| Objective(s):To explore the influence of family doctor contract service and peer education on community empty nest elderly diabetes patients through quantitative research;At the same time,qualitative interviews with empty nest elderly diabetic patients.To understand the feedback of residents of the family doctor contract service and peer education intervention,and to deeply explore the factors affecting the self-management of elderly patients with empty-nest diabetes in the community.Methods:This study is a mixed study,and the first part of the study is a quantitative study;using the quasi-experimental study method,while thirty empty-nest elderly diabetes patients who had long lived in Kunji Community,Panlong District,Kunming city were selected as the research objects.using family doctor contract services combined peer education as the intervention on the study subjects for one year.The fasting glucose,2-hour postprandial glucose and glycated hemoglobin values were measured before and after the intervention.Participants’ self-efficacy,self-management behavior,and quality of survival were also assessed by using the Diabetes Management Self-efficacy Scale(DMSES),the Geriatric Diabetes Self-management Behavior Scale(DSMB-O),and the Diabetes Quality of Life-specific Scale(DSQL).Members of the intervention team were responsible for the collection and collation of the data,and the descriptive analysis of the data was performed using the SPSS26.0 software.Two independent sample t-tests were used for data meeting the normal distribution,and the Mann-Whitney U rank sum test for non-normally distributed data.If the result(P<0.05)indicates that the difference is statistic ally significant.The second part is a qualitative study.On the basis of the above quantitative study,selected by objective sampling,10 participants were selected for follow-up in the last week for qualitative interview,to evaluate the intervention effect of family doctor contract service and peer education,and deeply explore the factors affecting self-management of elderly diabetic patients with empty nests in the community.thus complementary the quantitative research results,and understand the needs of the empty-nest elderly diabetic patients and the feelings of the family doctor contract service and peer support education.Results:1 Quantitative research results 1.1 Blood glucose controlThe fasting plasma glucose level and the blood glucose level 2 hours after meal of the empty nest elderly diabetes patients in the community are significantly different before and after the intervention,which are statistically significant(P<0.05);Before and after intervention,there was no significant difference in the glycosylated hemoglobin of patients,with no statistical significance(P>0.05).1.2 Self management efficacyThe total score of self-efficacy of the empty nest elderly diabetes patients in the community was 51.52±1.86 points before intervention,and 155.66±4.90 points after intervention,with a significant increase in the score and statistical significance(P<0.05).1.3 Self-management behaviorThe total score of self-management behavior of empty nest elderly diabetes patients in the community was 11.54 ±1.59 before the intervention and 22.43 ±3.84 after the intervention.The self management behavior was significantly improved,with statistical significance(P<0.05).1.4 Quality of lifeThe total score of the quality of life of the empty nest elderly diabetes patients in the community was 92.17 ±1.36 before the intervention,and 67.03±8.68 after the intervention.The quality of life was significantly improved,with statistical significance(P<0.05)2 Qualitative research resultsAfter in-depth analysis of the data,two themes were explored:the influencing factors of self-management of the empty nest elderly diabetes patients in the community,patient’s perception of family doctor contract service combined with peer education intervention.The factors that affect the self-management of empty nest elderly diabetes patients in the community mainly consist of the unsatisfactory blood glucose control in the physiological aspect due to irregular diet,the feeling of loneliness in the psychological aspect caused by the absence of children’s companionship,and the insufficient external support due to the lack of social attention to empty nest elderly diabetes patients.In terms of the perception of family doctor contract service combined with peer education intervention activities,(1)the patient’s attitude:the supporters believe that family doctor contract service combined with peer education intervention activities is beneficial to blood glucose control,while the people hold the neutral views believe that it is not necessarily beneficial;(2)Evaluation of patients:positive evaluation includes recognition that the intervention activity is conducive to reducing loneliness and the pressure of diabetes patients faced in diabetes self-management,is beneficial for emotional regulation and learning of diabetes knowledge,is conducive to the establishment of social relations and sense of belonging.The negative evaluation includes the sense of distance in communication and discussion caused by few activities,great amount but less compact activities each time,inconvenience of activities due to far locations,monotonous activities,few opportunities to show,large differences in activity groups.(3)Suggestions from patients:carry out individualized health education for patients,and improve the teaching level of nurses and peers.Conclusion(s):The combination of family doctor contract services and peer education can help patients effectively control their blood sugar,and improve their self management effectiveness,thus improve their self management behavior,and improve their quality of life.It has a good effect on improving the physical and mental health of patients,and is an intervention mode suitable for the empty nest elderly diabetes patients to carry out diabetes health management in the community. |
PDF Full Text Request