Effects of comprehensive nursing combined with rehabilitation intervention among elderly patients with diabetes mellitus
SHI Yaoxiong, XU Jie, WANG Xiaoying, HU Tao, FANG Zhen
Wenhui Street Community Health Service Center of Gongshu District (Gongshu District Traditional Chinese Medicine Hospital), Hangzhou, Zhejiang 310004, China
Abstract：Objective To evaluate the intervention effects of comprehensive nursing combined with rehabilitation intervention among elderly patients with diabetes mellitus in community settings, so as to provide the evidence for optimizing personalized management strategies for elderly diabetes and improving patients' quality of life at primary healthcare institutions. Methods A stratified random sampling method was used to select patients with diabetes mellitus aged ≥65 years who were under contracted management at Wenhui Subdistrict Community Health Service Center in Gongshu District, Hangzhou City from January 2023 to January 2024. The participants were randomly divided into an intervention group and a control group. The control group received routine community management, while the intervention group received comprehensive nursing combined with rehabilitation intervention in addition to routine management. The intervention period lasted 3 months, with follow-up until 6 months. Demographic information, lower extremity vascular status, and blood pressure levels were collected through Hangzhou Community Health Service Information System. Fasting plasma glucose, 2-hour postprandial blood glucose, and glycated hemoglobin were measured. Quality of life and adherence were assessed using the SF-36 Health Survey Scale and the Community Diabetes Patient Adherence Scale, respectively. Repeated-measures analysis of variance was used to compare differences between the two groups before and after intervention. Results The intervention group comprised 60 patients, including 32 males and 28 females, and the control group comprised 60 patients, including 30 males and 30 females. No statistically significant differences were found in baseline characteristics between the two groups, including gender, age, duration of diabetes, hypertension comorbidity, glycated hemoglobin, and quality of life scores (all P>0.05). Repeated-measures analysis of variance showed that at 3 months of intervention, there were significant interaction effects between group and time for fasting plasma glucose, 2-hour postprandial blood glucose, and glycated hemoglobin (all P<0.05), with greater reductions in the intervention group than in the control group. At 6 months of follow-up, there were significant interaction effects between group and time for all dimensions of quality of life scores (all P<0.05), with greater increases in the intervention group than in the control group, and scores were higher than those before intervention (all P<0.05). The rates of adherence, improvement in lower extremity vascular lesions, and blood pressure control achievement in the intervention group were higher than in the control group (95.00% vs. 78.33%, 86.67% vs. 51.66%, and 80.00% vs. 58.33%, all P<0.05). Conclusion Comprehensive nursing combined with rehabilitation intervention can improve blood glucose control, enhance quality of life, and increase the improvement of lower extremity vascular lesions rate and the blood pressure control achievement rate in elderly patients with diabetes.
[1] 任洁,鹿斌.《中国老年糖尿病诊疗指南(2024版)》指导下老年糖尿病的诊治重点与策略革新[J].中华全科医学,2025,23(11):1825-1829. [2] 杨盛谊,丁晓宇,杨卓乔,等.杭州市中老年人群2010—2018年“三高”指标变化趋势分析[J].中国全科医学,2020,23(18):2235-2241. [3] 骆雅萍,于淑娟,朱苗苗,等.社区老年糖尿病患者自我忽视的诠释性现象学研究[J].中华护理杂志,2024,59(2):203-209. [4] 中华人民共和国国家卫生健康委员会.关于加强基层慢性病健康管理服务的指导意见[EB/OL].[2026-02-24].https://www.nhc.gov.cn/jws/c100073/202510/3974d142eb1c4dd385b6e880f8617dcc.shtml. [5] LIU X Y,ZHANG L Y,FAN X Q,et al.Impact of family doctor system on diabetic patients with distinct service utilisation patterns:a difference-in-differences analysis based on group-based trajectory modelling[J/OL].BMJ Glob Health,2024,9(9)[2026-02-24].https://doi.org/10.1136/bmjgh-2023-014717. [6] 王素华,李立明,李俊.SF-36健康调查量表的应用[J].国外医学(社会医学分册),2001,18(1):4-8. [7] 孟亚军,李宁秀,陈建华,等.SF-36在中国HIV感染者中应用的信度和效度[J].现代预防医学,2007,34(13):2410-2412,2415. [8] 王洁,莫永珍,卞茸文,等.中文版8条目Morisky用药依从性问卷在老年2型糖尿病患者中应用信效度[J].中国老年学杂志,2015,35(21):6242-6244. [9] 李元召,吴斌,印其忠,等.传统运动模式干预社区2型糖尿病患者的效果评价[J].上海医药,2020,41(4):43-44,56. [10] 王春莉,李雪,范玉满,等.医养结合模式护理干预对老年2型糖尿病患者血糖水平、自我管理能力及心理状态的影响[J].黑龙江医药科学,2025,48(9):181-183,186. [11] GOODALL R J,ELLAUZI J,TAN M K H,et al.A systematic review of the impact of foot care education on self efficacy and self care in patients with diabetes[J].Eur J Vasc Endovasc Surg,2020,60(2):282-292.
