Hörnsten Asa, Lundman Berit, Stenlund Hans, Sandström Herbert
Department of Nursing, Umeå University, Umeå 90187, Sweden.
Diabetes Res Clin Pract. 2005 Apr;68(1):65-74. doi: 10.1016/j.diabres.2004.08.003.
The aim of this study was to evaluate, whether an educational intervention, focusing on patients' personal understanding of their illness, was more effective than care given according to national guidelines for diabetes care.
An intervention group (n = 44), with type 2 diabetes was compared with a control group (n = 60), with HbA1c as the primary outcome. The intervention included ten group sessions addressing themes related to the patients' personal understanding of their illness. The diabetes nurses involved were educated in theories about illness/wellness experiences and participated in group sessions where various caring strategies related to the patients' individual needs and understanding were reflected upon.
At 1-year follow-up the intervention group showed lower HbA1c levels (mean difference 0.94%; P < 0.001), lower triglycerides (mean difference 0.52 mmol/l; P = 0.002) and higher high-density lipoprotein (mean difference 0.15 mmol/l; P = 0.029) and treatment satisfaction than did the control group. The differences remained when adjusting for age, gender, body mass index or changed treatment during the intervention period. Within the intervention group, BMI and treatment satisfaction were also improved.
The intervention, which focused on patients' personal understanding of illness, was found to be effective in terms of metabolic control and treatment satisfaction.
本研究的目的是评估，聚焦于患者对自身疾病的个人理解的教育干预，是否比按照国家糖尿病护理指南提供的护理更有效。
将一个患有2型糖尿病的干预组（n = 44）与一个对照组（n = 60）进行比较，以糖化血红蛋白作为主要结果指标。干预包括十次小组会议，讨论与患者对自身疾病的个人理解相关的主题。参与的糖尿病护士接受了关于疾病/健康体验的理论教育，并参加了小组会议，会上反思了与患者个体需求和理解相关的各种护理策略。
在1年的随访中，干预组的糖化血红蛋白水平较低（平均差异0.94%；P < 0.001），甘油三酯较低（平均差异0.52 mmol/l；P = 0.002），高密度脂蛋白较高（平均差异0.15 mmol/l；P = 0.029），且治疗满意度高于对照组。在对年龄、性别、体重指数或干预期间的治疗变化进行调整后，差异仍然存在。在干预组内，体重指数和治疗满意度也有所改善。
聚焦于患者对疾病的个人理解的干预，在代谢控制和治疗满意度方面被发现是有效的。
