目的 基于计划行为理论探讨妊娠期糖尿病（GDM）孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别：①行为态度：认知不足,积极态度,消极态度;②主观规范：家庭影响,医护压力,人际压力;③知觉行为控制：知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。

Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus（GDM）based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including（1）Behavioral Attitudes：cognition deficiency,positive attitude,and negative attitude,（2）Subjective norms：family influence,medical pressure,interpersonal pressure,and（3）Perceptual behavior control：self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions．Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency．

目的 观察LACE风险模型下的护理干预策略在心脏瓣膜置换术后患者中的应用效果。方法 选取我院2021年3月—2022年3月心脏瓣膜置换术后患者82例作为研究对象,以患者入院顺序编号分为对照组、观察组,各41例。对照组予以常规护理,观察组予以LACE风险模型下的护理干预。比较2组出院时、干预后的自我管理能力及负性情绪;干预期间的术后并发症发生率、再入院率、用药依从性。结果 干预后观察组自我管理环境、自我管理行为、自我管理认知评分高于对照组（P<0.05）;观察组术后并发症发生率7.32%（3/41）、再入院率4.88%（2/41）均低于对照组24.39%（10/41）、21.95%（9/41,P<0.05）;观察组用药依从率97.56%（40/41）高于对照组78.05%（32/41,P<0.05）;干预后观察组汉密尔顿抑郁量表评分、汉密尔顿焦虑量表评分低于对照组（P<0.05）。结论 心脏瓣膜置换术后患者进行LACE风险模型下的护理干预后,患者的自我管理能力及用药依从性明显改善,同时其并发症发生率和再入院率有效降低,焦虑、抑郁等负性情绪得到缓解,具有良好护理效果。

Objective To observe the effect of nursing intervention strategy under LACE risk model in patients after heart valve replacement．Methods From March 2021 to March 2022,82 patients with heart valve replacement were enrolled as the study objects．The patients were divided into control group and observation group according to the order of admission,with 41 patients in each group．The control group was given routine nursing,and the observation group was given nursing intervention under LACE risk model．The self-management ability and negative emotions at discharge and after intervention were compared between the two groups．The incidence of postoperative complications,readmission rate and medication compliance during the intervention period were also compared．Results After intervention,the scores of self-management environment,self-management behavior and self-management cognition in the observation group were higher than those in the control group（P<0.05）．The postoperative complication rate of 7.32%（3/41）and readmission rate of 4.88%（2/41）in the observation group were lower than those of 24.39%（10/41）and 21.95%（9/41）in the control group（P<0.05）．The compliance rate of the observation group（97.56%）was higher than that of the control group（78.05%,P<0.05）．After intervention,the scores of Hamilton Depression Scale and Hamilton Anxiety Scale in the observation group were lower than those in the control group（P<0.05）．Conclusions After nursing intervention under LACE risk model for patients after heart valve replacement,the self-management ability and medication compliance of patients have been significantly improved,the incidence of complications and readmission rate have been effectively reduced,and negative emotions such as anxiety and depression have been alleviated,which has good nursing effect．

目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。

Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions．Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method．Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation．Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods．The conclusion part of the article proposes directions and challenges for future research．

目的 探究自我管理干预对慢性阻塞性肺疾病(COPD) 稳定期患者的临床疗效影响。方法 选取2013年6月—2014年6月我院诊断的COPD稳定期患者90例,随机分为对照组(45例)和观察组(45例)。对照组只给予常规治疗,观察组在常规治疗基础上给予自我管理干预,包括健康教育和康复训练,之后通过比较两组患者肺功能、6MWD、生活质量问卷(SGRQ)评分、急性发病频率、依从性等方面的变化来探讨自我管理干预对COPD治疗的临床意义。结果 观察组患者肺功能和6MWD较对照组有改善,观察组的SGRQ得分、急性加重频率显著低于对照组,而其依从性比例明显高于对照组,两组间差异在统计学上均有意义(P<0.05)。结论 加强COPD稳定期自我管理干预能够改善COPD的预后,值得在临床上进行应用。

目的 探讨糖尿病自我管理支持对社区2型糖尿病患者生化指标控制的影响。方法 2015年1月1日前已确诊为2型糖尿病患者,随机分为对照组和干预组,对照组303例按照广州市基本公共卫生服务包要求进行定期随访、体检及健康教育,干预组130例进行自我管理支持干预,观察两组生化指标的变化。结果 与对照组比较,自我管理支持组的空腹血糖、总胆固醇、甘油三酯、谷丙转氨酶、尿酸控制效果较好,差异有统计学意义(P<0.05)。结论 自我管理支持对社区2型糖尿病患者生化指标控制的效果良好,值得推广。

Objective To evaluate the control effect of biochemical criterion in patients with type 2 diabetes under diabetes self-management support in community. Methods 130 patients with type 2 diabetes in community from January 2015 to December 2015 accepting the diabetes self-management support were chosen as research group, another 303 diabetic patients without the diabetes self-management support were set as control group, the effect of management was analyzed. Results There was statistically significant difference (P<0.05) in biochemical criterion including blood sugar (BS), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and uric acid (UA). Conclusion Control effect of biochemical criterion was good in the diabetes self- management support for people with type 2 diabetes, which was worth to be popularized.

