医护一体化模式在老年肾功能不全合并糖尿病足患者护理中的应用

doi:10.12209/j.issn2709-1961.202012073

摘要/Abstract

摘要： 目的分析医护一体化模式在老年肾功能不全合并糖尿病足患者护理中的应用效果。方法选取76例老年肾功能不全合并糖尿病足患者作为研究对象，采用随机数字表法将其分成对照组和研究组，各38例。对照组采用常规护理，研究组采用医护一体化模式进行干预。采用舒适状况量表(GCQ)评估患者机体舒适度，统计患者住院时间和并发症发生情况。结果实施护理干预后，2组GCQ评分均较干预前提高，且研究组GCQ评分高于对照组，差异有统计学意义(P＜0.01)。研究组患者住院时间短于对照组，差异有统计学意义(P＜0.01)。2组并发症比较，差异无统计学意义（P＞0.05）。结论医护一体化模式在老年肾功能不全合并糖尿病足患者的护理中应用效果明显，能有效改善患者舒适状况。
关键词: 医护一体化; 肾功能不全; 糖尿病足; 专科护理

关键词: 医护一体化, 肾功能不全, 糖尿病足, 专科护理

Abstract: Objective To investigate the effect of doctor-nurse collaboration model in the nursing of elderly patients with renal failure and diabetic foot. Methods Totally 76 elderly patients with renal failure and diabetic foot were randomly divided into the control group and research group, 38 cases in each group. Patients in the control group received routine nursing management, and those in the study group were given nursing interventions based on doctor-nurse collaboration model. The General Comfort Questionnaire(GCQ) was used to assess patient comfort, and the length of stay and incidence of complications were compared between two groups. Results The GCQ scores of two groups were increased after nursing interventions, and GCQ score in the study group was higher than that in the control group (P＜0.01). The length of stay in the study group was shorter than that in the control group (P＜0.01). There was no significant difference in incidence of complications between two groups(P＞0.05). Conclusion Nursing interventions based on doctor-nurse collaboration model are effective to improve the comfort of patients with renal failure and diabetic foot.

Key words: doctor-nurse collaboration, renal failure, diabetic foot, specialist care

中图分类号:

R 473.5

郭茹, 张琳, 卓建钦, 雷蕾. 医护一体化模式在老年肾功能不全合并糖尿病足患者护理中的应用[J]. 中西医结合护理, 2021, 7(6): 85-88.

GUO Ru, ZHANG Lin, ZHUO Jianqin, LEI Lei. The application of doctor-nurse collaboration model in the nursing of elderly patients with renal failure and diabetic foot[J]. Chinese Journal of Integrative Nursing, 2021, 7(6): 85-88.

