McEwen Marylyn Morris, Pasvogel Alice, Murdaugh Carolyn, Hepworth Joseph
University of Arizona College of Nursing, Community and Health Systems Science Division, Tucson, Arizona (Dr McEwen, Dr Pasvogel, Dr Murdaugh, Dr Hepworth).
Diabetes Educ. 2017 Jun;43(3):272-285. doi: 10.1177/0145721717706031. Epub 2017 Apr 27.
Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.
目的 本研究旨在调查基于家庭的自我管理支持干预对2型糖尿病(T2DM)成人患者的影响。方法 采用两组实验性重复测量设计,将157对(T2DM患者及其家庭成员)随机分为干预组(接受教育、社会支持、家访和电话随访)或等待名单对照组。在基线、干预后(3个月)和干预后6个月收集数据。使用一系列2×3重复测量方差分析来检验假设,并通过交互对比评估即时和持续的干预效果。结果 饮食自我管理、运动自我管理、总体自我管理、糖尿病总体健康自我效能感和糖尿病总体自我效能感、医生困扰、治疗方案困扰、人际困扰和总体困扰随时间有显著变化。饮食自我管理、总体自我管理、糖尿病总体健康自我效能感、总体自我效能感、医生困扰、治疗方案困扰和人际困扰同样有持续效果。结论 结果支持并扩展了先前的研究,这些研究证明了与文化相关的基于家庭的干预措施在改善糖尿病自我管理方面的价值,并证实了需要强化、长期、量身定制的干预措施来实现血糖控制。