Skinner T Chas, Carey Marian E, Cradock Sue, Daly Heather, Davies Melanie J, Doherty Yvonne, Heller Simon, Khunti Kamlesh, Oliver Lindsay
School of Psychology & School of Medicine, University of Southampton, Southampton, UK.
Patient Educ Couns. 2006 Dec;64(1-3):369-77. doi: 10.1016/j.pec.2006.04.007. Epub 2006 Sep 29.
To determine the effects of a structured education program on illness beliefs, quality of life and physical activity in people newly diagnosed with Type 2 diabetes.
Individuals attending a diabetes education and self-management for ongoing and newly diagnosed (DESMOND) program in 12 Primary Care Trusts completed questionnaire booklets assessing illness beliefs and quality of life at baseline and 3-month follow-up, metabolic control being assessed through assay of HbA1c.
Two hundred and thirty-six individuals attended the structured self-management education sessions, with 97% and 64% completing baseline and 3-month follow-up questionnaires. At 3 months, individuals were more likely to: understand their diabetes; agree it is a chronic illness; agree it is a serious condition, and that they can affect its course. Individuals achieving a greater reduction in HbA1c over the first 3 months were more likely to agree they could control their diabetes at 3 months (r=0.24; p=0.05), and less likely to agree that diabetes would have a major impact on their day to day life (r=0.35; p=0.006).
Pilot data indicate the DESMOND program for individuals newly diagnosed with Type 2 diabetes changes key illness beliefs and that these changes predict quality of life and metabolic control at 3-month follow-up.
Newly diagnosed individuals are open to attending self-management programs and, if the program is theoretically driven, can successfully engage with the true, serious nature of diabetes.
确定结构化教育项目对新诊断出2型糖尿病患者的疾病认知、生活质量和身体活动的影响。
在12个初级保健信托机构参加糖尿病教育与自我管理(DESMOND)项目的患者,针对正在接受治疗的和新诊断出的患者,完成了问卷调查手册,在基线和3个月随访时评估疾病认知和生活质量,通过检测糖化血红蛋白评估代谢控制情况。
236名患者参加了结构化自我管理教育课程,97%和64%的患者分别完成了基线和3个月随访问卷。在3个月时,患者更有可能:了解自己的糖尿病;认同这是一种慢性病;认同这是一种严重疾病,且他们可以影响其病程。在最初3个月糖化血红蛋白降低幅度更大的患者,在3个月时更有可能认同他们能够控制自己的糖尿病(r=0.24;p=0.05),而认同糖尿病会对其日常生活产生重大影响的可能性较小(r=0.35;p=0.006)。
初步数据表明,针对新诊断出2型糖尿病患者的DESMOND项目改变了关键的疾病认知,且这些改变在3个月随访时可预测生活质量和代谢控制情况。
新诊断出的患者愿意参加自我管理项目,并且,如果该项目有理论驱动,能够成功认识到糖尿病的真实、严重本质。