糖尿病患者的大血管病变。护士在心血管并发症预防中的作用

Cimmino Olimpia, Mele Maria, Falconio Lucio Marcello, Pezzella Agata, Ruocco Vincenzo, Dell'Isola Antonio, Coppola Ciro, Di Cintio Mattia
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引用次数: 0

摘要

本文的主题是关于糖尿病患者的并发症、管理和教育的基本方面,特别是糖尿病患者的大血管病变并发症。糖尿病的患病率呈指数增长,其对心血管疾病的影响日益明显。事实上,糖尿病患者发生主要心血管事件的风险显著增加。这是由于动脉粥样硬化疾病在血管水平上具有特殊的侵袭性,与高血糖状态相关的内皮功能障碍是有利的。糖尿病是一种在世界范围内广泛传播的慢性疾病,随着人口的逐步老龄化和发病前危险条件的增加,注定在不久的将来会增加。事实上,我们正面临流行病数据证实的真正大流行病,这些数据表明,世界上有3亿多人受到糖尿病的影响。在意大利,糖尿病的治疗占总医疗支出的6.65%,每位患者的费用是全国平均水平的两倍多。鉴于糖尿病对公共卫生造成的重大负担,预防和改善糖尿病患者的护理应成为大多数社区和卫生系统的首要目标。对个人的影响是由于糖尿病患者可能出现的并发症,从预期和生活质量的降低来看,有重大的影响,包括经济上的影响。糖尿病护理的组织质量和效率4与更好的疾病控制、更好的并发症预后、更低的糖尿病相关死亡率相关。降低糖尿病患者的发病率和死亡率,改善糖尿病患者的生活质量,是目前在公共医疗机构工作的卫生保健专业人员、卫生保健组织和医务人员面临的挑战之一。治疗性教育干预措施的选择和后续实施,其有效性和与需求的一致性已得到证明,是改善糖尿病患者状况的重要步骤。糖尿病是一种慢性疾病,因此需要患者负责任的管理。糖尿病患者常常忘记与一种无声的疾病生活在一起,这种疾病除了急性并发症外,还表现出可能致命的长期并发症。因此,有必要进行有组织的干预,以增加患者对治疗计划的积极性和依从性,从而导致良好的代谢控制,获得知识,使他们能够充分控制疾病,从而提高生活质量。本论文的目的是在最重要的科学证据中研究生活方式改变的结果,考虑到代谢控制、获得的知识、自我管理、自我效能、生活质量和受试者满意度等方面。这项研究是通过咨询“Pubmed”和“google scholar”等国际数据库进行的。文章报道说,改变生活方式的教育增加了人们对疾病的认识,提高了自我管理技能,从而提高了生活质量。因此,糖尿病的发病率将会降低,许多心血管因素也会得到改善。此外,通过具体的结构化干预,护士在教育层面和心理层面都发挥着重要的作用。
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Macroangiopathy In Diabetic Patients. Role Of The Nurse In The Prevention Of Cardiovascular Complications
The subject of this paper concerns fundamental aspects of complications, management and education of the diabetic patient, especially the patient with macroangiopathic complications . The increase in the prevalence of diabetes mellitus is now exponential and its impact on cardiovascular diseases is increasingly evident. In fact, the patient with diabetes has a significantly increased risk of developing major cardiovascular events. This is due to the particular aggressiveness of atherosclerotic disease at the level of the vessels, favored by endothelial dysfunction linked to the hyperglycemic state. Diabetes is a chronic disease with very widespread diffusion all over the world, destined to increase in the near future with the progressive aging of the population and the increasing occurrence of risk conditions that precede its onset. We are in fact in the presence of a real pandemic confirmed by epidemiological data, which indicate that more than 300 million people in the world are affected by diabetes. In Italy, the treatment for diabetes absorbs 6.65% of the overall health expenditure, with a cost per patient that is more than double the national average. Given the significant burden diabetes places on public health, preventing and improving the care of people with diabetes should be a primary goal for most communities and health systems. The consequences for individuals are due to the complications that the person with diabetes can develop, in terms of a reduction in both the expectation and the quality of life, with significant repercussions, including economic ones. The organizational quality and efficiency of diabetic care 4 are correlated with better disease control, with a better prognosis of complications, leading to a lower diabetes-related mortality rate. Reducing morbidity and mortality and improving the quality of life of people with diabetes mellitus represent one of the current challenges for healthcare professionals, healthcare organizations and medical staff working in public healthcare facilities. The selection and subsequent implementation of therapeutic education interventions, whose efficacy and congruence with needs have been demonstrated, are essential steps towards improving the conditions of people with diabetes. Diabetes is a chronic disease and as such requires responsible management by those affected. Often people with diabetes forget to live with a silent disease which, in addition to acute complications, also manifests long-term complications which can become fatal. A structured intervention is therefore necessary that increases the motivation and adherence of patients to the therapeutic plan, thus leading to a good metabolic control, to an acquisition of knowledge that allows them an adequate management of the disease and a consequent better quality of life. The aim of this thesis is to research the results of lifestyle modification among the most important scientific evidence, taking into consideration aspects such as: metabolic control, acquired knowledge, self-management, self-efficacy, quality of life and satisfaction of the subjects. The research was carried out by consulting international databases such as “ Pubmed ” and “ google scholar ". The articles report that education for lifestyle change increases knowledge of one's illness, self-management skills and thus 2 an improvement in the quality of life. As a result, there will be a reduction in the incidence of diabetes and an improvement in numerous cardiovascular factors. Furthermore, the nurse plays a role of fundamental importance both at the educational level through specific structured interventions, and at the psychological level.
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