Kubiak Thomas, Hermanns Norbert, Schreckling Hans-Jürgen, Kulzer Bernhard, Haak Thomas
Institute of Psychology, University of Greifswald, Franz-Mehring-Str. 47, D-17487 Greifswald, Germany.
Patient Educ Couns. 2006 Feb;60(2):228-34. doi: 10.1016/j.pec.2005.01.008.
Aim of this study was to investigate the effectiveness of a patient education program for the treatment of hypoglycemia-associated problems in type 1 diabetic inpatients.
In this observational controlled pre-post study, the intervention group (IG; N = 105) participated in the new program, controls (control group CG; N = 102) received conventional patient education on hypoglycemia.
Follow-up data (mean follow-up: 6.63 months) were obtained from 177 patients (85.6%). Though severe hypoglycemia also decreased in CG to some degree, the decrease in IG was higher than in CG, but fails to reach significance between groups. Hypoglycemia awareness remained constant in IG, whereas some deterioration was observed in CG (p = 0.06). Prevalence of hypoglycemia-related problems decreased in IG, whereas in CG it remained constant. No differential effects with regard to psychological well being, fear of hypoglycemia and late complications, and control beliefs were observed.
The results suggest that the new intervention program is an effective treatment. The effectiveness should be confirmed, however, in a randomized controlled trial, also incorporating outpatient settings.
A self-management intervention targeting the patients' health beliefs and attitudes towards hypoglycemia and their diabetes self-management, rather than knowledge-centered patient education, can help to ameliorate or even prevent hypoglycemia-associated problems.
本研究旨在调查一项患者教育计划对1型糖尿病住院患者低血糖相关问题的治疗效果。
在这项观察性对照前后研究中,干预组(IG;N = 105)参与了新计划,对照组(CG;N = 102)接受了关于低血糖的常规患者教育。
从177名患者(85.6%)获得了随访数据(平均随访时间:6.63个月)。虽然CG组的严重低血糖也有一定程度的下降,但IG组的下降幅度高于CG组,但两组之间未达到显著差异。IG组的低血糖意识保持不变,而CG组则出现了一些恶化(p = 0.06)。IG组低血糖相关问题的患病率下降,而CG组则保持不变。在心理健康、对低血糖和晚期并发症的恐惧以及控制信念方面未观察到差异效应。
结果表明新的干预计划是一种有效的治疗方法。然而,其有效性应在一项随机对照试验中得到证实,该试验还应纳入门诊环境。
针对患者对低血糖及其糖尿病自我管理的健康信念和态度的自我管理干预,而非以知识为中心的患者教育,有助于改善甚至预防低血糖相关问题。