| ObjectiveThe Trans-Theoretical Model of change(TTM)nursing intervention program was developed to validate the impact of this nursing intervention program on the quality of life of elderly patients with Type 2 Diabetes Mellitus(T2DM)combined with frailty.The aim is to improve the self-efficacy of elderly patients,reduce their frailty,improve their blood glucose level and improve their quality of life.MethodsThis is a class experimental study,and 82 elderly patients with T2 DM combined with debilitation treated in the endocrine department of a tertiary care hospital in Inner Mongolia Autonomous Region from December 2021 to September 2022 were selected according to the inclusion and exclusion criteria.Patients in the east area of the endocrine department were set as the control group(n=41)and patients in the west area were set as the intervention group(n=41),during which six patients dropped out(three in the control group and three in the intervention group),resulting in the inclusion of a total of 76 cases.The control group implemented conventional nursing interventions for elderly patients with debilitating T2 DM,including dietary care,exercise,blood glucose monitoring,health education and discharge follow-up;the intervention group implemented a 3-month TTM nursing intervention program on the basis of conventional care,including pre-intentional phase,intentional phase,preparatory phase,action phase and maintenance phase,and adopted appropriate interventions according to the different phases in which the patients were in.Patients were assessed and analyzed before,at 1 month and at 3 months of intervention using the Tilburg Debilitation Scale,the Diabetes Management Self-Efficacy Scale,the SF-36 Quality of Life Scale,and fasting glucose,and changes in behavioral stages were assessed using the Behavioral Stage Assessment Questionnaire.In this study,the data were statistically analyzed using SPSS26.0statistical software.For general data,the mean ± standard deviation was used to express the measurement data using t-test;the count data were expressed as frequencies and percentages using χ~2 test,and the rank data were expressed as frequencies and percentages using rank sum test for comparison.The Tilburg debilitation scale,diabetes self-efficacy scale,SF-36 quality of life scale and fasting blood glucose in both groups conformed to normal distribution by repeated measures ANOVA,and did not conform to normal distribution by generalized estimating equation.Differences were considered statistically significant at P<0.05.Results(1)General information: general information(age,gender,marital status,education level,personal monthly income,years of illness,medical payment method,and whether other comorbidities were combined)of the two study groups were compared before the intervention,and the differences were not statistically significant(P> 0.05)and were comparable.(2)Comparison of Tilburg Frailty Scale scores: After the intervention in both groups,the total score of Tilburg Frailty Scale in the intervention group was significantly lower than that in the control group at 3 months of intervention,and the difference between the two groups was statistically significant(P<0.05);The Tilburg Frailty Scale somatic condition dimension score was significantly lower in the intervention group than in the control group at 3 months of intervention,and the difference between the two groups was statistically significant(P<0.05);The scores of the Tilburg Frailty Scale psychological status dimension in the intervention group were lower than those in the control group at 1 month and 3 months of intervention,and the difference between the two groups was statistically significant(P< 0.05);The Tilburg Frailty Scale social status dimension score was significantly lower in the intervention group than in the control group at 3 months of intervention,and the difference between the two groups was statistically significant(P<0.05)(3)Comparison of Diabetes Management Self-efficacy Scale scores: after the intervention in both groups,the scores on the diabetes management self-efficacy scale were higher in the intervention group than in the control group at 1 month and 3 months of the intervention,with statistically significant differences(P<0.05).(4)Comparison of Short-Form 36 item health survey scores: After the intervention,the physical function,somatic pain,and vitality dimensions were higher in the intervention group than in the control group at 1 month and 3 months of intervention,and the differences were statistically significant(P < 0.05);the physical function,general health,social function,emotional function,and mental health dimensions were significantly higher than in the control group at 3 months of intervention,and the differences were statistically significant(P<0.05).(5)Comparison of fasting blood glucose: After the intervention in both groups,the fasting glucose values in the intervention group were lower than those in the control group at 1 month and 3 months after the intervention,and the difference was statistically significant(P<0.05)..(6)Comparison of behavioral stage distribution changes before and after intervention: there was no statistically significant difference between the two groups at1 month of intervention(P>0.05),and the behavioral change stage distribution in the intervention group was better than that in the control group at 3 months of intervention,with statistically significant differences(P<0.05).ConclusionIt can be learned from this study that the nursing intervention program based on TTM theory can effectively improve the self-efficacy of elderly patients with T2 DM combined with debilitation,reduce debilitation,improve blood glucose,and ultimately improve the quality of life of patients when compared with the conventional nursing intervention program. |
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