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对私人诊所中2型糖尿病患者的结构化教育计划的评估。

Evaluation of a structured educational programme for type 2 diabetes patients seen in private practice.

作者信息

Boegner C, Fontbonne A, Gras Vidal M-F, Mouls P, Monnier L

机构信息

Department of Metabolic Diseases, Lapeyronie Hospital, 371, avenue Doyen G.-Giraud, 34295 Montpellier cedex 5, France.

出版信息

Diabetes Metab. 2008 Jun;34(3):243-9. doi: 10.1016/j.diabet.2008.01.003. Epub 2008 Apr 18.

Abstract

AIM

Structured education is necessary in the management of a chronic disease such as diabetes and should be readily offered to patients in different settings. Our aim was to demonstrate the feasibility and advantages of a group education programme for type 2 diabetic patients in a private setting in France.

METHODS

A programme of group education for patients with type 2 diabetes was initiated by a multidisciplinary group of volunteer healthcare providers, including general practitioners, specialists in diabetology and non-medical members. All volunteers received one day of training, and physicians were instructed to organize several sessions of group education for the type 2 diabetic patients who regularly attended their practice. The first 427 patients entering the programme were included in the study, and asked to fill in a questionnaire to assess their knowledge, beliefs and behaviours with regard to diabetes. Their physician filled in a medical form. Six months later, the same questionnaire and form were sent for follow-up information.

RESULTS

At six months versus baseline, patients exhibited small, but consistent, improvements: (i) fasting glucose 142+/-42 mg/dL (P<0.04) vs 146+/-44 mg/dL (P<0.04); (ii) HbA(1c) 7.41+/-1.26% vs 7.57+/-1.33% (P<0.01); and (iii) all of the main parameters of diabetes self-management recorded in the study. The percentage of patients who inspected their feet at least once a week increased from 67 to 77% (P<0.001). Patients improved their knowledge of the disease and developed a more positive attitude towards their diabetes.

CONCLUSION

Our study demonstrates that it is possible to organize educational sessions for diabetic patients in a private-practice setting. At six months, patients receiving these sessions showed benefits in terms of blood glucose control and other important markers of self-management of their disease.

摘要

目的

结构化教育对于糖尿病等慢性病的管理至关重要,应在不同环境中为患者提供。我们的目的是证明在法国私人环境中为2型糖尿病患者开展小组教育计划的可行性和优势。

方法

由包括全科医生、糖尿病专家和非医学成员在内的多学科志愿者医疗服务提供者团队启动了一项针对2型糖尿病患者的小组教育计划。所有志愿者均接受了为期一天的培训,医生被要求为定期就诊的2型糖尿病患者组织多场小组教育课程。纳入该研究的是最初参与该计划的427名患者,他们被要求填写一份问卷,以评估他们对糖尿病的知识、信念和行为。他们的医生填写一份医疗表格。六个月后,再次发送相同的问卷和表格以获取随访信息。

结果

与基线相比,六个月时患者有虽小但持续的改善:(i)空腹血糖从146±44毫克/分升(P<0.04)降至142±42毫克/分升(P<0.04);(ii)糖化血红蛋白从7.57±1.33%降至7.41±1.26%(P<0.01);以及(iii)研究中记录的糖尿病自我管理的所有主要参数。每周至少检查一次足部的患者比例从67%增加到77%(P<0.001)。患者对疾病的了解有所改善,并对自己的糖尿病形成了更积极的态度。

结论

我们的研究表明,在私人诊所环境中为糖尿病患者组织教育课程是可行的。六个月时,接受这些课程的患者在血糖控制和疾病自我管理的其他重要指标方面显示出益处。

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