Viklund G, Ortqvist E, Wikblad K
Medical Sciences, Uppsala University, Uppsala, Sweden.
Diabet Med. 2007 May;24(5):550-6. doi: 10.1111/j.1464-5491.2007.02114.x. Epub 2007 Mar 15.
To determine the effects of an empowerment programme on glycaemic control and empowerment, and to study the role of parental involvement.
The wait-list design is a randomized controlled trial lasting for 6 months, after which the control group participate in the same education programme as the intervention group. After 6 months, data from the two groups are analysed together (pre/post). Thirty-two teenagers with Type 1 diabetes (12-17 years) completed an empowerment group education programme, meeting weekly for 6 weeks. They were also offered an extra meeting together with their parents, which resulted in three groups: together with parents, only parents and no parent involvement at all. HbA(1c) was measured before intervention and after 6, 12, 18 and 24 months, and empowerment before, and 6 and 12 months after.
HbA(1c) and empowerment were similar in the intervention group and the control group 6 months after intervention. In pre/post analysis, HbA(1c) was significantly higher 6 and 12 months after intervention in teenagers > 14 years (from 8.4% to 9.3%; P < 0.05 to 9.6%; P < 0.01), but returned to baseline 18 months after the programme. In teenagers < or = 14 years of age, HbA(1c) did not change during the study. The teenagers felt more ready for changes after the programme than before (3.9 sd = 0.5 to 4.1 sd = 0.5; P < 0.05). In the teenagers in the group that involved their parents, there was a significant decrease in HbA(1c) 12 and 24 months after intervention, from 8.9% (sd = 1.1) to 7.6% (sd = 1.3; P < 0.05, confidence interval 0.37, 2.26).
This empowerment programme for teenagers with diabetes showed no positive glycaemic or empowerment effects. Empowerment programmes for diabetic teenagers in early and middle adolescence should include parental involvement.
确定一项赋权计划对血糖控制和赋权的影响,并研究家长参与的作用。
等待名单设计是一项持续6个月的随机对照试验,之后对照组参与与干预组相同的教育计划。6个月后,对两组数据进行综合分析(干预前/干预后)。32名1型糖尿病青少年(12 - 17岁)完成了一项赋权小组教育计划,每周会面一次,共6周。他们还与父母一起参加了一次额外的会面,由此形成三组:与父母一起、只有父母参与以及完全没有父母参与。在干预前以及干预后6、12、18和24个月测量糖化血红蛋白(HbA1c),并在干预前、干预后6个月和12个月测量赋权情况。
干预6个月后,干预组和对照组的糖化血红蛋白(HbA1c)及赋权情况相似。在干预前/干预后分析中,14岁以上青少年在干预后6个月和12个月时糖化血红蛋白(HbA1c)显著升高(从8.4%升至9.3%;P < 0.05,升至9.6%;P < 0.01),但在该计划实施18个月后恢复至基线水平。在14岁及以下青少年中,糖化血红蛋白(HbA1c)在研究期间未发生变化。青少年在该计划实施后比之前更愿意做出改变(3.9标准差 = 0.5至4.1标准差 = 0.5;P < 0.05)。在有父母参与的青少年组中,干预后12个月和24个月糖化血红蛋白(HbA1c)显著下降,从8.9%(标准差 = 1.1)降至7.6%(标准差 =