What are the nursing issues for metabolic syndrome?

Poor long-term compliance with lifestyle intervention, omissions in coordinated monitoring of multiple metabolic indicators, and insufficient response to the psychological internal friction caused by long-term management of chronic diseases are currently the sticking points that most affect patient prognosis.

Not long ago, Corey took in a 42-year-old long-distance truck driver with an abdominal circumference of 102, and his blood pressure, fasting blood sugar, and triglycerides were all on the critical line. The intervention plan for him was to get 6,000 steps a day and give up the habit of drinking cold beer with barbecue after running in the middle of the night. As a result, he came back after two weeks of long-distance running for a review, and his triglycerides soared to 7.2mmol/L. After asking, he found out that running at night was very sleepy, and he couldn't handle it without cold beer and barbecue. In fact, there are different opinions in the industry regarding this issue of compliance. Some nursing teams advocate strict clock-in constraints for patients, and they must review and adjust if they miss a check-in. Others feel that they must first adapt to the patient's occupational attributes. We later changed the plan for the driver. He did jumping jacks for 5 minutes during parking and loading and unloading, and switched to non-spicy braised food with room-temperature mineral water for late-night snacks. Instead of quitting all at once, he persisted for more than three months, and this time the re-examination indicators basically fell back to the normal range.

In addition to the old problem of compliance, many patients and even novice nurses ignore collaborative monitoring of multiple indicators. Many people only focus on fasting blood sugar or blood pressure at home, thinking that if one indicator is stable, everything is stable. Last year, there was a 60-year-old aunt who measured fasting blood sugar at home and kept it stable at 6m Mol/L, she told everyone she had good control. However, she didn’t come for a follow-up check-up in half a year. One day she came for a check-up in a daze. Small plaques had appeared in her carotid arteries. After questioning, she found out that her blood sugar often soared to more than 11 mmol/L 2 hours after a meal, and her blood lipids had not been checked for more than half a year, and they were all leaked. There are also differences in monitoring plans. Some advocate giving patients an integrated monitoring manual, in which weight, waist circumference, blood pressure, blood sugar, and blood lipids are all filled in according to time. Some think it is too complicated for the elderly to remember, which will discourage them from being motivated. Instead, it is better to only remind them to check three core indicators before each follow-up visit, without making it too cumbersome.

Another problem that is easily overlooked is the psychological internal friction of patients. Many people and even their family members think that metabolic syndrome is a "lazy disease" caused by "can't control their mouths and cannot move their legs". Patients themselves are also prone to feeling guilty. Two years ago, I met a 28-year-old Internet programmer. When he was first diagnosed, he did not dare to tell his colleagues that he had this problem. Every time the department had dinner, he would eat heavy oil and spicy food. After eating, he secretly induced vomiting, which in turn raised uric acid. He was so anxious that he had insomnia every day, and the more he controlled his indicators, the worse he got. Later, when I was chatting with him, I specifically told him that he didn’t need to completely avoid food. He could make up for it by eating hot pot occasionally and walking for half an hour, so he didn’t have to be mentally burdened. After he relaxed, he gradually stabilized his index.

In fact, after doing metabolic syndrome care for so long, the biggest feeling is that there is no one-size-fits-all solution, and it has to be adapted to the patient's actual life. After all, this is a chronic disease that needs to be managed for decades. Care that allows patients to persist is truly useful.