Jutterström L, Hörnsten Å, Sandström H, Stenlund H, Isaksson U
Department of Nursing, Umeå University, Umeå, Sweden.
Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Patient Educ Couns. 2016 Nov;99(11):1821-1829. doi: 10.1016/j.pec.2016.06.016. Epub 2016 Jun 17.
The aim of this study was to evaluate the effect of a patient-centered self-management support, in type 2 diabetes (T2D) with regard to metabolic changes.
182 patients were randomized into group intervention (GI), individual intervention (II) or internal controls (IC). An external control (EC) group was recruited from another county council. The intervention consisted of six sessions that featured themes, which regarded different views of their illness experiences. Data were collected in 2010 and 2011.
HbA1c was significantly decreased at 12-month follow-up with 5mmol/mol in the GI and 4mmol/mol in the II. In the IC group, the HbA1c was close to baseline. The EC group had increased HbA1c, though not significantly. When the HbA1c difference at baseline was adjusted, there was a significant difference between intervention groups and the EC-group.
Patient-centered self-management support, led by nurses, can lower HbA1c among patients with type 2 diabetes.
It is possible to train diabetes specialist nurses in clinical patient-centered care, and simultaneously influence patients' metabolic balance positively.
本研究旨在评估以患者为中心的自我管理支持对2型糖尿病（T2D）患者代谢变化的影响。
182名患者被随机分为组干预（GI）组、个体干预（II）组或内部对照组（IC）。外部对照组（EC）从另一个县议会招募。干预包括六次以不同疾病体验观点为主题的课程。数据于2010年和2011年收集。
在12个月的随访中，GI组的糖化血红蛋白（HbA1c）显著降低了5mmol/mol，II组降低了4mmol/mol。IC组的HbA1c接近基线水平。EC组的HbA1c有所升高，但不显著。调整基线时的HbA1c差异后，干预组与EC组之间存在显著差异。
由护士主导的以患者为中心的自我管理支持可降低2型糖尿病患者的HbA1c水平。
培训糖尿病专科护士进行以临床患者为中心的护理，并同时对患者的代谢平衡产生积极影响是可行的。
