| Objective:This study adopted We Chat Mini Programs continuous nursing service model to intervene and manage patients with type 2 diabetes mellitus,and evaluated the effect of blood glucose control,self-management level and quality of life of patients after discharge,in order to establish a new model of continuous nursing service for diabetic patients after hospital,so as to improve patients’ self-management ability and quality of life.Methods:1.This was a quasi-experimental study.From June 2019 to February 2020 108 patients with type 2 diabetes who met the inclusion criteria in a Grade 3A hospital in Nanchang City were selected,and divided into the experimental group and the control group from June 2019 to February 2020.2.The two groups were intervened for 6 months.The control group received traditional post-hospital continuing nursing care intervention,while the experimental group received continuing nursing care intervention based on We Chat Mini Programs,and the general data of the two groups were collected before intervention.The disease-related clinical indicators were collected 1-3 days before discharge,3rd month and 6th month after discharge,including fasting plasma glucose(FPG),2h plasma glucose(2h PG),hemoglobin A1c(Hb Alc),body mass index(BMI);meanwhile,the self-management level and quality of life scores of patients were collected separately.3.SPSS 23.0 statistical software was used for statistical processing and analysis of data.The main statistical methods were descriptive statistics,Chi-square experimental,t-experimental,and repeated measurement analysis of variance etc.Results:1.Finally,100 patients with type 2 diabetes completed all the three rounds of data collection in this study,there were 49 cases in the experimental group and 51 cases in the control group.Three days before discharge(before intervention),general data,disease-related clinical indexes(including fasting plasma glucose,2-hour postprandial blood glucose,hemoglobin A1 c,etc.),self-management level and quality of life between the two groups were comparable without statistical significance(P>0.05).2.The comparison between the two groups after intervention showed that(1)3 months after discharge,the scores of disease-related clinical indicators(including fasting plasma glucose,2h plasma glucose,hemoglobin A1c),selfmanagement behaviors(including foot care,treatment of hyperglycemia and hy poglycemia),and and psychological dimension scores of quality of life betwee n the two groups were statistically significant(P<0.05).The scores of diseaserelated clinical indicators(body mass index),self-management behavior(includ ing total score,diet,exercise,medication care,blood glucose monitoring)and quality of life(including total score,physiology,social relationship,treatment) were not statistically significant(P>0.05).(2)6 months after discharge,there w ere significant differences in disease-related clinical indexes(including fasting plasma glucose,2-hour postprandial blood glucose,hemoglobin A1c),self-man agement behavior(including total score,foot care,treatment of hyperglycemia and hypoglycemia)between the two groups(P<0.05).There was no significa nt difference in the scores of disease-related clinical indexes(body mass inde x),self-management behavior(including diet,exercise,medication nursing,blo od glucose monitoring)and quality of life(P >0.05).3.The self-comparison between the two groups after intervention showed that:(1)in the experimental group,3 months after discharge,there were significant differences in disease-related clinical indicators(including fasting plasma glucose,body mass index),self-management behavior(including total score,foot care,treatment of hyperglycemia and hypoglycemia),and quality of life(including total score,physiological and psychological).Compared with those before discharge,there were significant differences(P<0.05).6 months after discharge,scores of disease-related clinical indicators(fasting plasma glucose),self-management behaviors(including total score,exercise,medication nursing,foot care,and treatment of high and low blood glucose),and scores of quality of life(including total score and psychological score)were all better than those before discharge,with statistically significant differences(P<0.05).6 months after discharge,there were significant differences in disease-related clinical indicators(including fasting plasma glucose,hemoglobin A1 c,body mass index),self-management behavior(including medication care,treatment of hyperglycemia and hypoglycemia)and 3 months after discharge(P<0.05).(2)In the control group,3 months after discharge,the body mass index of disease-related clinical indexes was significantly different from that before discharge(P<0.05).6 months after discharge,the score of medication nursing dimension of self-management behavior was significantly different from that before discharge(P<0.05).6 months after discharge,the scores of disease-related clinical indicators,self-management behavior(medication and nursing)and quality of life(including total score and psychology)were statistically different from those of 3months after discharge(P<0.05).4.The results of repeated measurement analysis of variance showed that: there were significant differences in the observed time-point factors(intra-group factors)of disease-related clinical indicators(including fasting plasma glucose,body mass index)and self-management behaviors(including total score,diet,exercise,medication nursing,foot care,and treatment of high and low blood glucose),(F=5.159,P=0.013;F=23.418,P=0.000;F=8.878,P=0.000;F=3.492,P=0.045;F=5.939,P=0.005;F=16.252,P=0.000;F=2.993,P= 0.069;F=5.585,P=0.006;F=5.725,P=0.008);There were differences in the scores of disease-related clinical indicators(fasting plasma glucose),self-management behaviors(including foot care,high and low blood glucose treatment)and the interaction between groups(F=3.627,P=0.042;F=16.733,P=0.000;F=7.465,P=0.007);The effects of disease-related clinical indicators(fasting plasma glucose,2h plasma glucose),self-management behavior(total score),and quality of life(social relationship)were significant(F=7.753,P=0.006;F=4.846,P=0.030;F=4.373,P=0.039;F=5.324,P=0.023).Conclusions:1.Continuous nursing care intervention based on We Chat Mini Program can improve the blood glucose control of patients with type 2 diabetes and improve their self-management level.The longer the intervention time,the better the effect.2.Continuous nursing intervention based on We Chat Mini Program can improve the quality of life in the psychological dimension of type 2 diabetes patients,and the effect on the quality of life of other dimensions is not obvious,and its long-term application effect needs to be further studied. |
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