| Objective: To develop a simple identification table of Yin deficiency in senile diabetes mellitus by quantifying and evaluating the early symptoms of senile diabetes mellitus and objectively recognizing the relationship between symptoms and constitution.Guided by the theory of "IKAP" and using the "two-eight rule",a health education program for elderly diabetes with key elements at the top was constructed,and the nursing intervention plan of syndrome differentiation which around the monitoring assessment of the early symptoms of the disease and the health behavior correction was formed.Methods:(1)Through the review of the clinical medical records of 262 elderly patients with Yin deficiency constitution admitted to a level-A hospital of traditional Chinese medicine in Hunan province from January 2017 to December 2019,the frequency of senile diabetes-related constitution syndrome was counted,and the Questionnaire of Correlation between Yin Deficiency Constitution and Diabetes in the Elderly was formed.(2)Sixty cases of elderly diabetic patients with Yin deficiency constitution admitted to 3 Grade A hospitals of traditional Chinese medicine in Hunan province from November 2020 to January 2021 were selected and included.The self-made Questionnaire of Correlation between Yin Deficiency Constitution and Diabetes in the Elderly and the Classification and Determination Scale of TCM Constitutions in the Elderly(over 65 years old)developed by Wang Qi’s team were used for a cross-sectional investigation to analyze the correlation between the constitution elements of Yin Deficiency Constitutions and diabetes symptoms,and to develop a simple identification table of Yin Deficiency Constitutions in the Elderly Diabetes.The data of 30 elderly people with Yin deficiency but without diabetes were collected from other departments of the three surveyed hospitals as the control group,and the data of 30 patients from the original investigation group were randomly selected as the experimental group to verify the effectiveness of the simple identification table for senile diabetes with Yin deficiency.Through the stepwise discriminant analysis method,the valuable syndrome elements for discriminating Yin deficiency constitution were screened out,and then the OR value of each effective syndrome element was calculated to clarify the close degree of connection between each syndrome element and constitution.Pearson’s chi-square test was performed on the results of the two groups through a controlled clinical trial to confirm their validity,P<0.05 was considered to be statistically significant.(3)The first round of Delphi expert letter questionnaire was developed through literature research,and the second and third rounds of questionnaires were formed on the basis of the analysis of the results of the previous round.After three rounds of Delphi expert letter consultation,experts’ enthusiasm,authority,coordination coefficient,as well as the mean,standard deviation and coefficient of variation of each item were calculated respectively,and the items with the mean of importance score ≥4.5 and coefficient of variation <0.2 were selected to form the senior diabetes health education program with the top key elements.Results:(1)By retrospective study of medical records and cross-sectional investigation,stepwise discriminant analysis was used to screen out 5 syndromal elements closely related to Yin deficiency in senile diabetes mellitus,including thirst to drink,bitter mouth,dry stool,dry mouth and pharynx,and numbness at the ends of limbs.The accuracy of 5 syndrome elements was 98.3% when discriminating the constitution of the original 60 patients.(2)The clinical control experiment was conducted by using the simple identification table of Yin deficiency and substance in senile diabetes mellitus.There was no statistical significance between the two groups in gender,age,marital status,residence status,education level and other aspects(P>0.05),which was comparable.In terms of the accuracy of constitution judgment results,the experimental group was much higher than the control group.According to Pearson’s chi-square test,the difference between the two groups was statistically significant(P<0.05).(3)Through literature research,the first draft of the Delphi Expert Letter Questionnaire was formed.In three rounds of Delphi expert letter consultation,the enthusiasm of experts was 100%,and the authority coefficients were 0.939,0.947 and0.969,respectively.After three rounds of consultation,the experts’ opinions on each item were consistent(P<0.05),and a health education program for elderly diabetes with key elements at the top was preliminarily formulated.Conclusion:(1)Thirst to drink,bitter mouth,dry stool,dry mouth and pharynx,numbness of extremities are closely related to Yin deficiency in senile diabetes mellitus.(2)A simple identification table for Yin deficiency in senile diabetes has been preliminarily constructed,which has been clinically verified and has the potential for promotion and application.(3)The elderly diabetes health education program with the top key elements focuses on the cognitive and physiological characteristics of the elderly population,which is expected to have a positive impact on the early prevention and control of elderly diabetes. |
