罗伊适应模式对妊娠期糖尿病患者的负性情绪、自我效能感及妊娠结局的影响

冯丽 罗旭雯

【摘要】 目的：探討罗伊适应模式对妊娠期糖尿病患者的负性情绪、自我效能感及妊娠结局的应用效果。方法：选取2016年6月-2018年1月于本院确诊并完成分娩的妊娠期糖尿病患者60例作为研究对象，根据随机抽样法将其分成对照组和观察组，各30例。对照组给予常规针对性护理干预，观察组在常规针对性护理的基础上给予罗伊适应模式的护理干预，比较两组干预前后的负性情绪、自我效能感评分及不良妊娠结局的发生情况。结果：干预后，两组SDS和SAS评分与干预前比较均明显降低，且观察组均明显低于对照组，差异均有统计学意义（P<0.05）。干预后两组共性管理、症状管理评分及总分与干预前比较均明显升高，且观察组均明显高于对照组，差异均有统计学意义（P<0.05）。对照组的各项不良妊娠结局发生情况均明显高于观察组，差异均有统计学意义（P<0.05）。结论：采用罗伊适应模式的护理对妊娠期糖尿病患者进行干预，可以有效减轻孕产妇的抑郁程度，改善自我效能状况，减少不良分娩结局的发生，提高患者生活质量水平。

【关键词】 妊娠期糖尿病； 负性情绪； 自我效能； 妊娠结局

【Abstract】 Objective：To explore the application effect of Roys adaptation model on negative emotions，self-efficacy and pregnancy outcomes in patients with gestational diabetes mellitus.Method：A total of 60 patients with gestational diabetes mellitus who diagnosed and delivered in our hospital from June 2016 to January 2018 were selected as the study objects.According to the random sampling method，they were divided into control group and observation group，30 cases in each group.The control group was given routine targeted nursing intervention，the observation group was given Roys adaptation model on the basis of routine targeted nursing intervention.The negative emotion，self-efficacy scores before and after intervention and adverse pregnancy outcomes between the two groups were compared.Result：After intervention，SDS and SAS scores of the two groups were significantly lower than those of before intervention，and the observation group were significantly lower than those of the control group，the differences were statistically significant （P<0.05）.After intervention，the scores of common management，symptom management and total score of the two groups were significantly higher than those of before intervention，and the observation group were significantly higher than those of the control group，the differences were statistically significant （P<0.05）.The incidence of adverse pregnancy outcomes in the control group were significantly higher than those in the observation group，the differences were statistically significant （P<0.05）.Conclusion：Roys adaptation model nursing intervention for gestational diabetes mellitus patients can effectively alleviate the depression of pregnant and lying-in women， improve self-efficacy，reduce the occurrence of adverse delivery outcomes and improve the quality of life of patients.

【Key words】 Gestational diabetes mellitus； Negative emotion； Self-efficacy； Pregnancy outcome

First-authors address：Guangchang Peoples Hospital，Guangchang 344900，China

doi：10.3969/j.issn.1674-4985.2018.33.027

妊娠期糖尿病（gestaional diabetes mellitus，GDM）指有潜在糖耐量减退、妊娠前糖代谢正常或者妊娠期才出现或确诊的糖尿病。大多数GDM患者的糖代谢水平在产后可以恢复到正常水平，但与此同时患者患2型糖尿病机会可能会有所增加，应该给予重视[1-3]。对GDM患者最主要、最基本的治疗方法是运动、饮食治疗。大多数GDM患者让血糖得到良好的控制只需进行蛋白质和碳水化合物的摄入适当、脂肪的摄入量减少等营养物质的单纯饮食治疗[4]。治疗效果不佳时需注射胰岛素。本研究采用罗伊适应模式的护理对GDM患者进行干预，进一步探讨GDM患者负性情绪、自我效能感及妊娠结局的应用效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年6月-2018年1月于本院确诊并完成分娩的妊娠期糖尿病患者60例作为研究对象，纳入标准：（1）均符合WHO妊娠期糖尿病诊断标准；……