基于Roy适应理论的健康宣教配合智慧平台在T1DM带泵治疗患儿中的应用

目的　探讨基于Roy适应理论的健康宣教配合智慧平台在1型糖尿病（T1DM）带泵治疗患儿中的应用效果。方法　纳入2020年5月至2022年5月经郑州儿童医院收治的84例T1DM带泵治疗患儿及主要监护人作前瞻性研究，按随机数字表法设为对照组（患儿42例，主要监护人42例）及观察组（患儿42例，主要监护人42例）。对照组予以常规健康宣教，观察组则于对照组基础上，基于Roy适应理论的健康宣教配合智慧平台实施干预，比较两组主要监护人健康教育知识掌握程度、照护水平及患儿血糖控制效果、治疗依从性。统计学方法采用χ²检验、t检验。结果　两组主要监护人干预前健康教育知识掌握度、照护者负担水平（ZBI）、家庭关怀度（APGAR）比较，差异均无统计学意义；两组干预后健康教育知识掌握度、APGAR均有提高，ZBI有所降低，观察组健康教育知识掌握度［（68.15±7.36）分比（54.62±10.18）分］、APGAR［（8.03±1.35）分比（6.72±1.13）分］均高于对照组，ZBI［（26.87±5.21）分比（30.24±5.48）分］低于对照组（t=6.98、4.822、2.888，均P<0.05）；两组患儿干预前HbA1c、FBG比较，差异无统计学意义。两组干预后糖化血红蛋白（HbA1c）、空腹血糖（FBG）均有降低，观察组HbA1c［（6.51±0.58）%］、FBG［（6.76±0.65）mmol/L］低于对照组［（7.44±0.86）%、（7.83±0.91）mmol/L］，差异均有统计学意义（t=5.810、6.201，均P<0.05），且观察组干预后HbA1c、FBG合格率高于对照组（χ²=7.244、5.833，均P<0.05）；经Redit分析，两组患儿治疗依从性比较，差异有统计学意义（χ²=2.090，P<0.05），且观察组MMAS-8评分高于对照组，差异有统计学意义（t=11.770，P<0.05）。结论　基于Roy适应理论的健康宣教配合智慧平台应用于T1DM带泵治疗患儿，可提升主要监护人健康教育知识掌握程度，提高照护水平，且患儿血糖控制效果良好，治疗依从性上升。

Application of health education and wisdom platform based on Roy's adaptation theory in children with T1DM treated with pumps

Objective　To explore the application effect of health education and wisdom platform based on Roy's adaptation theory in children with type 1 diabetes mellitus (T1DM) treated with pumps. Methods　From May 2020 to May 2022, 84 children with T1DM treated with pumps in Zhengzhou Children's Hospital and their main guardians were included for a prospective study. They were divided into a control group and an observation group, with 42 children and 42 guardians in each group. The control group took routine health education. On the basis of the control group, the observation group were given the health education based on Roy's adaptation theory and the intervention of the smart platform. The main guardians' mastery of health education knowledge, nursing levels, blood sugar control effects, and children' treatment compliances were compared between the two groups. χ² and t tests were applied Results　There were no statistical differences in the mastery of health education knowledge, caregivers' burden (ZBI), and family care (APGAR) between the two groups before the intervention. After the intervention, the mastery of health education knowledge (68.15±7.36) vs. (54.62±10.18)] and APGAR (8.03±1.35) vs. (6.72±1.13)] increased and the ZBI (26.87±5.21) vs. (30.24±5.48)] decreased in both groups; the mastery of health education knowledge and APGAR were higher and the ZBI was lower in the observation group than in the control group t=6.98, 4.822, and 2.888; all P<0.05]. There were no statistical differences in glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) between the two groups before the intervention. After the intervention, the HbA1c and FBG in both groups decreased; the HbA1c and FBG in the observation group were lower than those in the control group (6.51±0.58)% vs. (7.44±0.86)% and (6.76±0.65) mmol/L vs. (7.83±0.91) mmol/L], with statistical differences (t=5.810 and 6.201; both P<0.05). The qualified rates of HbA1c and FBG in the observation group after the intervention were higher than those in the control group (χ²=7.244 and 5.833; both P<0.05). After Redit analysis, there was a statistical difference in the treatment compliance between the two groups (χ²=2.090, P<0.05).The MMAS-8 score of the observation group was higher than that of the control group (7.01±0.47) vs. (5.64±0.59)], with a statistical difference (t=11.770, P<0.05). Conclusion　The application of health education based on Roy's adaptation theory and smart platform in T1DM children treated by pump therapy can improve the mastery of health education knowledge of the main guardians, the care level, and treatment compliance, with good blood sugar control effect.