Lavelle Dianne, Zeitoun Joanah, Stern Marianne, Butkiewicz Elise, Wegner Elfie, Reinisch Courtney
School of Nursing, Rutgers University.
Overlook Family Medicine Residency, Atlantic Health.
Cureus. 2016 Jul 25;8(7):e710. doi: 10.7759/cureus.710.
Diabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients' homes.
Baseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided.
The biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address.
This project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting.
糖尿病自我管理教育和家访已被证明能改善糖尿病患者的临床结局。本试点项目的目的是评估在患者家中开展自我管理教育的可行性和有效性。
收集一组成年糖尿病患者的基线生物特征数据。罗格斯大学护理学院的博士生对19名患者进行了家访。家访内容包括知识评估、家中食物审查、糖尿病自我管理教育以及教授正确使用血糖仪和血压计等监测工具。干预后获取生物标志物，并与基线生物标志物进行比较。收集描述性生活方式数据，并提供定制患者教育的机会。
教育干预后的四个月内，生物标志物总体有所改善。平均糖化血红蛋白（A1C）降低了12%（p = 0.0107），平均血糖降低了12%（p = 0.0994），平均体重指数（BMI）降低了2%（p = 0.1490），收缩压降低了1%（p = 0.4196），舒张压保持稳定。设定具体目标进一步提高了个体计划解决领域的改善程度。
本项目支持先前的研究，即家庭教育项目可以改善糖尿病的自我管理并导致健康指标的改善。该研究的益处包括在确保正确使用家庭健康监测设备方面的个人关注、建立自我管理信心以及识别在诊所环境中可能不易察觉的治疗障碍。
