Venmans Leonie M A J, Gorter Kees J, Hak Eelko, Rutten Guy E H M
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Diabetes Care. 2008 Mar;31(3):402-7. doi: 10.2337/dc07-0744. Epub 2007 Dec 4.
The aim of this study was to assess the short-term effects of an educational program on (determinants of) self-reported health-seeking behavior for infections of the urinary tract (UTIs) and lower respiratory tract (LRTIs) in patients with type 2 diabetes.
In a randomized controlled trial, 1,124 patients with type 2 diabetes aged between 44 and 85 years participated. The intervention consisted of a multifaceted educational program with an interactive meeting, a leaflet, a Web site, and a consultation with the diabetes care provider. The program focused on the needs of patients, apparent from a prior focus group and questionnaire study. The primary outcome measure was an indicator of health-seeking behavior for UTIs and LRTIs, defined as the proportion of participants with a positive score on at least seven of nine determinants, six from the Health Belief Model and the additional three domains of knowledge, need for information, and intention. The primary outcome was measured with questionnaires at baseline and after 5 months.
Complete outcome data were available for 468 intervention group patients and 472 control group patients. In all, 68% of the intervention group patients attended the meeting. At baseline, 28% of the participants from the intervention group had a positive score on seven of the nine determinants, compared with 27% from the control group. After the educational program, these percentages were 53 and 32%, respectively (P < 0.001).
Our educational program positively influenced determinants of health-seeking behavior for common infections in patients with type 2 diabetes.
本研究旨在评估一项教育计划对2型糖尿病患者自述的针对尿路感染（UTIs）和下呼吸道感染（LRTIs）的就医行为（及其决定因素）的短期影响。
在一项随机对照试验中，1124名年龄在44至85岁之间的2型糖尿病患者参与其中。干预措施包括一个多方面的教育计划，其中有一次互动会议、一份传单、一个网站以及与糖尿病护理提供者的一次咨询。该计划聚焦于患者的需求，这从之前的焦点小组和问卷调查研究中可以明显看出。主要结局指标是UTIs和LRTIs就医行为的一个指标，定义为在九个决定因素中至少七个得分为阳性的参与者比例，其中六个来自健康信念模型，另外三个领域是知识、信息需求和意愿。主要结局在基线时和5个月后通过问卷调查进行测量。
468名干预组患者和472名对照组患者有完整的结局数据。总体而言，68%的干预组患者参加了会议。在基线时，干预组28%的参与者在九个决定因素中的七个上得分为阳性，而对照组为27%。在教育计划实施后，这些百分比分别为53%和32%（P<0.001）。
我们的教育计划对2型糖尿病患者常见感染就医行为的决定因素产生了积极影响。
