Mayberry Robert, Willock Robina Josiah, Boone Leslie, Lopez Patricia, Qin Huanying, Nicewander David
The authors were all from the Baylor Health Care System Institute for Health Care Research and Improvement in Dallas, Tex. Robert Mayberry, MS, MPH, PhD, was director of Health Equity Research, Robina Josiah Willock, MPH, PhD, was a health services researcher, Leslie Boone, MPH, was associate director for research administration, and Patricia Lopez, MS, was a research associate in the institute's Equity Research Group. Huanying Qin, MS, is a biostatistician, and David Nicewander, MS, is director and biostatistician of Analytical Tools and Programming in the institute's Quantitative Services Group.
Diabetes Spectr. 2010 Jul 1;23(3):171-176. doi: 10.2337/diaspect.23.3.171.
To measure patient activation and its relationship to glycemic control among adults with type 2 diabetes who had not participated in a formal diabetes self-management education program as a baseline assessment for tailoring diabetes education in a primary care setting.
Patient activation was assessed in a stratified, cross-sectional study of adults with controlled ( = 21) and uncontrolled ( = 27) type 2 diabetes, who were receiving primary care at a unique family practice center of Baylor Health Care System in Dallas, Tex.
The mean patient activation was 66.0 (95% confidence interval [CI] 60.8-71.2) among patients with uncontrolled diabetes and 63.7 (55.9-71.5) among those with controlled diabetes ( = 0.607). A significant association was observed between the self-management behavior score and activation among patients whose glycemia was under control (ρ = 0.73, = 0.01) as well as among patients with uncontrolled glycemia (ρ = 0.48, < 0.001).
Although activation is correlated with self-management and may be important in tailored patient-centered approaches to improving diabetes care outcomes, the highest stage of activation may be necessary to achieve glycemic control. These findings reinforce the importance of conducting prerequisite needs assessments so diabetes educators are able to tailor their educational interventions to individual patients' needs and readiness to take action.
对于未参加过正规糖尿病自我管理教育项目的2型糖尿病成人患者,测量其患者激活水平及其与血糖控制的关系,以此作为在初级保健机构中定制糖尿病教育的基线评估。
在一项分层横断面研究中,对2型糖尿病控制良好(n = 21)和控制不佳(n = 27)的成人患者进行患者激活水平评估,这些患者在得克萨斯州达拉斯贝勒医疗系统的一家独特的家庭医疗中心接受初级保健。
糖尿病控制不佳的患者平均患者激活水平为66.0(95%置信区间[CI] 60.8 - 71.2),糖尿病控制良好的患者为63.7(55.9 - 71.5)(P = 0.607)。在血糖得到控制的患者中(ρ = 0.73,P = 0.01)以及血糖控制不佳的患者中(ρ = 0.48,P < 0.001),自我管理行为评分与激活水平之间均观察到显著关联。
虽然激活水平与自我管理相关,并且在以患者为中心的定制方法中对于改善糖尿病护理结局可能很重要,但可能需要最高阶段的激活水平才能实现血糖控制。这些发现强化了进行前置需求评估的重要性,以便糖尿病教育工作者能够根据个体患者的需求和采取行动的准备程度来定制教育干预措施。