Department of Health Promotion and Education, University of Utah, USA.
J Telemed Telecare. 2013 Dec;19(8):443-9. doi: 10.1177/1357633X13512069. Epub 2013 Nov 6.
We evaluated the feasibility and effectiveness of a website designed to improve compliance to treatment protocols in adolescents with type-1 diabetes. Fifty-nine adolescents, 13-18 years of age, were randomly assigned to a control or experimental group. The control group received standard medical care as usual. The experimental group participated in an interactive, 7-week web-based intervention, taking part in problem-solving through discussion forums, chat rooms and blogs. Fifty of the 59 participants (85%) completed measures assessing diabetes-related quality of life, self-efficacy and outcome expectations. These variables were expected to be interrelated and their combined effects were considered as mediators of compliance. There was a marginally significant difference between the two groups on these combined measures (P = 0.052), with the control group scoring significantly higher on Positive Outcome Expectations (P = 0.03) both pre- and post-treatment. Attrition in the period between recruitment and the beginning of the intervention reduced power. Self-Efficacy was significantly correlated with Positive Outcome Expectations (r = 0.30, P = 0.037) and Diabetes Self-Management and Diabetes Quality of Life for Youths (r = 0.43, P = 0.002). In an exit survey, 90% of participants indicated that they were more willing to comply with their treatment protocol after participating in the intervention. An online website is a promising tool to bring adolescents with a chronic disease together, providing problem solving activities and social support.
我们评估了一个旨在提高青少年 1 型糖尿病治疗方案依从性的网站的可行性和有效性。将 59 名 13-18 岁的青少年随机分为对照组和实验组。对照组接受标准的常规医疗护理。实验组则参与了为期 7 周的互动式网络干预，通过讨论论坛、聊天室和博客参与解决问题。59 名参与者中的 50 名（85%）完成了评估糖尿病相关生活质量、自我效能和结果预期的测量。这些变量预期是相互关联的，它们的综合效应被认为是依从性的中介因素。在这些综合措施上，两组之间存在显著差异（P=0.052），对照组在正性结果预期上的得分明显更高（P=0.03），无论是在治疗前还是治疗后。招募和开始干预之间的人员流失降低了效力。自我效能与正性结果预期显著相关（r=0.30，P=0.037），与糖尿病自我管理和青少年糖尿病生活质量也显著相关（r=0.43，P=0.002）。在一项退出调查中，90%的参与者表示，他们在参与干预后更愿意遵守治疗方案。一个在线网站是一种很有前途的工具，可以将患有慢性病的青少年聚集在一起，提供解决问题的活动和社会支持。
