Navicharern Rungrawee, Aungsuroch Yupin, Thanasilp Sureeporn
Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Aug;92(8):1102-12.
To examine the effects of multifaceted nurse-coaching intervention on diabetic complications which were assessed by HbA1c, blood pressure, LDL-C levels and satisfaction with nursing intervention of persons with type 2 diabetes.
Quasi-experimental design study was conducted from October 2007 to March 2008. Forty participants with type 2 diabetes of two Red Cross Health Stations in Bangkok, Relief and Public Health Bureau of the Thai Red Cross Society, were selected by purposive sampling and matched pair The participants of the 11th Red Cross Health Station were the control group (n=20) who received the usual care while the participants of the 2nd Red Cross Health Station were the experimental group (n=20) who received the multifaceted nurse-coaching intervention over 12 weeks. A multifaceted nurse-coaching intervention was performed on a trail basis on the coaching model of Eaton and Johnson (2001). The coaching process included assessment, goal definition, analysis, exploring, action plan, learning and feedback and consisted of 3 individualized sessions and 2 follow-up phone calls over 12 weeks. The community nurses were trained to be involved in the intervention. Data from each participant were collected by using a questionnaire related to their personal demography and signs or risk factors of diabetic complications including HbA1c, blood pressure and LDL-C testing, and interviewing satisfaction with nursing intervention questionnaire. The data were analyzed using dependent samples t-test, and independent sample t-test.
Both groups were similar in age, sex and duration of diabetic history. After 12 weeks, the mean average of HbA1c of the experimental group was significantly lower than that of the control group (x(exp) = 7.10, SD = .67 vs. x(cont) = 7.72, SD = .97; p < or = 0.5). There was no statistically significant difference in blood pressure between the experimental group and the control group (systolic blood pressure: x(exp) = 121.0, SD = 10.28 vs. x(cont) = 127.4, SD = 15.30; p > 0.5, diastolic blood pressure: x(exp) = 81.30, SD = 9.18 vs. x(con) = 79.4, SD = 19.43; p > .05). There was also no difference between the two groups in average mean of LDL-C level (x(exp) = 123.60, SD = .45.53 vs. X(cont) = 110.40, SD = 25.60; p > .05). The participants in the experimental group had significantly higher satisfaction score than the control group (x(exp) = 4.91, SD = 0.91 vs. x(cont) = 2.49, SD = 0.18; p < 0.5).
The multifaceted nurse-coaching intervention could reduce HbA1c and increase satisfaction but could not decrease blood pressure and LDL-levels in persons with type 2 diabetes who received the intervention for 12 weeks.
通过糖化血红蛋白（HbA1c）、血压、低密度脂蛋白胆固醇（LDL-C）水平以及2型糖尿病患者对护理干预的满意度，来研究多维度护士指导干预对糖尿病并发症的影响。
2007年10月至2008年3月进行了一项准实验设计研究。通过目的抽样和配对，选取了泰国红十字会曼谷救济与公共卫生局下属两个红十字卫生站的40名2型糖尿病患者。第11个红十字卫生站的参与者为对照组（n = 20），接受常规护理；第2个红十字卫生站的参与者为实验组（n = 20），在12周内接受多维度护士指导干预。基于伊顿和约翰逊（2001年）的指导模式进行了多维度护士指导干预的试验。指导过程包括评估、目标定义、分析、探索、行动计划、学习和反馈，在12周内包括3次个性化课程和2次随访电话。社区护士经过培训参与干预。通过使用与个人人口统计学以及糖尿病并发症体征或危险因素相关的问卷收集每位参与者的数据，包括HbA1c、血压和LDL-C检测，并访谈对护理干预问卷的满意度。使用配对样本t检验和独立样本t检验对数据进行分析。
两组在年龄、性别和糖尿病病史时长方面相似。12周后，实验组的HbA1c平均水平显著低于对照组（x（实验组）= 7.10，标准差 = 0.67；x（对照组）= 7.72，标准差 = 0.97；p ≤ 0.5）。实验组和对照组之间的血压无统计学显著差异（收缩压：x（实验组）= 121.0，标准差 = 10.28；x（对照组）= 127.4，标准差 = 15.30；p > 0.第五章，舒张压：x（实验组）= 81.30，标准差 = 9.18；x（对照组）= 79.4，标准差 = 第十九点四三；p > 0.05）。两组的LDL-C水平平均均值也无差异（x（实验组）= 123.60，标准差 = 45.53；x（对照组）= 110.40，标准差 = 25.60；p > 0.05）。实验组的参与者满意度得分显著高于对照组（x（实验组）= 4.91，标准差 = 0.91；x（对照组）= 2.49，标准差 = 0.18；p < 0.5）。
多维度护士指导干预可降低2型糖尿病患者的HbA1c并提高满意度，但在接受12周干预的患者中不能降低血压和LDL水平。
