健康与疾病发育起源理论指导膳食护理对妊娠期糖尿病病人自我管理能力和妊娠结局的影响

    Influence of dietary nursing guided by developmental origins of health and disease on self-management ability and pregnancy outcome of patients with gestational diabetes mellitus

    • 摘要:
      目的 探讨健康与疾病发育起源理论指导膳食护理对妊娠期糖尿病(GDM)病人自我管理能力和妊娠结局的影响。
      方法 采用简单随机抽样法选择93例GDM病人作为研究对象,随机分为对照组47例和观察组46例。对照组病人实施常规膳食护理,观察组病人实施健康与疾病发育起源理论指导的膳食护理。比较2组病人干预前后的自我管理能力、饮食行为依从性、血糖水平及妊娠结局。
      结果 确诊当日,2组病人GDM孕妇自我管理评价量表(SSPGDM)、2型糖尿病患者饮食行为依从性测评量表(DBCS-T2DM)各维度评分及总分差异无统计学意义(P>0.05);干预8周后,2组病人SSPGDM、DBCS-T2DM各维度评分及总分均高于确诊当日(P < 0.05),且观察组病人SSPGDM、DBCS-T2DM各维度评分及总分均高于对照组(P < 0.05~P < 0.01)。组内比较显示,2组病人干预2、6、8周后餐后2 h血糖均低于确诊当日(P < 0.05),干预6、8周后餐后2 h血糖均低于干预2周后(P < 0.05),干预8周后餐后2 h血糖低于干预6周后(P < 0.05)。组间比较显示,确诊当日、干预2周后2组病人空腹血糖和餐后2 h血糖差异无统计学意义(P>0.05),干预6、8周后观察组病人空腹血糖和餐后2 h血糖均明显低于对照组(P < 0.01)。
      结论 针对GDM病人实施健康与疾病发育起源理论指导的膳食护理,能有效提高其自我管理能力和饮食行为依从性,对改善病人血糖水平和妊娠结局有积极作用。

       

      Abstract:
      Objective To investigate the influence of dietary nursing guided by developmental origins of health and disease on self-management ability and pregnancy outcome of patients with gestational diabetes mellitus(GDM).
      Methods Ninety-three patients with GDM were selected by simple random sampling, and randomly divided into the control group(47 cases) and observation group(46 cases).The control group received the routine diet nursing, the observation group received diet nursing guided by developmental origins of health and disease.The self-management ability, diet behavior compliance, blood glucose level and pregnancy outcome before and after intervention were compared between two groups.
      Results On the day of diagnosis, there was no statistical significance in the scores and total scores of GDM maternal self-management evaluation scale(SSPGDM) and dietary behavior compliance scale for patients with type 2 diabetes mellitus(DBCS-T2DM) between two groups(P>0.05).After 8 weeks of intervention, the each dimension scores and total scores of SSPGDM and DBCS-T2DM in two groups were higher than those on the day of diagnosis(P < 0.05), and the each dimension scores and total scores of SSPGDM and DBCS-T2DM in the observation group were higher than those in control group(P < 0.05 to P < 0.01).The results of intra-group comparison showed that the 2 h postprandial blood glucose in two groups after 2, 6 and 8 weeks of intervention were lower than that on the day of diagnosis(P < 0.05), the 2 h postprandial blood glucose in two groups after 6 and 8 weeks of intervention were lower than that after 2 weeks of diagnosis(P < 0.05), and the 2 h postprandial blood glucose after 8 weeks of intervention in two groups were lower than that after 6 weeks of interventionn(P < 0.05).The results of inter-group comparison showed that there was no statistical significance in fasting blood glucose and 2 h postprandial blood glucose between two groups on the day of diagnosis and after 2 weeks of intervention(P>0.05), and the fasting blood glucose and 2 h postprandial blood glucose in the observation group were significantly lower than those in control group after 6 and 8 weeks of intervention(P < 0.01).
      Conclusions Dietary nursing directed by developmental origins of health and disease for GDM patients can effectively improve their self-management ability and dietary behavior compliance, and has a positive role in improving the blood glucose level of patients and pregnancy outcomes.

       

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