| Objectives:To evaluate the effects of senior nurses on type 2 diabetes mellitus blood glucose control,and provide a reference for the management of type 2 diabetes in communities in China.Methods:The senior nurses set up nurse clinics in communities to manage the "three people and four diseases"(namely,the elderly,the infants and the pregnant,and four kinds of patients suffering from hypertension,diabetes,cerebral apoplexy and psychosis)in communities,based on the platform of innovative urban health alliance of Anhui medical reform office,and the senior nurses as a link to manage the "three people and four diseases" in communities.This study took the senior nurse of tertiary hospital to manage the type 2 diabetes patients in community as an example.The prospective research methods was adopted.As the senior nurse intervention care group(SNIC)where the diabetes nurse clinic was set up and the conventional care group(CC)in another pilot community,196 cases of type 2 diabetes patients were recruited by convenience sampling in two pilot communities from August 2017 to January 2018.And 98 cases of participants were recruited in each group.The senior nurse intervention care group received the intervention of senior nurse based on the community routine care,including the one-to-one evaluation and guidance in nursing clinic,collective-education intervention,regular follow-up and guidance while the conventional care group received the community routine care from the family doctor,including the regular follow-up and guidance.The general demographic data questionnaire,diabetes knowledge questionnaire,diabetes health behavior questionnaire and patient satisfaction questionnaire were used respectively,to collect patients' general demographic data,diabetes knowledge,diabetes health behaviors,glycosylated hemoglobin levels,fasting blood glucose,body mass index,and patients' satisfaction with the community between the two groups were compared before and after 6 months' intervention.SPSS 23.0 statistical software was used for data analysis,the independent sample t test was used to compare the quantitative data between two groups,and chi-square test was used to compare the qualitative data.Results: In this study,196 valid data were included(95.61% of the valid data)in 205 data,which excluded the 9 interviewees for lost visits and incomplete data.There was no significant difference in demographic data between the intervention care group and the conventional care group which included 98 patients respectively.(P> 0.05).Patients in the two groups both had poor knowledge of diabetes,and there was no significant difference between the two groups at baseline(P> 0.05).After 6 months' intervention,the knowledge rate of diabetes in SNIC group improved more than that in CC group and there had a statistic difference(P< 0.05).Before the intervention,the health behaviors of diabetes in two groups had no significant difference(P> 0.05);After 6 months' intervention,the health behaviors of diabetes in SNIC group improved significantly compared with those in CC group(P< 0.05).And the fasting blood glucose,glycosylated hemoglobin and body mass index in two groups had no difference before the intervention(P> 0.05).After 6 months' intervention,the fasting blood glucose,glycosylated hemoglobin and BMI in both groups improved,the first two index improved significantly more than that in CC group(P<0.05)while the last one had no statistically difference.Conclusion:Patient's blood glucose control level and satisfaction could be enhanced by the management of senior nurse,which could provide a reference for China's community diabetes management.Arranging senior nurses in communities is a conducive way to increase the accessibility of high-quality nursing resources in the community,expanding the practice scope of senior nurses,and improving senior nurses' professional value,which also provide a reference for the development of advanced nurse practioner in communities. |
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