論文題目：護理干預在改善老年糖尿病人營養(yǎng)狀況中的應用 摘 要 研究目的 通過對2 型糖尿病患者(type 2 diabetes metillus,T2DM)進行個體化健 康教育及個體化、量化飲食護理，探討適合本地區(qū)飲食習慣的糖尿病飲食護理 模式，提高患者生活質(zhì)量。 研究方法 在我市48 個社區(qū)中隨機選取4個社區(qū)，在社區(qū)內(nèi)以自愿為原則選擇100 例T2DM 患者作為研究對象，采用食物頻率表調(diào)查患者營養(yǎng)狀況并測量空腹血糖及糖化血紅蛋白水平。對照組患者接受群體健康教育，護理組患者在群體健康教育基礎上接受個體化健康教育及個體化、量化飲食指導。護理三個月后評價血糖、糖化血紅蛋白控制情況。 研究結果 (1) 護理前T2DM 患者的營養(yǎng)狀況，總能量(男，2215kcal vs. 1900kcal;女，1897kcal vs. 1800kcal)高于營養(yǎng)治療原則推薦值(P<0.05)，能量來源分配不合理，脂肪供熱比為32%，高于推薦攝入量(20%~30%)，碳水化合物供熱比為52%， 低于推薦攝入量(55%~60%).維生素C(70.85±61.25mg vs. 100mg)、維生素B1(0.87±0.38mg vs. 1.3mg) 、維生素E(7.02±3.23mg vs. 10mg) 及鈣(706.93±311.97mg vs. 1000mg) 的攝入量明顯低于推薦攝入量. (2) 護理前兩組患者對糖尿病相關知識知曉率普遍較低。護理結束后，對照組和護理組對各項知識的知曉率均有所提高，且從提高的百分率看，護理組提高更為明顯。護理前對照組和護理組患者對能否預防糖尿病、能否控制糖尿病及控制糖尿病的信心差異無統(tǒng)計學意義(P>0.05)。 研究結論 (1) T2DM 患者營養(yǎng)狀況：總能量攝入過高；熱能來源比例分配不當；某些維生素及礦物質(zhì)攝入不合理；膳食纖維攝入量也明顯低于推薦攝入量。 (2)個體化健康教育及個體化、量化飲食能夠通過增加患者的知識，改變患者的態(tài)度，進而改變不良行為，從而有效控制血糖。
關鍵詞: 2型糖尿病；體重指數(shù)；空腹血糖 營養(yǎng)治療
研究類型：類實驗性研究
Title: The effective of dietary intervention in patients with old Diabetes Mellitus ABSTRACT Objective: To explore the reasonable dietary intervention mode of type 2 diabetes mellitus (T2DM) and to improve the quality of life in patients with T2DM.Through group health education among all the patients and quantized dietary intervention in individual. Methods: Randomly sampled four communities among 48 communities in Tangshan city. 25 volunteers with T2DM were selected in every community. A total of 100 patients were randomly allocated into the control group and the intervention group on the base of community. The nutrition status of subjects was investigated by Food Frequency Questionnaire, and fasting plasma glucose (FPG) and HbAlc were tested. All the subjects received health education and dietary counseling both in control group and the intervention group within 3 months. Additionally the subjects in the intervention group received individualized health education and quantized dietary counseling from community doctors who were trained during the period of intervention. Results:(1) The intake of total energy (men, 2215kcal vs. 1900kcal; women,1897kcal vs. 1800kcal) was significantly higher than nutrition therapy principle recommendation value (P<0.05). The proportion of energy resources wasunreasonable. The fat (32% vs. 20%~30%) and the carbohydrate (52% vs.55%~60%) were higher and lower than recommendation nutrition intake (RNI). (2)Before the intervention, the rates of awareness among all the subjects are generally low. After the intervention, though the rates of awareness both in the control group and the intervention group rose, the rate in the intervention group rose more than in the control group. Before the intervention, the rates of attitude and confidence related with diabetes between two groups were not significantly different (P>0.05). Conclusion: The result indicates that，based on correctly evaluating the behavior state of patients，paramedic staff should apply the“Family—Centered Care”principle to practice psychological health education to the NS children and their whole families．These Call not only boost the combined therapy efficacy of disease，but also promote optimization of the family environment，which Can improve the life quality and enhance attending ability of family members，and then achieve the real meaning health．At the same time，it also provide new theory basis and methods for pediatrics clinic nursing practice．
Key words:type 2 diabetes mellitus; individualized; health education; dietary intervention Type:Experimental research
