Berry Diane C, Williams Wanda, Hall Emily Gail, Heroux Regina, Bennett-Lewis Tara
University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina (Dr Berry; Ms Hall)
Rutgers University, Camden, New Jersey (Dr Williams)
Diabetes Educ. 2016 Feb;42(1):96-107. doi: 10.1177/0145721715620022. Epub 2015 Dec 7.
The purpose of this study was to evaluate an interdisciplinary approach and test the efficacy of diabetes group visits tailored to low-income patients in a community-based medical practice.
A randomized repeated measures design was used with 40 patients in the experimental group and 40 patients in the control group. The diabetes group visit consisted of individualized sessions with a physician or nurse practitioner to review medications and conduct a medical examination and group sessions to deliver diabetes self-management education. Data collected included clinical data and questionnaires. A control group shared comparable demographic characteristics, medication regimens, and baseline A1C levels.
The patients in the experimental group decreased their A1C, triglycerides, and heart rate from time 1 to time 5 and maintained their high-density lipoprotein significantly more than the control group. In exit interviews, the patients said that the group diabetes visits helped them be more accountable about their diabetes self-management goals.
Diabetes group visits that combined diabetes self-management education and a medical visit with a health care provider improved A1C and were well received by the patients. The study provided patients with a quality program in an environment in which they felt safe to learn and that met them where they were in their diabetes self-management behaviors. This approach could be widely disseminated into other clinic settings that serve patients with type 2 diabetes.
本研究旨在评估一种跨学科方法,并测试针对社区医疗实践中低收入患者量身定制的糖尿病小组就诊的疗效。
采用随机重复测量设计,实验组有40名患者,对照组有40名患者。糖尿病小组就诊包括与医生或执业护士进行个性化问诊以审查用药情况并进行体格检查,以及开展小组问诊以提供糖尿病自我管理教育。收集的数据包括临床数据和问卷。对照组具有相似的人口统计学特征、用药方案和基线糖化血红蛋白(A1C)水平。
从时间1到时间5,实验组患者的糖化血红蛋白、甘油三酯和心率均有所下降,且高密度脂蛋白水平的维持情况显著优于对照组。在出院访谈中,患者表示糖尿病小组就诊有助于他们更负责地实现糖尿病自我管理目标。
将糖尿病自我管理教育与医疗保健提供者的就诊相结合的糖尿病小组就诊改善了糖化血红蛋白水平,并受到患者的好评。该研究在一个让患者感到安全可学习的环境中为他们提供了一个高质量项目,该项目契合了患者在糖尿病自我管理行为方面的实际情况。这种方法可广泛推广到其他为2型糖尿病患者服务的诊所环境中。