基于ITHBC理論的護理干預聯合健康宣教在GDM患者中的應用

【摘要】 目的：觀察基于健康行為改變整合理論（integrated theory of health behavior change，ITHBC）的護理干預聯合健康宣教在妊娠期糖尿病（gestational diabetes mellitus，GDM）患者中的應用。方法：選取2021年4月—2022年4月玉林市婦幼保健院收治規律孕檢的GDM患者200例，以隨機數字表法分成對照組和觀察組，各100例。對照組給予健康宣教指導，觀察組在常規健康教育宣教指導基礎上給予基于ITHBC理論的護理干預聯合健康宣教。比較兩組健康教育內容掌握評分與健康促進生活方式量表（HPLP）評分及生化指標，統計干預后的遵醫行為情況及GDM患者對干預的滿意度。結果：干預后2周，兩組健康教育內容掌握評分與HPLP評分均較干預前提升，且觀察組均高于對照組（Plt;0.05）。干預后，空腹血糖、餐后2 h血糖水平均較干預前明顯降低，且觀察組均明顯低于對照組，差異均有統計學意義（Plt;0.05）。觀察組各項遵醫行為比例較對照組均明顯升高，差異均有統計學意義（Plt;0.05）。觀察組對干預的總滿意度高于對照組，差異有統計學意義（Plt;0.05）。結論：開展基于ITHBC理論的護理干預聯合健康宣教對GDM的聯合干預手段，可以有效地提升GDM患者對于健康教育內容的掌握及健康行為能力，平穩降低血糖指標，提升遵醫行為與對干預的滿意度，效果理想。

【關鍵詞】 健康行為改變整合理論 護理干預 健康宣教 聯合干預 妊娠期糖尿病

Application of Nursing Intervention Based on ITHBC Theory Combined with Health Education in Patients with GDM/LI Li， LAI Yuqing， ZHAN Xiaofeng. //Medical Innovation of China， 2023， 20（31）： 0-099

[Abstract] Objective： To observe the application of nursing intervention based on integrated theory of health behavior change （ITHBC） combined with health education in patients with gestational diabetes mellitus （GDM）. Method： A total of 200 GDM patients admitted to Yulin Maternal and Child Health Hospital for regular pregnancy examination from April 2021 to April 2022 were selected， and divided into the control group and the observation group by random number table method， with 100 cases in each group. The control group was given routine health education guidance， while the observation group was given nursing intervention combined with health education based on the ITHBC theory on the basis of routine health education guidance. The scores of health education content mastery， health promotion lifestyle profile （HPLP） scores， and biochemical indicators between the two groups were compared， and the compliance behavior and the satisfaction of GDM patients with the intervention after the intervention were calculated. Result： After 2 weeks of intervention， the scores of health education content mastery and HPLP in both groups were improved compared with those before intervention， and those in the observation group were higher than those in the control group （Plt;0.05）. After intervention， the levels of fasting blood glucose and 2 hour postprandial blood glucose were significantly reduced compared with those before treatment， and those in the observation group were significantly lower than those in the control group， the differences were statistically significant （Plt;0.05）. All compliance behaviors proportions in the observation group were significantly increased compared to those in the control group， the differences were statistically significant （Plt;0.05）. The overall satisfaction rate with intervention in the observation group was higher than that in the control group， the difference was statistically significant （Plt;0.05）. Conclusion： Conducting nursing interventions based on the theory of ITHBC combined with health education for GDM can effectively improve GDM patients' mastery of health education content and health behavior abilities， steadily reduce blood sugar indicators， and improve compliance behavior and satisfaction with the intervention， the effect is ideal.

[Key words] Integrated theory of health behavior change Nursing intervention Health education Joint intervention Gestational diabetes mellitus

First-author's address： Yulin Maternal and Child Health Hospital， Guangxi， Yulin 537000， China

doi：10.3969/j.issn.1674-4985.2023.31.022

妊娠期糖尿病（gestational diabetes mellitus，GDM）伴隨著目前人們的生活方式的改變，據相關統計國內GDM的發病率，呈現出一種逐年上升趨勢，增加誘發不良妊娠結局[1]。對其進行營養學指導，可以平穩血糖[2]。結束妊娠之后，可能產生肥胖、糖尿病。……