| ObjectiveBy studying the application of health education based on the PRECEDE-PROCEED Model in the prevention of osteoporosis in patients with type2 diabetes,improving the level of self-management of patients with type 2 diabetes in preventing chronic complications of osteoporosis,the PRECEDE-PROCEED Model for the community is developed as the theoretical framework of the health education plan provides a reference basis for the development and implementation of clinical and community type 2 diabetes with osteoporosis prevention strategies.Methods1.Review the literature and interview the patients with type 2 diabetes,analyze the risk factors related to type 2 diabetes with osteoporosis from the aspects of propensity factors,contributing factors and strengthening factors.With reference to the China Guidelines for the Prevention and Treatment of Type 2 Diabetes and the International Osteoporosis Risk Assessment Form,an initial questionnaire was prepared and pre-tested,and the validity and reliability of the questionnaire were evaluated.The final formal questionnaire was formed after revision.2.A total of 220 patients with type 2 diabetes who were examined at Xiguan Community and Hutai Community Health Service Center in Chengxi District,Xining City from June 2018 to December 2019 were selected as the formal survey objects.They were randomly divided into a control group and a experimentalgroup.The conventional health education model was adopted.The experimental group adopted the PRECEDE-PROCEED health education on the basis of the control group.The formal formwas used for testing.The relevant data were collected before the intervention,6 months,12 months,and 18 months after the intervention.toevaluate the effect of the intervention.Result1.The questionnaire for the prevention of osteoporosis in patients with type2 diabetes has five dimensions,including knowledge,attitude,behavior,contributing factors and strengthening factors,with a total of 36 items.After pre-experimentation,the internal reliability of the questionnaire was 0.949,and the internal reliability of each dimension was 0.930(knowledge),0.761(attitude),0.818(behavior),0.649(enabling factor),and 0.718(reinforcing factor).The retest reliability of the questionnaire was 0.945,and the retest reliability of each dimension was 0.933(knowledge),0.774(attitude),0.823(behavior),0.656(contributory factor),and0.764(reinforcement factor).2.Before receiving health education,there was no statistically significant difference in the knowledge dimension scores between the test group and the control group,which was comparable.The scores of the knowledge dimension of the experimental group at the three time points after the intervention were significantly higher than those of the control group(P <0.05).This shows that the knowledge of diabetes in the experimental group is better than that in the control group.At the same time,the difference becomes more obvious as time goes on.3.There was no significant difference in the knowledge dimension score between the experimental group and the control group before the intervention(P>0.05),which is comparable;the score of the knowledge dimension of the experimental group at the three time points after the intervention was significantly higher than that of the control group(P <0.05).This shows that the improvement ofdiabetes attitude in the experimental group is better than that in the control group,and the difference is more obvious as time goes on.4.There was no significant difference in behavioral dimension scores between the experimental group and the control group before and 6 months after the intervention(P> 0.05);the behavioral dimension scores of the experimental group at12 and 18 months after the intervention were significantly higher than the control group(P < 0.05).The above results show that the compliance of the patients in the experimental group was better than that in the control group.5.There was no significant difference between the experimental group and the control group in promoting dimension scores before and 6 months after intervention(P> 0.05);the experimental group’s contributing dimension scores were significantly higher in the experimental group than in the control group at 12 and 18 months after intervention(P < 0.05).The above results show that the experimental group is better than the control group in improving the contributing factors.6.There was no significant difference in the scores of the reinforcement dimension between the experimental group and the control group before intervention,6 months after the intervention,and 12 months after the intervention(P> 0.05).0.05).The above results indicate that the improvement effect of the enhancement factor in the experimental group is better than that in the control group.7.There was no significant difference of fasting blood glucose between the experimental group and the control group before the intervention and 6 months after the intervention(P> 0.05);the experimental group at the 12 and 18 months after the intervention was significantly lower than the control group(P <0.05)For 2-hour postprandial blood glucose,there was no significant difference between the experimental group and the control group before the intervention(P> 0.05);the experimental group at 6 months,12 after the intervention,and 18 months after the intervention was significantly lower than the control group(P < 0.05).According to the above results,the blood glucose control in the experimental group was better than that in the control group.In conclusion1.The questionnaire for prevention of osteoporosis in patients with type 2diabetes prepared using the PRECEDE-PROCEED Model as a theoretical framework has good reliability and validity,which can provide theoretical support for clinical and community doctors to assess the risk of osteoporosis in patients with type 2diabetes.2.The health education based on the PRECEDE-PROCEED Model can significantly improve the awareness rate of osteoporosis-related knowledge in patients with type 2 diabetes,strengthen the confidence in treating the disease and the sense of responsibility for self-management,strengthen treatment compliance,improve lifestyle,and better Control blood sugar level,improve patients’ self-management ability,prevent and cure complications,and effectively increase the levels of their contributing factors and strengthening factors,and ultimately achieve the purpose of preventing osteoporosis. |
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