Department of Medicine, University of British Columbia School of Medicine, Diamond Health Care Center, Vancouver, BC.
Prev Chronic Dis. 2012;9:E109. doi: 10.5888/pcd9.110313. Epub 2012 Jun 7.
Diabetes-related health improvements achieved from self-management education interventions are not sustained long-term. We examined the health effects at 1 year follow-up of a 2-year, empowerment-based, diabetes self-management support intervention designed for African Americans.
We collected data from 52 African American adults with type 2 diabetes who completed the 3-year study. The intervention consisted of weekly groups led by 2 health care professionals and emphasized experiential learning, emotional coping, problem solving, goal setting, and action planning; group discussion was guided by participant-identified self-management priorities and concerns. Measurements were taken at baseline, 24 months (postintervention), and 36 months (1 year follow-up) to assess glycemic control; weight; body mass index; serum cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels; systolic and diastolic blood pressure; self-care behaviors; diabetes-specific quality of life; and diabetes empowerment.
Following the 2-year diabetes self-management support intervention, we found significant improvements for following a healthy diet (P = .03), spacing carbohydrates evenly across the day (P = .005), using insulin as recommended (P = .047), and achieving diabetes-specific quality of life (P = .02). At 1-year follow-up, not only did participants sustain the behavioral improvements made in the 2-year diabetes self-management support intervention, but they also demonstrated additional improvements in glycemic control (P < .001) and in serum cholesterol (P < .001) and low-density lipoprotein cholesterol levels (P = .001).
Participation in an empowerment-based diabetes self-management support intervention may have a positive and enduring effect on self-care behaviors and on metabolic and cardiovascular health.
通过自我管理教育干预实现的与糖尿病相关的健康改善并不能长期持续。我们研究了一项针对非裔美国人的为期两年的、以赋权为基础的糖尿病自我管理支持干预措施在两年后随访 1 年时的健康效果。
我们从 52 名完成了 3 年研究的患有 2 型糖尿病的非裔美国成年人那里收集了数据。该干预措施由两名医疗保健专业人员每周领导的小组组成，强调体验式学习、情绪应对、解决问题、设定目标和行动计划；小组讨论以参与者确定的自我管理重点和关注点为指导。在基线、24 个月（干预后）和 36 个月（1 年随访）测量血糖控制、体重、体重指数、血清胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平、收缩压和舒张压、自我护理行为、糖尿病特异性生活质量和糖尿病赋权情况。
在为期两年的糖尿病自我管理支持干预之后，我们发现以下方面有显著改善：遵循健康饮食（P =.03）、均匀分配全天碳水化合物（P =.005）、按照建议使用胰岛素（P =.047）和实现糖尿病特异性生活质量（P =.02）。在 1 年随访时，参与者不仅维持了在 2 年糖尿病自我管理支持干预中取得的行为改善，而且在血糖控制（P <.001）以及血清胆固醇（P <.001）和低密度脂蛋白胆固醇水平（P =.001）方面也有了额外的改善。
参与以赋权为基础的糖尿病自我管理支持干预可能对自我护理行为以及代谢和心血管健康产生积极和持久的影响。
