Development and Application of a Continuity of Care Program for Diabetic Retinopa-thy Patients Based on the Omaha System
OBJECTIVE To explore the construction and application of a continuity of care program for diabetic retinopathy(DR)patients based on the Omaha System.METHODS A total of 104 DR patients treated at the Eye Center of Renmin Hospital of Wuhan University from January 15th,2022,to May 31st,2022,were randomly divided into an observation group and a control group,with 52 patients in each group.The control group received routine DR care and discharge guidance,while the observation group received a continuity of care program built on the Omaha System,implemented once a month for six consecutive months.The self-management level,fasting blood glucose(FBG),postprandial 2-hour blood glucose(PBG),glycated hemoglobin(GH),and retinal screening rates were compared between the two groups before and after the intervention.RESULTS(1)Nursing problems:The observation group had a total of 591 nursing problems,with an average of 11.36 nursing problems per patient.(2)Self-management ability:After the intervention,the scores of various items and the total score in the control group increased compared to before the intervention(tdiet=16.261,texercise= 5.949,tblood glucose monitoring=5.609,tfoot care=7.298,ttotal score=19.147,all P=0.000).After the intervention,the observation group´s scores for various items and the total scores increased compared to before the intervention(tdiet=32.370,texercise=14.915,tblood glucose monitoring=13.248,tfoot care=42.670,ttotal score=45.475,all P=0.000).After the intervention,the observation group´s scores for various items and the total score were higher than those in the control group(tdiet=9.091,texercise=11.996,tblood glucose monitoring= 11.192,tfoot care=38.894,ttotal score=29.149,all P=0.000),with statistically significant differences.(3)Blood glucose control:After the intervention,the levels of postprandial 2 hours blood glucose and glycated hemoglobin in the control group decreased compared to before the intervention(tPBG= 2.245,P=0.029;tGH=7.607,P=0.000).After the intervention,the observation group´s levels of fasting blood glucose,postprandial 2 hours blood glucose,and glycated hemoglobin all decreased compared to before the intervention(tFBG=5.477,tPBG=5.748,tGH=13.101,all P=0.000).After the intervention,the observation group´s levels of fasting blood glucose,postprandial 2 h blood glucose,and glycated hemoglobin were lower than those in the control group(tFBG=4.865,tPBG= 5.174,tGH=7.836,all P=0.000),with significant differences.(4)Retinal screening rate:After the intervention,the retinal screening rate in the observation group was 94.23%,which was higher than the 53.85%in the control group,with statistically significant differences(χ2=22.061,P= 0.000).CONCLUSIONS Constructing and implementing continuity of care based on the Omaha System for DR patients is helpful in assessing patients´ nursing problems,improving self-management,delaying the progression of DR,and has certain clinical application value.
Omaha Systemcontinuity of carediabetic retinopathyself-managementreti-nal screening
NETL
NSTL
万方数据
维普
