摘要 目的：探讨基于奥马哈系统的个性化延续护理在糖尿病患者护理中的应用

Abstract Objective: To explore the application effect of personalized continuing care based on the Omaha system in the care of diabetic patients. Methods: A randomized controlled study was used to randomly divide 108 diabetic patients who were treated in our ward from June 2018 to June 2019 into a reference group and an experimental group. The responsible nurses of the reference group gave routine health education and specialized guidance during their hospitalization. When discharged from the hospital, the responsible nurse gave discharge education and paper-based discharge guidance. The evaluation cycle was: 1 week, 1 month, 3 months, and 6 months after discharge, and assessed through a self-made evaluation scale; patients in the experimental group were routinely evaluated after admission. Health education and specialty guidance, point out that on the basis of discharge education and paper-based discharge guidance, and invite patients to join the diabetes continuation care group, implement continuation care intervention based on the Omaha system. The evaluation period is: 1 week after discharge, At 1 month, 3 months, and 6 months, the evaluation was conducted through the evaluation scale, and the effects of the two groups of patients' cognitive and behavioral status were compared. Results: 1 month, 3 months, and 6 months after discharge, patients in the experimental group were significantly higher in disease knowledge, rational use of drugs, reasonable diet, healthy lifestyle, blood glucose compliance rate, and compliance with regular follow-up visits than those in the reference group. The follow-up assessment of the patients in the group was statistically significant (P＜0.05). Conclusion: The application of continuation care intervention based on the Omaha system in diabetic patients can significantly improve the level of disease-related knowledge, rational medication compliance, rational diet compliance, healthy lifestyle compliance, blood glucose compliance rate, and timely follow-up visits Compliance, reduce and prevent the deterioration of the patient’s health, and improve the quality of life of diabetic patients.

摘要 目的：探讨基于奥马哈系统的个性化延续护理在糖尿病患者护理中的应用效果。方法：采用随机对照研究的方法将我病区2018年6月—2019年6月经治的108例糖尿病患者随机分成参照组和实验组，参照组患者住院期间责任护士给予常规健康教育和专科指导，出院时责任护士给予出院宣教和纸质版出院指导，评估周期为：出院后1周、1个月、3个月、6个月，通过自制评估量表进行评估；实验组患者入院后在常规健康教育和专科指导，指出院时行出院宣教和纸质版出院指导的基础上并邀请患者加入糖尿病延续护理群，实施基于奥马哈系统的延续性护理干预，评估周期为：出院后1周、1个月、3个月、6个月，通过评估量表进行评估导，对两组患者认知、行为状况等进行效果比较。结果：实验组患者出院后1个月、3个月、6个月患者疾病知识水平、合理用药性、合理饮食、健康生活方式、血糖达标率和按时复诊依从性明显高于参照组患者，两组患者随访评估比较统计学差异确切（P＜0.05）。结论：基于奥马哈系统的延续护理干预在糖尿病患者中的应用可以明显提高糖尿病患者的疾病相关知识水平、合理用药依从性性、合理饮食依从性、健康生活方式依从性、血糖达标率和按时复诊依从性，减少和预防患者的健康状况恶化，提高糖尿病患者生活质量。

Objective: To explore the application effect of individualized continuous nursing based on Omaha System in the nursing of diabetic patients. Methods: 108 cases of diabetic patients treated in our ward from June 2018 to June 2019 were randomly divided into the reference group and the experimental group. The responsible nurses in the reference group were given routine health education and specialist guidance during hospitalization, and the responsible nurses were given discharge education and paper-based discharge guidance when they were discharged. The assessment period was 1 week, 1 month, 3 months and 6 months after discharge After admission, the patients in the experimental group were given routine health education and specialist guidance, and on the basis of hospital discharge education and paper discharge guidance, patients were invited to join the diabetes continuing care group, and the extended nursing intervention based on Omaha System was implemented. The evaluation cycle was 1 week, 1 month, 3 months and 6 months after discharge The cognitive and behavioral status of the two groups were compared. Results: the level of disease knowledge, rational drug use, reasonable diet, healthy lifestyle, blood glucose compliance rate and timely follow-up compliance of patients in the experimental group were significantly higher than those in the reference group at 1 month, 3 months and 6 months after discharge, and the follow-up evaluation of the two groups was statistically significant difference (P < 0.05). Conclusion: the application of continuous nursing intervention based on Omaha System in diabetic patients can significantly improve the disease-related knowledge level, rational medication compliance, reasonable diet compliance, healthy lifestyle compliance, blood glucose compliance rate and timely follow-up compliance, reduce and prevent the deterioration of patients' health status, and improve the quality of life of diabetic patients.<BR>