Deakin T A, Cade J E, Williams R, Greenwood D C
Nutrition & Dietetic Department, Burnley, Pendle & Rossendale Primary Care Trust, East Lancashire, UK.
Diabet Med. 2006 Sep;23(9):944-54. doi: 10.1111/j.1464-5491.2006.01906.x.
To develop a patient-centred, group-based self-management programme (X-PERT), based on theories of empowerment and discovery learning, and to assess the effectiveness of the programme on clinical, lifestyle and psychosocial outcomes.
Adults with Type 2 diabetes (n = 314), living in Burnley, Pendle or Rossendale, Lancashire, UK were randomized to either individual appointments (control group) (n = 157) or the X-PERT Programme (n = 157). X-PERT patients were invited to attend six 2-h group sessions of self-management education. Outcomes were assessed at baseline, 4 and 14 months.
One hundred and forty-nine participants (95%) attended the X-PERT Programme, with 128 (82%) attending four or more sessions. By 14 months the X-PERT group compared with the control group showed significant improvements in the mean HbA1c (- 0.6% vs. + 0.1%, repeated measures anova, P < 0.001). The number needed to treat (NNT) for preventing diabetes medication increase was 4 [95% confidence interval (CI) 3, 7] and NNT for reducing diabetes medication was 7 (95% CI 5, 11). Statistically significant improvements were also shown in the X-PERT patients compared with the control patients for body weight, body mass index (BMI), waist circumference, total cholesterol, self-empowerment, diabetes knowledge, physical activity levels, foot care, fruit and vegetable intake, enjoyment of food and treatment satisfaction.
Participation in the X-PERT Programme by adults with Type 2 diabetes was shown at 14 months to have led to improved glycaemic control, reduced total cholesterol level, body weight, BMI and waist circumference, reduced requirement for diabetes medication, increased consumption of fruit and vegetables, enjoyment of food, knowledge of diabetes, self-empowerment, self-management skills and treatment satisfaction.
基于赋权理论和发现学习理论，开发一个以患者为中心的、基于小组的自我管理项目（X-PERT），并评估该项目在临床、生活方式和心理社会结局方面的有效性。
居住在英国兰开夏郡伯恩利、彭德尔或罗斯endale的2型糖尿病成年患者（n = 314）被随机分为单独预约组（对照组）（n = 157）或X-PERT项目组（n = 157）。X-PERT项目组的患者被邀请参加六次为时2小时的自我管理教育小组课程。在基线、4个月和14个月时评估结局。
149名参与者（95%）参加了X-PERT项目，其中128名（82%）参加了四次或更多次课程。到14个月时，与对照组相比，X-PERT组的平均糖化血红蛋白水平有显著改善（-0.6%对+0.1%，重复测量方差分析，P < 0.001）。预防糖尿病药物增加的治疗所需人数（NNT）为4[95%置信区间（CI）3, 7]，减少糖尿病药物的NNT为7（95% CI 5, 11）。与对照组患者相比，X-PERT组患者在体重、体重指数（BMI）、腰围、总胆固醇、自我赋权、糖尿病知识、身体活动水平、足部护理、水果和蔬菜摄入量、食物享受程度和治疗满意度方面也显示出统计学上的显著改善。
2型糖尿病成年患者参加X-PERT项目14个月后，血糖控制得到改善，总胆固醇水平、体重、BMI和腰围降低，糖尿病药物需求减少，水果和蔬菜摄入量增加，食物享受程度提高，糖尿病知识增加，自我赋权增强，自我管理技能提高，治疗满意度提升。
