Intervention of Health Promotion: The Effectiveness of Treatment of Chronic Psychiatric Diabetes Patients with A Long-Term-Care Team Based on A Specialist of Endocrinology and Metabolism in A Psychiatric Center.

• Main Authors: YANG, CHIN-CHOU, 楊晉州
• Other Authors: TSAI, SING-LING
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/mp2jb7

碩士 === 輔仁大學 === 跨專業長期照護碩士學位學程在職專班 === 108 === Introduction: Diabetes is prevalent in many countries and its costs of medical care are increasing. The proportion of diabetes is higher in psychiatric patients than that of general population, and the difficulties of treatment also raises significantly. Purpose: Most studies about integrated diabetes care were focused on non-psychiatric patients. Our study will analyze the glycemic change in chronic psychiatric patients with type 2 diabetes in a psychiatric center, after a full-time specialist of endocrinology and metabolism participated in the long-term-care team and directly involved in the integrated care. Methods: Our retrospective study included 56 resident patients in the chronic psychiatric wards. The specialist of endocrinology and metabolism was engaged in the integrated care team since January 2018. We first used paired-t test to analyze the glycemic change between 2016 and 2017 before our interventional care, and then analyze the glycemic change between 2017 and 2018 after our interventional care. Results: The results showed that this care model has positive impacts on the patient's eating habits and activity habits. Chi-square test analysis showed significant relationship between the improvement of eating habits and average glycated hemoglobin (HbA1c) level (X2=4.487, p=0.034), and also between the improvement of activity habits and average HbA1c level (X2=11.864, p=0.001). The average HbA1c and fasting blood glucose (AC) of all patients were both significantly improved (p<0.05). For female patients, the average HbA1c and AC were both improved, but there was no significant change noted (p>0.05). For male patients, the average HbA1c was significantly improved, but there was no significant change found in average AC (P>0.05). Conclusion: To our best knowledge, this is the first study of diabetes care based on a full-time specialist of endocrinology and metabolism, who was directly involved in the long-term care team in a psychiatric center. The results showed that this care model has positive impacts on the patient's eating habits and activity habits. The average HbA1c and AC were both significantly improved after our intervention. This study not only provides a positive and feasible approach to medical systems of long-term care, but also setup a health promotion measure that deserves attention and should be actively implemented and promoted.