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目的 探讨共同照护模式对2型糖尿病患者教育管理的效果,以期建立更高效的糖尿病教育管理模式.方法 选取2017年8-10月就诊于首都医科大学附属北京潞河医院内分泌科门诊2型糖尿病患者共210例.按照随机数字表法分为干预组和对照组,每组105例.干预组最终完成研究103例,对照组完成100例.其中干预组采用共同照护教育模式,对照组采用常规教育管理模式.干预时间为12个月,最终对203例患者的糖化血红蛋白(HbA1c)、体质量指数(BMI)水平及糖尿病自我行为管理能力进行比较.结果 干预后,干预组HbA1c、BMI分别为(6.47 ± 0.66)%、(22.28 ± 2.41)kg/m2,对照组分别为(6.90 ± 0.61)%、(23.49 ± 1.59)kg/m2,2组比较差异有统计学意义(t=-4.63、0.00,P<0.01).干预后,干预组糖尿病自我管理能力健康饮食、运动、自我血糖监测、遵医嘱监测血糖、自我足部检查、用药评分分别为(6.08 ± 1.34)、(6.06 ± 1.59)、(5.18 ± 2.00)、(5.28 ± 1.99)、(4.64 ± 2.54)、(6.80 ± 0.55)分,对照组分别为(5.43 ± 1.71)、(5.46 ± 1.89)、(4.27 ± 1.64)、(4.23 ± 1.64)、(3.57 ± 2.74)、(5.30 ± 2.68)分,2组比较差异有统计学意义(t=-4.03～-2.73,P<0.05).结论 相对于传统教育管理模式而言,共同照护模式以患者为中心,整合多学科人员共同协作,为患者提供系统化、规范化、个性化的管理,共同照护模式改善2型糖尿病患者血糖水平及自我管理能力效果更佳.

Objective To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM. Methods Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant. Results At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/㎡, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/㎡, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P<0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P < 0.05). Conclusion Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.