quality Of Life For Patients With High Risk For Diabetic Foot

OBJECTIVETo assess self-efficacy and quality of life in patients with high risk for diabeticfoot; to study the effects of comprehensive nursing intervention with protectionmotivation theory on self-efficacy and quality of life for patients with high risk fordiabetic foot.METHODSThis study was quasi-experimental study.Using the convenience sampling method,80diabetic patients with high risk for diabetic foot were choosen for the study. Thepatients met the experimental requirements from the endocrinology department of3A hospital in Hengyang. Patients were divided into the intervention group and thecontrol group with40in each. The patients in the control group were given withconventional nursing, while the patients in the intervention group were given withcomprehensive protective motivation intervention besides the conventional nursingfor six months. Using the revised DMQLS, diabetes foot self-efficaey scale, twogroups of blood glucose,blood lipid metabolic index and foot examination(FPG,PBG2h,HbA1c,HDL-CH,LDL-CH,TC,TG,vinegar,sense of pain location,hot,cold,and pressure,touch, vibration perception,the dorsalis pedis artery pulse andABI). Blood glucose, blood lipidmetabolic index and foot examination were used toevaluate the patients in both groups before and3and6months after interventionrespectively. Blood glucose included fasting plasma glucose (FPG), postprandial2hours blood glucose (PBG2h), andglycosylated hemoglobin (HbA1c). Blood lipid metabolic index included total cholesterol (TC), high-density lipoproteincholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride(TG). Foot examination included sense of pain, location awareness, hot and coldtemperature sense, touch sense, vibration sense, pressure sense dorsalis pedis pulseand ankle brachial index(ABI). All the data were collected and analyzed bySPSS17.0software package with descriptive analysis, t-test, repetitive measurevariance analysis and multivariate variance analysis.RESULTS(1)69patients completed the whole study.36patients were in intervention group, and33patients were in control group.(2)The total score of69patients with high risk for diabetic foot of life quality was(3.41±0.37).Scores in all dimensions, The lowest score was disease dimension(3.22±0.66);the highest score was the social dimension (3.82±0.85).(3)The total score of self-efficacy with diabetic foot patients was (12.47±2.75). Scoresin all projects, the highest score was (3.21±0.95) about wearing soft-bottom,comfortable, breathable and suitable footwear during ordinary time;The lowest scorewas (1.87±0.93) about doing foot check every day and applying moisturizer ifnecessary.(4) The total score of life quality and average score of each dimension in theintervention group were all lower than those in the control group after3months and6months (P <0.001); And the total score of life quality and average score of eachdimension in the intervention group after6months intervention were lower than thatafter3months intervention (P <0.001). The difference was not statistically significantbetween before and after intervention in control groups (P＞0.05).(5) The total score of self efficacy in the experiment group was higher than that in thecontrol group after intervention for3and6months (P <0.001); And the total score ofself efficacy in the intervention group after6months intervention were higher thanthat after3months intervention(P <0.001); The difference was not statisticallysignificant between before and after intervention in control groups(P＞0.05). (6) All the indicators(exclude HDL-CH) in the intervention group after interventionfor3and6months were higher than that in the control group (P <0.05); And all theindicators(exclude HDL-CH) in the intervention group after intervention for6monthswere lower than that after intervention for3months (P <0.001);. The scores betweenthree months intervention and six months intervention were not statistically differentin the control group (P＞0.05).CONCLUSION(1) The quality of life and self-efficacy in patients with high risk for diabetic footwere below the medium level.(2) PMT comprehensive intervention were helpful for patient’s blood glucosecomtrol;.(3) PMT comprehensive intervention could make the patients with high risk fordiabetic foot taking precautionary measures from diabetic foot and promote thequality of life and self-efficacy.