Cinar A Basak, Schou Lone
Oral Public Health Department, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int Dent J. 2014 Jun;64(3):155-63. doi: 10.1111/idj.12093. Epub 2014 Feb 18.
To assess the role of toothbrushing self-efficacy (TBSE) in diabetes management by comparing health education (HE) and health coaching (HC) in type 2 diabetes.
The data [HbA1c , Clinical Attachment Loss (CAL), TBSE] were collected initially and after intervention. Participants were allocated randomly to HC (n = 77) and HE (n = 109) groups.
The low TBSE subgroup showed greater improvement in TBSE in the HC group (∆mean:23.4 ± 9.2) than the HE group (∆mean:12.4 ± 10.3), (P < 0.01). The moderate TBSE group showed significant improvements only in the HC group (P < 0.001).There was a significant reduction in HbA1c and CAL in all the TBSE subgroups in HC (P < 0.05), which was significantly higher than in the HE groups (P < 0.05). Improvements in TBSE and CAL were explanatory variables for the reduction in HbA1c among the HC patients in all the TBSE subgroups (P < 0.05). Among HE patients, improvement in CAL was an explanatory variable for change at HbA1c in the low TBSE subgroup.
The present findings show that HC is more effective in terms of reduced HbA1c and CAL compared with HE. The data suggest that HC unlocks positive self-intrinsic motivation, anchoring the self-efficacy/competency beliefs for adjustment of healthy lifestyles. Thus, TBSE may be a practical starting point for empowerment and more effective outcomes.
通过比较2型糖尿病患者的健康教育(HE)和健康指导(HC),评估刷牙自我效能(TBSE)在糖尿病管理中的作用。
在干预前后收集数据[糖化血红蛋白(HbA1c)、临床附着丧失(CAL)、TBSE]。参与者被随机分配到HC组(n = 77)和HE组(n = 109)。
低TBSE亚组在HC组中TBSE的改善程度(平均变化:23.4±9.2)大于HE组(平均变化:12.4±10.3),(P < 0.01)。中度TBSE组仅在HC组中有显著改善(P < 0.001)。HC组中所有TBSE亚组的HbA1c和CAL均显著降低(P < 0.05),且显著高于HE组(P < 0.05)。在所有TBSE亚组的HC患者中,TBSE和CAL的改善是HbA1c降低的解释变量(P < 0.05)。在HE患者中,CAL的改善是低TBSE亚组中HbA1c变化的解释变量。
目前的研究结果表明,与HE相比,HC在降低HbA1c和CAL方面更有效。数据表明,HC能激发积极的自我内在动力,巩固自我效能/能力信念以调整健康的生活方式。因此,TBSE可能是增强能力和取得更有效结果的一个切实可行的起点。