Application Of Protective Motivation Theory In Self-management Of Diabetic Patients With High Risk Foot

Objectives:To analyze the effect of individualized comprehensive intervention of protective motivation theory on self-management behavior of diabetic high risk foot patients and the effect of individual comprehensive intervention of protective motivation theory on self-management behavior of diabetic high risk foot patients.To improve the diabetic high-risk foot patient self-management ability to provide reference and nursing guidance.Methods:This study is an experimental intervention study.A convenient sampling method was used to select 70 diabetic patients with high risk foot who were hospitalized in the Endocrinology Department of Grade 3A Hospital in Yunnan Province from July 2016 to December 2016.According to the random number table,70 cases were randomly divided into control group and intervention group,35 cases in each group.The control group was given routine nursing intervention in endocrine department,and the intervention group was given individualized comprehensive intervention based on the theory of protective motivation for 6 months on the basis of routine nursing,including the establishment of patientsundefined personal files.Set up multidisciplinary comprehensive intervention team,teach in groups,"one-to-one"individualized nursing guidance,nurse-patient "hypoglycemic exercise",patient experience exchange meeting,family and patient association,intervention team discussion,individualized psychological counseling and WeChat,Telephone and other means of information follow-up and other aspects.The survey and evaluation tools were as follows:general social demography questionnaire;disease related information questionnaire;high risk diabetic foot screening registration form;diabetic foot self-management behavior scale;laboratory examination.Results:1.In the two groups,there were no significant differences in general social demographic data,high risk diabetic foot screening results,blood glucose and lipids related metabolic index between the control(35case)and the intervention group(35case)(P>0.05).2.The scores of self-management behavior were compared between the two groups before intervention,and the self-management of patients in the control group before intervention was compared.The total score of the dimension of rational behavior was 36.80 ±7.49,the scores of control level of blood sugar,foot nursing and daily life management were 7.29 ±2.08 and 12.91 ±3.37,16.60 ±4.490.The total score of self-management behavior dimension of intervention group was 36.71 ±9.27,and the score of three dimensions was 7.43 ±2.10.13.14 ±3.09,16.14 ±4.54.There was no significant difference between the two groups(P>0.05).3.Univariate analysis showed that there were differences in self-management behavior among patients with different age,sex,education,income level,marital status,medical insurance,course of disease,BMI level,visual impairment,previous health education on diabetic foot,etc.The difference was statistically significant(P<0.05).4.The dependent variables were the control level of diabetic foot self-management behavior,the dimension of foot nursing and daily life management,the dimension of disease monitoring and management.In the univariate analysis of general data and disease-related data,the variables with statistical differences were independent variables,and multivariate linear regression was carried out.At the level of 0.05,economic income,Two variables of course of disease entered the regression equation in which the control level of blood sugar was taken as dependent variable;the five variables of education degree,medical insurance,sex,course of disease and BMI level entered the regression equation with foot nursing and daily life management as dependent variables;Three variables of disease course BMI level entered the regression equation with disease monitoring and management as dependent variables,and four variables,education level,medical insurance,course of disease and BMI level,entered the regression equation with the total score of self-management dimension as dependent variable.5.After 6 months of intervention,the results of blood glucose and lipid metabolism in the two groups were better than those in the control group,and the difference was statistically significant(P<0.05).6.After 6 months of intervention,the score of self-management behavior in the intervention group was 54.71 ±5.29,which was higher than that in the control group 48.31 ±6.42,and the level of blood glucose control in the intervention group was higher than that in the control group.The scores of foot nursing and daily life management were 9.97 ±1.40,17.63 ± 1.63 and 27.11 ±2.62,respectively,which were significantly higher than those of the control group 9.46 ± 1.36,16.00 ±2.17,22.86±3.26,(P<0.01).7.The total score of self management behavior in intervention group was 54.71+5.29scores,which was higher than that before intervention 36.71+9.27.The intervention group was treated with the management of blood glucose control,foot care and daily life management,and the scores of 3 dimensions were 9.97+1.40,17.63+1.63and 27.11+2.62,higher than those before intervention 7.43+2.10,13.14 ＋3.09,16.14 + 4.54,the difference was statistically significant(P<0.05).Conclusion:1.The self-management level of high risk foot patients with diabetes mellitus was moderate and lower than that of the patients with diabetes mellitus high risk foot,and the individual comprehensive intervention based on protective motivation theory could effectively improve the metabolic indexes such as blood glucose,blood lipid and so on,and help the patients with high risk foot of diabetes to improve their self-management ability.Establish and maintain healthy self-management behavior.2.This study proves that comprehensive intervention based on protective motivation theory is an effective way to improve patients’ self-management and ability.It provides an important reference basis for nursing intervention to improve the self-management ability of high-risk diabetic foot patients.