The Study Of Intervention In The Young And Middle-aged Patients With Type 2 Diabetes Basing On Transtheoretical Model

Objective:Based on the transtheoretical model as the theoretical basis,formulate interventions for behavioral changes in patients with diabetes mellitus to improve the patient’s ability to self-management,reduce the patient’s pain,while promoting the stability of blood sugar and glycated hemoglobin.Methods:Using a randomized controlled intervention study,according to the established exclusion and inclusion criteria,131 patients with type 2diabetes who were hospitalized in the endocrinology department of a top-three hospital in Nanchong City were selected for study.The control group was given routine nursing interventions,including monitoring blood glucose,glycated hemoglobin,dietary health guidance,healthy exercise guidance,insulin injections,performance of hypoglycemic reactions,and treatment measures;the intervention group adopted a cross-theoretical model on the basis of routine nursing care to assess the patient’s behavioral stage,formulate a matching implementation plan according to the patient’s condition,and then implement the intervention in stages,mainly from diet,exercise,blood glucose monitoring,medication guidance,The six aspects of hypoglycemia prevention and psychological guidance are respectively explained,and roughly formulated programs:such as one-on-one health education,health promotion manuals,relevant knowledge for patients,Wechat group regularly push knowledge,and self-observation forms to record their daily situation.Fostering hobbies and teaching patients to relax training to stimulate positive emotions;to play the role of family and peer support,regular telephone follow-up,out-patient follow-up and knowledge lectures.Both groups used behavioral change stage scale,DSCS,fasting blood glucose and glycated hemoglobin and diabetes psychology before intervention（T0）,3months（T3）and 6 months（T6）intervention.DDS indicators were evaluated to compare the improvement of patients’behavioral changes,self-manag-ement,fasting blood glucose and HbA1c,and psychological distress.Results:1.The demographic data of the two groups were compared:including age,gender,occupation,education level,family monthly income,medical insurance,disease duration,complications,etc.The results showed that the differences were not statistically significant（P>0.05）,indicating the comparability of two groups.2.Baseline data showed that baseline scores showed no statistically significant differences in DSCS,fasting blood glucose,HbA1c,and DDS in the two groups of patients（P>0.05）.Baseline status was consistent between the two groups.3.The behavioral changes of the two groups were compared,and the results showed that after 3 months of intervention（T3）and 6 months of intervention（T6）,there was a statistically significant difference in behavioral changes between the two groups（P<0.05）;At the end of the intervention,the behavior of the two groups was changed to 100%.The patients across the 3stages were:47 cases（72.3%）in the intervention group and 20 cases（30.3%）in the control group.The behavior change of the intervention group was better than that of the control group.4.Comparing DSCS,fasting blood glucose and HbA1c between the two groups,the results showed that the fasting blood glucose（F=3.97,P<0.05）and HbA1c（F=5.36,P<0.01）scores of the intervention group were significantly lower than those of the control group,while the DSCS score（F=345.55,P<0.01）was higher than that of the control group（P<0.05）;during the follow-up period,the blood glucose and the intervention group and control group.Both glycosylated hemoglobins showed a decreasing trend and DSCS increased.However,the trend of changes in the intervention group was more pronounced（P<0.05）.As time went on,the difference in scores between the two groups of patients continued to expand,and the time and intervention showed significant interactions.（P<0.05）;The pairwise comparison found that in the third trimester（T₃）and the sixth trimester（T₆）,the scores of fasting blood glucose（F=88.24,P<0.01）and HbA1c（F=62.51,P<0.01）in the intervention group were significantly lower than those in the control group,and the DSCS score（F=345.55,P<0.01）was higher than that in the control group.The time increases and increases.5.Comparing the DDS between the two groups,the results showed that the scores of DDS scores and dimensions in the intervention group were significantly lower than those in the control group（P<0.05）;the trend analysis found that the scores of the DDS scores and the dimensions in both groups decreased significantly.Trend,but compared with the control group,the decline trend in the intervention group was more obvious（P<0.05）;over time,the score difference between the two groups gradually increased,and there was a significant interaction between time and intervention（P<0.05）;In the intervention of the third month（T₃）and the sixth month（T₆）,the intervention group scored significantly lower than the control group.Conclusion:1.Transtheoretical model was applied to develop interventions for patients with diabetes-related emotional distress,to promote positive coping styles,to improve the patient’s behavior,to improve the patient’s self-management ability,and to stabilize the patient’s blood glucose and glycated hemoglobin.2.Transtheoretical model has expanded the new field of diabetes psychological research and provided new methods and theoretical support for future intervention strategies.