Joensen Lene Eide, Meldgaard Andersen Merete, Jensen Sabrina, Nørgaard Kirsten, Willaing Ingrid
Diabetes Management Research, Steno Diabetes Center Copenhagen, Gentofte.
Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark.
Patient Prefer Adherence. 2017 Nov 2;11:1879-1890. doi: 10.2147/PPA.S142204. eCollection 2017.
The aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what effects are appropriate to expect, according to participants? and 2) to what extent did these effects occur?
Two peer support intervention programs were conducted in a diabetes specialist clinic (N=30). A participatory and adaptable approach allowed flexibility in the content of peer support meetings, which were facilitated by a diabetes nurse. Individual interviews explored participants' perception of effects of the intervention. Interview data were analyzed qualitatively. Participants (n=27) completed a baseline and postintervention questionnaire that included items assessing diabetes empowerment, diabetes distress, diabetes-specific social support, and diabetes loneliness. HbA1c levels were compared before and after the intervention.
Participants experienced enhanced diabetes-specific social capital, diabetes motivation, awareness of personal diabetes practices, and serenity and openness in life with diabetes. They also became more aware of treatment and support possibilities. Negative effects included feeling sad or upset after the meetings or feeling different than and not as well-controlled as other participants. Quantitative analyses showed enhanced social support, decreased eating distress and trends toward enhanced diabetes empowerment, decreased diabetes loneliness, and decreased diabetes distress (powerlessness). We found fewer positive and/or negative outcomes among participants who felt no need for peer support or felt that the group was not a unit or that important issues were not addressed.
The study indicated that flexible and participatory peer support can strengthen diabetes-specific social capital and improve participants' well-being and diabetes empowerment. Awareness of participants' incentives for attending peer support, as well as the risk of people feeling isolated within peer support groups, is essential to creating effective diabetes-specific social support.
本研究旨在探讨在临床环境中,针对使用胰岛素泵治疗的1型糖尿病成人患者,开展灵活且具参与性的同伴支持干预措施的效果,重点关注增强糖尿病特异性社会资本。关键问题如下:1)根据参与者的看法,预期会有哪些合适的效果?2)这些效果在多大程度上出现了?
在一家糖尿病专科诊所开展了两项同伴支持干预项目(N = 30)。采用参与性和适应性方法,使同伴支持会议的内容具有灵活性,由一名糖尿病护士提供协助。通过个体访谈探究参与者对干预效果的看法。对访谈数据进行定性分析。参与者(n = 27)完成了一份基线和干预后问卷,其中包括评估糖尿病自我管理能力、糖尿病困扰、糖尿病特异性社会支持和糖尿病孤独感的项目。比较干预前后的糖化血红蛋白水平。
参与者体验到糖尿病特异性社会资本增强、糖尿病动力增强、对个人糖尿病治疗方法的认识提高,以及在糖尿病生活中更加平静和开放。他们也更加了解治疗和支持的可能性。负面影响包括会议后感到悲伤或心烦意乱,或者感觉与其他参与者不同且血糖控制不如其他人。定量分析显示社会支持增强、饮食困扰减少,以及糖尿病自我管理能力增强、糖尿病孤独感降低和糖尿病困扰(无助感)降低的趋势。在那些认为不需要同伴支持或觉得小组不是一个整体或重要问题未得到解决的参与者中,我们发现的积极和/或消极结果较少。
该研究表明,灵活且具参与性的同伴支持可以增强糖尿病特异性社会资本,改善参与者的幸福感和糖尿病自我管理能力。了解参与者参加同伴支持的动机,以及人们在同伴支持小组中感到孤立的风险,对于创建有效的糖尿病特异性社会支持至关重要。