目的 评价自我管理小组干预对社区2型糖尿病患者的管理效果。方法 在2013年底选取本区社区卫生服务中心100例患者研究,运用自身对照方法,管理1年后对其自我管理效能、生化指标、空腹血糖、糖化血红蛋白进行比较。结果 管理一年后饮食控制、运动控制、药物依从性、监测依从性、足部护理等指标差异有统计学意义(P<0.05)。空腹血糖、糖化血红蛋白、总胆固醇、尿酸下降,差异有统计学意义(P<0.05)。空腹血糖达标率由12%上升到37%,糖化血红蛋白达标率由10%上升到34%,差异有统计学意义(P<0.05)。结论 自我管理小组干预提高了社区2型糖尿病患者自我管理水平,改善了主要的生化指标,值得社区推广应用。

Objective To evaluate the function of self-management group program on patients with type 2 diabetes in community. Methods Self-management was carried out for one year among 100 patients with type 2 diabetes, the effect of management was analyzed. Results There was statistically significant difference in diet control, motion control, drug compliance, monitoring compliance, and foot care after one year intervention (P<0.05). GLU, HbA1c, CHOL, UA were decreased. The difference was statistically significant (P<0.05). Conclusion Self-management of group intervention is effective in patients with type 2 diabetes, is worthy of further popularization and application.

       受现代人们生活、饮食习惯改变、心理压力增加和睡眠质量下降等因素影响，胃食管反流病的发病率逐渐增加，对患者的工作生活和情绪造成了极大的影响。自我管理能够以患者为中心，提高患者在疾病治疗中的参与度，节约医疗资源，被广泛应用在慢性病管理中。而胃食管反流病患者的自我管理仍处于初步发展阶段，缺少科学、系统的评估工具和能够广泛实行的干预流程。文章通过对胃食管反流病患者的自我管理的概念、评估工具、干预方案等方面进行综述， 旨在为胃食管反流病患者自我管理的干预提供参考。

       As modern lifestyles and dietary habits change，psychological stress increases，and sleep quality declines，the prevalence of gastroesophageal reflux disease（GERD）has been rising．This condition significantly impacts patients' work，daily life，and emotional well-being．Self-management，which centers on patient involvement，enhances participation in disease treatment，conserves medical resources，and is widely used in managing chronic diseases．However，self-management for GERD patients is still in its early stages，lacking scientifically systematic assessment tools and broadly applicable intervention protocols．This study reviews the concepts，assessment tools，and  intervention programs of self-management GERD patients，aiming to provide reference for the intervention of self-management of GERD patients．

       目的   探讨基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响。方法   根据中心随机法将郑州大学第二附属医院2021年1月—2023年1月收治的88例急性胰腺炎患者作为研究对象，其中传统组44例给予常规干预，微视频组44例在传统组的基础上结合微视频的护理干预，比较两组患者疾病知晓情况、自我管理能力和遵医行为情况。结果   干预2个月后，微视频组病例脱落3例，传统组病例脱落4例，两组疾病知晓各维度高于干预前，且微视频组高于传统组，其中疾病病因（t=3.151，P=0.003）、临床症状（t=7.165，P＜0.001）、并发症（t=5.497，P＜0.001）、如何预防疾病复发（t=8.195，P＜0.001）；两组自我护理能力量表（ESCA）各维度评分高于干预前，且微视频组高于传统组，其中各维度评分结果为自我护理技能（t=2.787，P=0.007）、自我概念（t=2.272，P=0.026）、自护责任感（t=2.644，P=0.011）、健康知识水平（t=3.321，P=0.001）；两组遵医行为各维度评分高于干预前，且微视频组高于传统组，其中各维度评分结果为饮食依从性（t=6.271，P＜0.001）、用药依从性（t=3.539，P=0.001）、锻炼依从性（t=4.469，P＜0.001）、定期复查（t=2.764，P=0.007）。结论   通过运用微视频的护理干预能够提高急性胰腺炎患者疾病知识的掌握，促进机体自我管理水平的恢复，进而提高遵医行为。

       Objective  To explore the impact of micro video based nursing interventions on disease awareness，self-management and compliance behavior in patients with acute pancreatitis．Methods  According to the central randomization method，88 patients with acute pancreatitis admitted to the Second Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were selected as the research subjects．Among them，44 patients in the traditional group received routine intervention，and 44 patients in the micro video group received nursing intervention combined with micro video on the basis of the traditional group．The disease awareness，self-management ability and compliance behavior of the two groups of patients were compared．Results  After two months of intervention，three cases were dropped out in the micro video group and four cases were dropped out in the traditional group．The disease awareness in both groups was higher than that before intervention，and the micro video group was higher than the traditional group，including disease etiology（t=3.151，P=0.003），clinical symptoms（t=7.165，P＜0.001），complications（t=5.497，P＜0.001） and how to prevent disease recurrence（t=8.195，P＜0.001）．The scores of ESCA in both groups were significantly higher than those before intervention，and the micro video group was higher than the traditional group in terms of self-care skills（t=2.787，P=0.007），self-concept（t=2.272，P=0.026），self-care responsibility（t=2.644，P=0.011） and health knowledge level（t=3.321，P=0.001）．The scores of all dimensions of compliance behavior in both groups were significantly higher than those before intervention，and the micro video group had higher scores than the traditional group in terms of dietary compliance（t=6.271，P＜0.001），medication compliance（t=3.539，P=0.001），exercise compliance（t=4.469，P＜0.001） and  regular follow-up（t=2.764，P=0.001）．Conclusions  The use of micro video nursing interventions can improve the mastery of disease knowledge in patients with acute pancreatitis，promote the recovery of the body’s self-management level，and thereby improvemedical compliance behavior．