Leadership in Self-Care for Outpatient Diabetes Patients

by lkts1ji2kod on 2011-04-07 12:31:59

[Key words] Diabetes; Patient; Nursing Guidance

With the improvement of people's living standards, diabetes has become a common and prevalent disease that severely endangers human health, and it is also a disease that is easily neglected by people [1]. Through providing self-care guidance to outpatient diabetes patients, we have achieved good results in controlling blood sugar levels and preventing complications.

1 Materials and Methods

1.1 Personal Data: From April to October 2008, nurses at the health education consultation service desk of our hospital provided nursing guidance to 480 diabetic patients. Among them, there were 276 males and 204 females, aged between 16 and 78 years old, with an average age of 47 years. 325 had a junior high school education or above, and 155 had a college degree or above. All were type 2 diabetic patients.

1.2 Method: One-on-one nursing guidance was provided to patients who came to the health education consultation service desk to inquire about diabetes knowledge. Patients were encouraged to study diabetes-related books, and relevant books on the prevention and treatment of diabetes through diet and lifestyle were provided for them to copy, borrow, and read. Health education prescriptions and diabetes knowledge booklets were distributed free of charge.

2 Self-Care Guidance for Diabetic Patients

2.1 Psychological Nursing Guidance: The onset of diabetes, like other diseases, involves biological, social, and psychological factors, with social and psychological factors playing a significant role. Patients newly diagnosed with diabetes often experience anxiety and fear, while those with chronic diabetes have a strong desire for a cure. By addressing these psychological factors, health care guidance can help patients correctly understand and deal with their illness, explaining the importance of positive emotions and systematic treatment in controlling blood sugar levels. Encourage patients to bravely face reality and build confidence in overcoming the disease.

2.2 Guidance to Avoid Misconceptions: Diabetes is a chronic lifelong disease. A lifelong disease means that once contracted, it cannot be completely cured, which applies to diabetes. Some diabetic patients do not fully embrace their patient role after being diagnosed and pay little attention to their diet. Others believe media advertisements and secret remedies, which is unscientific. Since diabetes is a genetic condition, "one-time cures" are impossible until gene therapy becomes available. Irresponsible advertisements can only lead to financial loss and delayed treatment for patients.

2.3 Dietary Nursing Guidance: Dietary therapy is the most basic and important treatment method for diabetes. Diabetic patients must control their blood sugar through diet while maintaining normal nutritional needs to carry out daily work and life. Therefore, dietary therapy is crucial for diabetic patients [2]. Under the guidance of medical staff, diabetic patients should develop meal plans based on personal eating habits. The three major nutrients should be reasonably balanced, with a varied diet, allowing small frequent meals and avoiding smoking and alcohol. Diabetic patients should follow the "four fixed one unfixed" dietary principle: fixed time, fixed meal, fixed quantity, fixed nutrients, but unfixed food types, restricting carbohydrate intake.

2.4 Exercise Nursing Guidance: Exercise therapy is a treatment method applied to diabetic patients. Muscle exercise can promote glucose uptake and lower blood sugar [3]. Scientific exercise can improve cardio-pulmonary function, relieve stress, and regulate the body’s immune system. Diabetic patients can choose light, slow-paced exercise methods according to their physical condition and preferences, with a planned routine and persistence, such as walking, jogging slowly, practicing Tai Chi, etc. Exercise time should be chosen 1~1.5 hours after meals, 20~30 minutes per session, at least 5 times a week.

2.5 Medication Nursing Guidance: When diet and exercise therapies do not adequately control the condition, drug treatment should be considered. Oral hypoglycemic drugs should be taken according to the doctor's instructions, on time and in the correct dosage. Do not arbitrarily increase or decrease the dose, switch medications, or trust secret recipes or folk remedies. Scientific treatment should be maintained. Understand the pharmacological effects, side effects, usage, and dosage of the prescribed hypoglycemic drugs, and guide patients on simple methods to handle hypoglycemia when it occurs.

2.6 Blood Sugar Monitoring Guidance: If diabetes is not properly controlled, various complications may arise. Therefore, patients or their families should learn how to monitor blood sugar and urine sugar levels. Nowadays, self-testing blood glucose meters and urine sugar test strips are readily available. Special emphasis is placed on monitoring postprandial 2-hour blood glucose, with timing starting from the first bite of food. Through self-monitoring, necessary information can be provided and help patients effectively control their blood sugar.

2.7 Lifestyle Nursing Guidance: Guide patients to develop good living habits, paying attention to personal hygiene, especially skin and foot hygiene, avoiding colds, and having a regular lifestyle. Elderly patients should carry sweets and emergency cards when going out. The content of the emergency card includes: name, address, contact telephone number, indicating that they have diabetes, and if fainting occurs, please provide sweets or send them to the hospital.

3 Conclusion

Diabetes is a common endocrine metabolic disease. The fundamental pathological change is the disorder of sugar, fat, protein metabolism, and secondary vitamin, water, electrolyte metabolism caused by relative or absolute insulin deficiency. It is one of the major diseases affecting health and threatening human life. In the early stages, there are no symptoms, but as it progresses, clinical manifestations such as polyuria, polydipsia, polyphagia, fatigue, and weight loss may appear. Severe cases can lead to ketoacidosis or hyperosmolar coma. During the course of the disease, cardiovascular, renal, ocular, neurological diseases, and infections often occur as complications. Therefore, early detection, long-term treatment, and scientific nursing to prevent complications are crucial. After receiving guidance from nurses, diabetic patients gain a basic understanding of diabetes, eliminate anxiety, reduce mental burdens, correctly approach their disease, maintain proper diet, exercise, and drug treatment, keeping blood sugar, blood pressure, and cholesterol within normal ranges. This enhances the patient's self-care ability, improves bodily functions, effectively reduces complications, and thereby improves quality of life.

[Reference]

[1] Dai Zhenhua. Investigation and Analysis of Diabetes Patients' Health Knowledge Level and Nursing Countermeasures [J]. Traditional Chinese Medicine Guide, 2005, 11(7):73.

[2] Chen Fang. Health Education Intervention on Lifestyle of Diabetic Patients [J]. Journal of Qiqihar Medical University, 2006, 27(13):188.

[3] Huang Jinfang, Liu Yuying. Nursing Health Education [M]. Beijing: Science and Technology Press, 2005:177.

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