van der Does Albertine M B, Mash Robert
Division of Family Medicine and Primary Care, Stellenbosch University, Box 19063, Tygerberg 7505, South Africa.
Prim Care Diabetes. 2013 Dec;7(4):289-95. doi: 10.1016/j.pcd.2013.07.002. Epub 2013 Aug 8.
To evaluate the Take Five School (TFS) group education programme for patients with Type 2 Diabetes in South Africa.
Questionnaires, administered before and after 4 sessions of an hour each of group education, measured the effect on self-care activities in 84 patients from 6 different clinics. Individual interviews with health care workers (HCWs) and focus group interviews (FGI's) with patients explored attitudes.
A significant improvement in adherence to a diabetic diet, physical activity, foot care and the perceived ability to teach others was seen. There was no significant change in smoking or adherence to medication. Qualitative data revealed that comprehensive education was appreciated, that the group process was deemed supportive, that HCWs doubt the effect of education in general and that a combination of group and individual sessions was seen as an option worth exploring. Strengths, weaknesses, opportunities and threats to the TFS are identified. Recommendations are made to improve the programme and its environment.
Significant self-reported improvements in self-care activities after a group-education programme support the view that introducing structured group education for Type 2 Diabetics in a South African public sector primary care context holds promise. Group education for diabetics, especially in resource limited settings, should be sustained and further research should focus on clinical outcomes.
评估南非针对2型糖尿病患者的“五步教学法学校”(TFS)团体教育项目。
在每次时长为一小时的团体教育课程的4节课前后发放问卷,测量其对来自6个不同诊所的84名患者自我护理活动的影响。对医护人员(HCWs)进行个人访谈,并对患者进行焦点小组访谈(FGI's)以探究态度。
在糖尿病饮食、体育活动、足部护理以及向他人传授知识的感知能力方面的依从性有显著改善。吸烟或药物依从性方面无显著变化。定性数据显示,综合教育受到赞赏,团体过程被认为具有支持性,医护人员总体上怀疑教育的效果,并且团体和个人课程相结合被视为值得探索的一种选择。确定了TFS的优势、劣势、机会和威胁。提出了改进该项目及其环境的建议。
团体教育项目后自我护理活动在自我报告方面有显著改善,这支持了在南非公共部门初级保健环境中为2型糖尿病患者引入结构化团体教育具有前景的观点。糖尿病患者的团体教育,尤其是在资源有限的环境中,应持续开展,并且进一步的研究应聚焦于临床结果。