目的观察分析妊娠期糖尿病患者采用动机性访谈干预对患者自我管理能力的影响。方法选取妊娠期糖尿病患者480例为研究对象,数字法随机分为观察组和对照组,各240例。对照组给予常规护理干预,观察组给予2次动机性访谈,观察比较两组患者干预前后自我管理能力改善情况、血糖控制情况及护理满意度情况。结果组间比较,观察组在自我管理行为量表中饮食、运动、血糖监测、足部护理、遵医嘱服药5个维度评分高于对照组,差异均有统计学意义(P<0.05)。干预后观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于对照组,差异有统计学意义(P<0.05)。观察组护理总满意率为96.6%,高于对照组的82.6%,差异有统计学意义(χ²=24.962,P<0.05)。结论动机性访谈干预妊娠期糖尿病孕妇能够有效提高患者自我管理水平,改善血糖控制情况,提高患者护理满意程度,提高母婴的健康水平,值得临床推广应用。

Objective To observe and analyze the effect of motivational interviewing intervention on self-management ability of patients with gestational diabetes mellitus. Methods A total of 480 pregnancy women with gestational diabetes were selected as research object,and were randomly divided into observation group( n = 240) and control group( n = 240). Control group were given routine nursing intervention,observation group were given motivational interviewing intervention 2 times. The improvement of selfmanagement ability,blood glucose control and nursing satisfaction were compared between the two groups before and after the intervention. Results Observation group showed higher score in five dimensions of self management behavior scale than that of the control group,such as diet,exercise,blood glucose monitoring,foot care,take medicine following doctor's advice,the differences were statistically significant( P < 0. 05). After intervention,observation group had lower level in fasting blood glucose,postprandial 2h blood glucose and Hb A1 c than control group,the difference was statistically significant( P < 0. 05). The nursing satisfaction rate in observation group was 96. 6%,which was higher than that in the control group( 82. 6%),the difference was statistically significant( P < 0. 05). Conclusion The motivational interviewing intervention of pregnant women with gestational diabetes could improve the patient's self management level effectively; improve glycemic control and patient satisfaction with care. This method can improve maternal and child health,and it is worthy of clinical application.