Background: To investigate the effects of a comprehensive nursing intervention program oriented toward psychological adaptation on blood glucose control, psychological status, and self-management capabilities in middle-aged and elderly diabetic patients and to analyze the correlations between patients' psychological status, glycemic control, and self-management ability. Methods: A total of 104 middle-aged and elderly diabetic patients were selected and randomly divided into a control group (n=50) and an intervention group (n=54) using a random number table. The control group received routine nursing intervention, including basic health education, blood glucose monitoring guidance, standardized dietary planning, and exercise instruction. The intervention group received an additional psychological adaptation-oriented comprehensive nursing program, comprising individualized disease management, multi-level psychosocial support, family support system construction (a quaternary model integrating patient-family-medical staff-community), and staged self-management capability training. The intervention period was 6 months, with assessments conducted at baseline, 3 months, and 6 months post intervention. The Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were used to evaluate psychological status, while the Summary of Diabetes Self-Care Activities (SDSCA) assessed self-management ability. Fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were monitored. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8), and follow-up rates were recorded. Pearson correlation analysis was used to assess relationships between variables. Results: After 6 months of intervention, the intervention group showed significantly lower SDS scores (41.25 ± 8.43 vs 51.86 ± 9.12, P < .001) and SAS scores (40.62 ± 7.83 vs 50.84 ± 7.98, P < .001) compared to the control group. The intervention group demonstrated higher SDSCA scores (71.85 ± 6.42 vs 61.85 ± 7.26, P < .001) than the control group. HbA1c levels (7.21 ± 0.78% vs 7.73 ± 0.84%, P < .001) and FPG (7.13 ± 0.68 vs 7.82 ± 0.76 mmol/L, P < .001) were significantly lower in the intervention group. Medication adherence (MMAS-8 ≥ 6 points: 88.89% vs 72.00%, P=.008) and follow-up completion rates (92.59% vs 78.00%, P=.018) were superior in the intervention group. Correlation analysis revealed significant associations between patients' psychological status and both glycemic control (r=0.465- 0.486, P < .05) and self-management ability (r =-0.512 to -0.534, P < .01). Conclusion: A psychological adaptation-oriented comprehensive nursing intervention program effectively improves psychological status, enhances self-management ability, and optimizes glycemic control in middle-aged and elderly diabetic patients. The close correlation between patients' psychological status, glycemic control, and self-management ability suggests that psychological intervention should be emphasized in the nursing management of middle-aged and elderly diabetic patients.
Chengming Diao (Mon,) studied this question.
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