Department of Nursing, School of Medicine, Tongji University, Shanghai, China.
J Adv Nurs. 2012 Dec;68(12):2766-77. doi: 10.1111/j.1365-2648.2012.06059.x. Epub 2012 Jun 7.
A protocol for a new peer-led self-management programme for community-dwelling older people with diabetes in Shanghai, China.
The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising.
Quasi-experimental.
This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks.
This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China.
为中国上海的社区老年糖尿病患者制定一种新的同伴主导的自我管理方案的协议。
2 型糖尿病的患病率不断上升,给公共卫生带来了重大挑战。适当的教育计划可以帮助糖尿病患者实现自我管理和更好的健康结果。为数量不断增加的糖尿病患者提供教育计划对中国医疗保健系统构成了真正的挑战,该系统因人员和资金短缺而紧张。实证文献和专家意见表明,同伴教育计划很有前途。
准实验。
本研究是一种非等效对照组设计(2008 年 1 月批准的方案)。将从两个不同但相似的社区中招募总共 190 人,每组 95 人。该方案基于社会认知理论,将包括基本的糖尿病指导以及社会支持和自我效能增强的小组活动。基本的糖尿病指导课程将由健康专业人员提供,而社会支持和自我效能增强的小组活动将由同伴领袖领导。结果变量包括:自我效能感、社会支持、自我管理行为、抑郁状态、生活质量和医疗保健利用,这些将在基线、4 周和 12 周时进行测量。
这种针对中国患者的基于理论的方案有可能改善糖尿病的自我管理和随后的健康结果。此外,考虑到中国医疗保健资源短缺,通过同伴领袖和现有社区网络参与的交付模式尤其有前途。