目的 通过评估非直属附属医院临床教学质量的影响因素,探讨保障非直属附属医院同质化教学的方法。方法 将实习同学分为院校组和混合组两组,运用德尔菲法调查法对非直属附属医院临床教学过程中所遇到的困难进行分析,并提出教学改革的意见和评价。结果 得出的调查结论对教师、学生、医院教学管理人员和学校教学管理人员都提出了更高的要求,可以为达到同质化教学提供参考。结论 有针对性的开展临床教学工作,变被动教学为主动的教与学,使临床教学达到同质化,从而达到更佳的教学效果。

Objective To explore the methods of guaranteeing homogeneity teaching in Non-affiliated hospitals by assessing the factors affecting the quality of clinical teaching in Non-affiliated hospitals. Methods Divide the students into two groups:college group and mixed group,to meet the process of clinical teaching in Non-affiliated hospitals in difficulty were analyzed by using the Delphi survey method, and put forward opinions and evaluation. Results the survey findings put forward higher requirements for teachers, students, hospital teaching administrators and school teaching administrators, which can provide references for achieving homogeneity teaching. Conclusion targeted clinical teaching should be carried out to change passive teaching into active teaching and learning, so that clinical teaching can be homogenized, so as to achieve better teaching effect.

       目的   探讨自行设计教育路径在非内分泌科糖尿病患者同质化管理中的应用效果。方法    采用时间分段法将200例非内分泌科住院糖尿病患者分为对照组和研究组各100例，对照组所在非内分泌科各科室责任护士在糖尿病联络护士指导下进行糖尿病常规健康教育，研究组自行设计非内分泌科糖尿病健康教育路径并实施同质化管理，观察比较两组患者糖尿病知识知晓程度、血糖水平、自我管理能力、护理满意度。结果   出院时研究组患者密西歇根糖尿病知识测试问卷（DKT）评分（18.37±3.06）分，对照组为（16.01±3.59）分，研究组高于对照组（t=5.004，P＜0.05）；管理6个月空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbA_lc）分别为［7.00（7.00，8.00）］mmol/L、［8.00（6.00，9.00）］mmol/L、［7.50（6.00，8.00）］%，对照组分别为［8.00（7.00，10.00）］mmol/L、［9.00（8.00，11.00）］mmol/L、［8.00（7.00，9.00）］%，研究组均低于对照组（Z=6.398、5.248、3.034，均P＜0.05）；研究组糖尿病自我管理能力行为量表（SDSCA-6）评分、纽卡斯尔护理满意度量表（NNSS）评分分别为（35.36±4.75）分、（83.42±6.92）分，对照组分别为（30.90±7.56）分、（72.31±9.26）分，研究组均高于对照组（t=4.998、9.614，均P＜0.05）。结论   糖尿病教育路径结合同质化管理能提高非内分泌科住院糖尿病患者糖尿病知识的掌握程度，有效控制血糖水平，提高患者自我管理能力和对护理工作满意度。

      Objective   To explore the application effect of self-designed education path in homogenization management of non-endocrinology diabetic patients．Methods   A total of 200 inpatients with diabetes in non-endocrinology departments were divided into control group and research group with 100 cases in each group．The  responsible  nurses in the  non-endocrinology departments of the control group conducted routine diabetes health education under the guidance of diabetes liaison nurses．The research group designed its own non-endocrinology diabetes health education path and implemented homogenized management．The knowledge level of diabetes mellitus，blood sugar level，self-management ability and nursing satisfaction of the two groups were observed and compared．Results   At discharge，the DKT score of the study group was（18.37±3.06） and that of the control group was（16.01±3.59），which was higher than that of the control group（t=5.004，P＜0.05）．After 6 months management，FBG，2 HPBG and HbA_lc of study group were［7.00（7.00，8.00）］ mmol/L，［8.00（6.00，9.00）］ mmol/L，［7.50（6.00，8.00）］%，respectively，while those in the control group was［8.00（7.00，10.00）］mmol/L，［9.00（8.00，11.00）］mmol/L and［8.00（7.00，9.00）］%，respectively．The study group was lower than the control group（Z=6.398，5.248，3.034，all P＜0.05）．SDSCA-6 scores and NNSS scores in the study group were（35.36±4.75）scores and（83.42±6.92）scores，respectively，while those in the control group were（30.90±7.56）scores and（72.31±9.26）scores，which were higher in the study group than in the control group（t=4.998，9.614，all P＜0.05）．Conclusions   The combination of diabetes education pathway and homogenized management can improve the mastery of diabetes knowledge，effectively control blood sugar level，improve patients’ self-management ability and satisfaction with nursing work．