参考文献

[1] 中国中西医结合学会肾脏疾病专业委员会. 慢性肾衰竭中西医结合诊疗指南[J]. 中国中西医结合杂志, 2015, 35(9): 1029-1033.
THE RENAL DISEASE COMMITTEE OF CHINESE ASSOCIATION OF INTEGRATIVE MEDICINE. Traditional Chinese Medicine and Western Medicine Practice Guidance for the Diagnosis and Management of Chronic Renal Failure[J]. Chin J Integr Tradit West Med, 2015, 35(9): 1029-1033.(in Chinese)
[2] 黄丽容, 吕丽雪, 劳美铃, 等. 糖尿病足病人营养风险与其临床预后及生存质量的关系[J]. 护理研究, 2020, 34(18): 3296-3301.
HUANG L R, LYU L X, LAO M L, et al. Relationship between nutritional risk of patients with diabetic foot and their clinical prognosis and quality of life[J]. Chin Nurs Res, 2020, 34(18): 3296-3301.(in Chinese)
[3] DIETRICH I, BRAGA G A, MELO F G, et al. The diabetic foot as a proxy for cardiovascular events and mortality review[J]. Curr Atheroscler Rep, 2017, 19(11): 1-5.
[4] 韩芳, 陈立英, 王亮, 等. 医护一体化模式管理糖尿病足[J]. 中医学报, 2014, 29(B07): 505.
HAN F, CHEN L Y, WANG L, et al. Manage diabetic foot with doctor-nurse collaborating model[J]. J Henan Univ Chin Med, 2014, 29(B07): 505.(in Chinese)
[5] 闫瑞红, 闫瑞霜, 张爱萍. 医护一体化工作模式在糖尿病足患者创面治疗中的应用[J]. 齐鲁护理杂志, 2018, 24(13): 112-114.
YAN R H, YAN R S, ZHANG A P. Application of doctor-nurse collaborating model in the treatment of diabetic foot wound [J]. J Qilu Nurs, 2018, 24(13): 112-114.(in Chinese)
[6] 陈利鸿, 冉兴无. 糖尿病足的心理社会研究：我们正在取得进步[J]. 中华糖尿病杂志, 2020, 12(7): 451-455.
CHEN L H, RAN X W. Psychosocial research in the diabetic foot: are we making progress? [J]. Chin J Diabetes Mellit, 2020, 12(7): 451-455.(in Chinese)
[7] 高丽, 黄红, 陈娟. 老年糖尿病肾病腹膜透析患者的护理[J]. 现代中西医结合杂志, 2012, 21(29): 3270-3271.
GAO L, HUANG H, CHEN J. Nursing management of elderly patients undergoing peritoneal dialysis for diabetic nephropathy[J]. Mod J Integr Tradit Chin West Med, 2012, 21(29): 3270-3271.(in Chinese)
[8] 李玲, 李姮瑛, 何霁, 等. 糖尿病肾病患者系统健康教育的效果评价[J]. 西部医学, 2012, 24(10): 2014-2015.
LI L, LI H Y, HE J, et al. Effect evaluation of System health education on diabetic kidney disease[J]. Med J West China, 2012, 24(10): 2014-2015.(in Chinese)
[9] 王翔宇, 张倩, 薛耀明. 终末期肾病患者糖代谢紊乱的研究进展[J]. 中华糖尿病杂志, 2021, 13(1): 10-13.
WANG X Y, ZHANG Q, XUE Y M. Research progress of disorders of glucose metabolism in patients with end-stage renal disease[J]. Chin J Diabet, 2021, 13(1): 10-13.
[10] 帅记焱, 徐江祥, 黄小红, 等. 糖尿病足综合康复治疗的临床疗效观察[J]. 中华物理医学与康复杂志, 2012, 34(2): 125-128.
SHUAI J Y, XU J X, HUANG X H, et al. Clinical effects of comprehensive rehabilitation therapy on patients with a diabetic foot[J]. Chin J Phys Med Rehabilitation, 2012, 34(2): 125-128.(in Chinese)
[11] PAISEY R B, ABBOTT A, LEVENSON R, et al. Diabetes-related major lower limb amputation incidence is strongly related to diabetic foot service provision and improves with enhancement of services: peer review of the South-West of England[J]. Diabet Med, 2018, 35(1): 53-62.
[12] 马晓龄. 医护一体化康复护理在老年慢性肾功能衰竭维持性血液透析患者中的应用[J]. 中国医药指南, 2020, 18(22): 12-14.
MA X L. Application of integrated doctor-nurse rehabilitation nursing in senile chronic renal failure patients with maintenance hemodialysis[J]. Guide China Med, 2020, 18(22): 12-14.(in Chinese)
[13] 龚艳, 杨莉琴, 张霞, 等. 医护一体化在糖尿病足伤口治疗中的应用[J]. 现代医药卫生, 2017, 33(24): 3839-3842.
GONG Y, YANG L Q, ZHANG X, et al. Application of doctor-nurse collaboration in the treatment of diabetic foot wound[J]. J Mod Med Heal, 2017, 33(24): 3839-3842.(in Chinese)

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