Sixta Constance S, Ostwald Sharon
The University of Texas Health Science Center Houston, School of Nursing (Dr Sixta, Dr Ostwald)
Sixta Consulting Inc, Pearland, Texas (Dr Sixta)
Diabetes Educ. 2008 Mar-Apr;34(2):299-309. doi: 10.1177/0145721708314490.
The purpose of this study is to evaluate the impact of a promotores-led diabetes self-management program by comparing the outcomes (knowledge, beliefs, and HbA1c level) of Mexican American patients with type 2 diabetes who received usual diabetic care in a wait-list control group to those who received self-management education and follow-up by promotores in consultation with clinic providers and staff.
This randomized control study compared the results of 63 patients who attended a promotores-led culturally sensitive diabetes self-management course at a community clinic with 68 patients in a wait-list, usual-care control group. Participants were Mexican Americans with type 2 diabetes who were patients at the clinic and at least 18 years of age. At baseline, 3 months, and 6 months, the Diabetes Knowledge Questionnaire (DKQ), Health Beliefs Questionnaire (HBQ), and HbA1c levels (drawn by the clinic laboratory) were collected.
There was a significant improvement in the intervention group's DKQ scores over time and in treatment by time. The baseline HbA1c level was 7.49 and did not change over time in either group. The DKQ, HBQ, and HbA1c results were significantly affected by age; the DKQ and HbA1c were affected by years with diabetes.
The promotores-led diabetes self-management course improved the knowledge of patients with diabetes. Participant baseline HbA1c level was close to therapeutic level (much lower than reported in previous studies), suggesting participants received good medical care within the community clinic.
本研究的目的是通过比较在候补对照组中接受常规糖尿病护理的2型糖尿病墨西哥裔美国患者与在促进者与诊所提供者和工作人员协商后接受自我管理教育及随访的患者的结果(知识、信念和糖化血红蛋白水平),来评估由促进者主导的糖尿病自我管理项目的影响。
这项随机对照研究比较了63名在社区诊所参加由促进者主导的具有文化敏感性的糖尿病自我管理课程的患者与68名在候补常规护理对照组中的患者的结果。参与者为患有2型糖尿病的墨西哥裔美国人,他们是该诊所的患者且年龄至少18岁。在基线、3个月和6个月时,收集糖尿病知识问卷(DKQ)、健康信念问卷(HBQ)以及糖化血红蛋白水平(由诊所实验室检测)。
随着时间推移以及在治疗过程中,干预组的DKQ得分有显著改善。基线糖化血红蛋白水平为7.49,两组在随访期间均未发生变化。DKQ、HBQ和糖化血红蛋白结果受年龄显著影响;DKQ和糖化血红蛋白受糖尿病病程影响。
由促进者主导的糖尿病自我管理课程提高了糖尿病患者的知识水平。参与者的基线糖化血红蛋白水平接近治疗目标(远低于先前研究报道),这表明参与者在社区诊所接受了良好的医疗护理。