Department of Nursing, Damai Medical and Heart Clinic, Melaka 75300, Malaysia.
Health Educ Res. 2011 Oct;26(5):896-907. doi: 10.1093/her/cyr047. Epub 2011 Jun 29.
We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia.
我们采用单盲设计,评估了基于自我效能概念的简短结构化糖尿病教育方案对自我护理和血糖控制的效果。共有来自两个环境的 164 名血糖控制不佳的参与者通过计算机生成的列表被随机分为对照组(n=82)和干预组(n=82),其中 151 名参与者完成了研究。在 12 周的时间里,每月进行一次干预,针对饮食、身体活动、药物依从性和血糖自我监测(SMBG)等自我护理实践进行干预。在两组参与者中,使用预调查和后调查在第 0 周和第 12 周评估这些自我护理实践,同时还评估糖化血红蛋白 A1c(HbA1c)和糖尿病知识。在意向治疗分析(n=164)中,干预组改善了 SMBG(P<0.001)、身体活动(P=0.001)、HbA1c(P=0.03)、糖尿病知识(P<0.001)和药物依从性。与对照组相比,在第 12 周时,HbA1c 差异调整了 SMBG 频率、药物依从性和体重变化,仍具有统计学意义(P=0.03)。对于组内比较,糖尿病知识(P<0.001)、HbA1c 水平(P<0.001)、SMBG(P<0.001)和药物依从性(P=0.008)在干预组中从基线开始均有所改善。在对照组中,只有糖尿病知识有所改善(P<0.001)。这些发现有助于马来西亚发展自我管理糖尿病教育。