Cooper Helen, Booth Katie, Gill Geoff
Faculty of Health & Social Care, Department of Community & Child Health, University of Chester,Chester United Kingdom.
Diabetes Res Clin Pract. 2008 Nov;82(2):165-71. doi: 10.1016/j.diabres.2008.07.013. Epub 2008 Sep 19.
We have assessed the effect of a structured, empowerment-based educational system ("LAY or "Look After Yourself") for patients with type 2 diabetes. A randomised controlled trial (RCT) was conducted, testing the system against standard support. Using 3 centres, 89 patients participated in the study. Outcome measures included glycated haemoglobin (HbA(1c)), body mass index (BMI) and a variety of quantitative psychological and educational measures. Assessment was made at 6 months ("short-term") and 12 months ("long-term") post-intervention. The educational programme was associated with benefits in HbA(1c) levels (p=0.005), illness attitudes (p=0.04), and perceived treatment effectiveness (p=0.03) at 6 months follow-up compared to controls. At 12 months however, only illness attitudes (p=0.01), and self-monitoring (p=0.002) showed benefit. A combined outcome measure showed positive benefit for the educational programme both at 6 months (p=0.001) and 12 months (p=0.002). This structured educational programme, aimed at encouraging self-help, was associated with only limited benefits in glycaemic control, but there were significant educational and psychological benefits. Diabetes education should be regarded as having broad patient-based positive outcomes, and should not be expected to have lasting benefits on glycaemic control.
我们评估了一种针对2型糖尿病患者的结构化、基于赋权的教育体系(“LAY”或“照顾好自己”)的效果。开展了一项随机对照试验(RCT),将该体系与标准支持措施进行对比测试。利用3个中心,89名患者参与了研究。结果指标包括糖化血红蛋白(HbA1c)、体重指数(BMI)以及各种定量的心理和教育指标。在干预后6个月(“短期”)和12个月(“长期”)进行评估。与对照组相比,在6个月随访时,教育项目在糖化血红蛋白水平(p = 0.005)、疾病态度(p = 0.04)和感知治疗效果(p = 0.03)方面带来了益处。然而,在12个月时,只有疾病态度(p = 0.01)和自我监测(p = 0.002)显示出益处。一项综合结果指标显示,教育项目在6个月(p = 0.001)和12个月(p = 0.002)时均带来了积极益处。这个旨在鼓励自助的结构化教育项目,在血糖控制方面仅带来有限的益处,但在教育和心理方面有显著益处。糖尿病教育应被视为具有广泛的基于患者的积极成果,不应期望其对血糖控制有持久益处。