論文編號(hào):HL201  論文字?jǐn)?shù):15116.頁(yè)數(shù):26

論文題目：護(hù)理干預(yù)在改善老年糖尿病人營(yíng)養(yǎng)狀況中的應(yīng)用
摘 要
 研究目的
 通過對(duì)2 型糖尿病患者(type 2 diabetes metillus,T2DM)進(jìn)行個(gè)體化健
康教育及個(gè)體化、量化飲食護(hù)理，探討適合本地區(qū)飲食習(xí)慣的糖尿病飲食護(hù)理
模式，提高患者生活質(zhì)量。
 研究方法
 在我市48 個(gè)社區(qū)中隨機(jī)選取4個(gè)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(duì)象，采用食物頻率表調(diào)查患者營(yíng)養(yǎng)狀況并測(cè)量空腹血糖及糖化血紅蛋白水平。對(duì)照組患者接受群體健康教育，護(hù)理組患者在群體健康教育基礎(chǔ)上接受個(gè)體化健康教育及個(gè)體化、量化飲食指導(dǎo)。護(hù)理三個(gè)月后評(píng)價(jià)血糖、糖化血紅蛋白控制情況。
 研究結(jié)果
  (1) 護(hù)理前T2DM 患者的營(yíng)養(yǎng)狀況，總能量(男，2215kcal vs. 1900kcal;女，1897kcal vs. 1800kcal)高于營(yíng)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(hù)理前兩組患者對(duì)糖尿病相關(guān)知識(shí)知曉率普遍較低。護(hù)理結(jié)束后，對(duì)照組和護(hù)理組對(duì)各項(xiàng)知識(shí)的知曉率均有所提高，且從提高的百分率看，護(hù)理組提高更為明顯。護(hù)理前對(duì)照組和護(hù)理組患者對(duì)能否預(yù)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(jì)學(xué)意義(P>0.05)。
 研究結(jié)論
 (1) T2DM 患者營(yíng)養(yǎng)狀況：總能量攝入過高；熱能來源比例分配不當(dāng)；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(gè)體化健康教育及個(gè)體化、量化飲食能夠通過增加患者的知識(shí)，改變患者的態(tài)度，進(jìn)而改變不良行為，從而有效控制血糖。
 
關(guān)鍵詞: 2型糖尿病；體重指數(shù)；空腹血糖  營(yíng)養(yǎng)治療

研究類型：類實(shí)驗(yàn)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

 目  錄
 摘 要 IV
ABSTRACT V
1 緒論 1
1.1背景及意義 1
1.2目的和目標(biāo) 2
1.3關(guān)鍵詞及定義 2
1.3.1體重指數(shù) 2
1.3.2空腹血糖 2
1.3.3 2型糖尿病 2
1.4 文獻(xiàn)回顧 2
1.4.1老年糖尿病人飲食治療的意義 2
1.4.2老年糖尿病人飲食治療的現(xiàn)狀 4
1.4.3老年糖尿病人膳食結(jié)構(gòu)的現(xiàn)狀 5
2 研究設(shè)計(jì) 7
2.1研究設(shè)計(jì) 7
2.2研究對(duì)象 7
2.3研究工具 7
2.4研究步驟 7
2.5統(tǒng)計(jì)分析 8
3.結(jié)果 9
3.1一般情況比較 9
3.2護(hù)理前患者營(yíng)養(yǎng)狀況 9
3.2.1能量攝入狀況及三大營(yíng)養(yǎng)素供熱比 9
3.2.2營(yíng)養(yǎng)素?cái)z入狀況 9
4.討論 11
4.1T2DM患者的營(yíng)養(yǎng)狀況 11
4.1.1能量攝入狀況及來源分配 11
4.1.2維生素 11
4.1.3礦物質(zhì) 12
4.1.4膽固醇與膳食纖維 12
4.2個(gè)體化、量化飲食護(hù)理效果評(píng)價(jià) 13
5.推論與建議 15
5.1結(jié)論 15
5.2建議 15
5.3本研究局限性及展望 15
致    謝 16
 參考文獻(xiàn) 17