Guelph Family Health Team, Guelph, Ontario, Canada.
School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.
Can J Diabetes. 2018 Oct;42(5):470-477.e2. doi: 10.1016/j.jcjd.2017.11.003. Epub 2017 Nov 23.
Diabetes self-management refers to all activities patients undertake to care for their illness, promote health and prevent the long- and short-term effects of diabetes. This study compared the effectiveness of 2 diabetes self-management education methods by examining changes in glycated hemoglobin (A1C) levels and knowledge, attitudes and behaviours (KABs) after traditional group education (TE) or with diabetes conversation maps (CMs). The CMs group was postulated to show greater decrease in A1C levels and improved KABs scores compared to the TE group.
A sample of 21 eligible clients from Diabetes Care Guelph were randomly assigned into 2 groups: 10 receiving education through CMs and 11 through TE. Changes in knowledge and attitude were determined by using questionnaires and repeated-measures pretest and post-test design before and after the education sessions. Changes in A1C levels were determined by comparing values at baseline and at 3 months after receiving diabetes education. Two focus groups were conducted to obtain participants' perceptions of the education methods and self-reported KAB changes.
Significant differences in knowledge and attitude score changes were observed from baseline/initial education and after 3 months. Both groups had significant decreases in A1C levels from baseline to 3 months afterward. Focus groups revealed themes common to both groups, such as benefits of early education, the need for multiple lifestyle behaviour changes and feelings about social support.
CMs had a significant impact and are effective for group education. The changes observed may lead to improved diabetes self-management, thus reducing costly health complications related to poorly controlled diabetes.
糖尿病自我管理是指患者为照顾自己的疾病、促进健康和预防糖尿病的长期和短期影响而进行的所有活动。本研究通过检查糖化血红蛋白(A1C)水平的变化以及传统小组教育(TE)或糖尿病对话图(CM)后的知识、态度和行为(KAB),比较了两种糖尿病自我管理教育方法的有效性。假设 CM 组在 A1C 水平下降和 KAB 评分改善方面优于 TE 组。
从 Guelph 糖尿病护理中抽取 21 名符合条件的患者,随机分为两组:10 名通过 CM 接受教育,11 名通过 TE。通过问卷和重复测量预测试和后测试设计,在教育课程前后确定知识和态度的变化。通过比较基线和接受糖尿病教育 3 个月后的 A1C 值来确定 A1C 水平的变化。进行了两次焦点小组讨论,以了解参与者对教育方法的看法和自我报告的 KAB 变化。
从基线/初始教育到 3 个月后,知识和态度得分的变化有显著差异。两组的 A1C 水平均从基线显著下降至 3 个月后。焦点小组揭示了两个组共有的主题,如早期教育的好处、需要多次改变生活方式行为以及对社会支持的感受。
CM 对小组教育有显著影响且有效。观察到的变化可能会导致更好的糖尿病自我管理,从而减少与控制不佳的糖尿病相关的昂贵的健康并发症。