论文部分内容阅读
目的探讨随时间推移2型糖尿病患者对自我血糖监测的看法。设计纵向、定性研究。地点苏格兰洛锡安地区初级和中级医疗保健机构。患者 18名2型糖尿病患者。结局评估指标患者糖尿病临床诊断确立后4年内,通过对其反复深入的随访获得的结果。结果分析研究揭示了3个方面的主题——专业医务人员的作用;对血糖值的理解和对高血糖的处理;及自我血糖监测的作用。自我监测之所以随着时间的推移出现了减少,专业医务人员的行为在其中起着关键性的作用:患者解释说医生注重的是糖化血红蛋白水平,认为对他们自己监测的血糖值不感兴趣,好像是暗示血糖自我监测不值得继续进行。一些患者将血糖值看作是好坏行为的象征——尤其是女性,当血糖高时会惩罚她们自己。一些患者坚持自我监测,发现血糖值难以理解,并且不知道如何处理高血糖。使自己放心和习惯是坚持自我监测的主要原因。只有很少一部分患者利用自我监测来实行和维持行为方式的改变。结论患者的言论反映了2型糖尿病自我血糖监测的有效性和作用在临床上尚未被肯定。患者对自我监测的结果未采取相应的措施,部分是因为缺乏处理高血糖或低血糖的教育。专业医务人员的态度应该明确:患者到底应不应该、什么时候进行自我监测以及他们应该如何理解并处理血糖监测结果,尤其是高血糖。
Objective To investigate the self-monitoring of blood glucose in type 2 diabetic patients over time. Design longitudinal, qualitative research. Location Primary and secondary health care facilities in Lothian, Scotland. 18 patients with type 2 diabetes. Outcome Measures The outcomes of patients with diabetes after 4 years of clinical diagnosis were established through repeated follow-up visits. Results Analysis The study revealed three topics - the role of professional medical staff; understanding of blood glucose levels and the treatment of hyperglycemia; and the role of self-monitoring of blood glucose. The reason why self-monitoring has diminished over time is that professional medical practitioners play a crucial role: Patients explain that physicians focus on glycosylated hemoglobin levels and are not as interested in the blood glucose level they themselves monitor, as if It is implied that blood glucose self-monitoring is not worth continuing. Some patients see the value of blood sugar as a symbol of good and bad behavior - especially in women who punish themselves when the blood sugar is high. Some patients insist on self-monitoring, found that blood glucose levels difficult to understand, and do not know how to deal with high blood sugar. Maintaining self-reliance and habit is the main reason for insisting on self-monitoring. Only a small percentage of patients use self-monitoring to implement and maintain behavioral changes. Conclusion The patient’s remarks reflect the validity and role of self-monitoring of blood glucose in type 2 diabetes in clinically unanswered. Patients did not take appropriate measures for the results of self-monitoring, partly because of a lack of education on hyperglycemia or hypoglycemia. The attitude of the professional medical staff should be clear: the patient should not, when self-monitoring and how they should understand and deal with blood glucose monitoring results, especially hyperglycemia.