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家庭为基础的药师干预对 2 型糖尿病的影响:一项随机对照试验。

Family-based intervention by pharmacists for type 2 diabetes: A randomised controlled trial.

机构信息

Pharmacy Division, Thepha Hospital, Lam Phai Thepha Road, Thepha, Songkhla, 90150, Thailand.

Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand.

出版信息

Patient Educ Couns. 2019 Jan;102(1):85-92. doi: 10.1016/j.pec.2018.08.015. Epub 2018 Aug 11.

Abstract

OBJECTIVES

To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.

METHODS

This was a prospective randomised controlled trial. Participants with type 2 diabetes were randomly assigned to an intervention group (n = 98) or a control group (n = 98). A pharmacist delivered the educational sessions and encouraged family members to take an active role in self-management practices for the intervention patients. The control patients received usual care.

RESULTS

At the end of the study (9-month follow-up), greater reduction in glycosylated haemoglobin (HbA) occurred in the intervention group than in the control group (-1.37% and -0.21%, respectively; P < 0.001). Between-group differences in the improvements of low-density lipoprotein cholesterol (LDL-C) and blood pressure were found (P < 0.05). Higher scores in diabetes knowledge of patients, family support, medication adherence, self-management and self-efficacy were seen in the intervention group than in the control group (P < 0.05). Multivariable analysis showed family members who were spouses or women were strong predictors of improved glycaemic control.

CONCLUSION

Family-involvement intervention is helpful in diabetes management, especially having spouses or women as caregivers.

PRACTICE IMPLICATIONS

Family involvement should be encouraged in diabetes care.

摘要

目的

研究家庭干预对 2 型糖尿病的疗效,并探讨血糖控制的预测因素。

方法

这是一项前瞻性随机对照试验。将 2 型糖尿病患者随机分为干预组(n=98)和对照组(n=98)。药剂师提供教育课程,并鼓励家庭成员在干预患者的自我管理实践中发挥积极作用。对照组患者接受常规护理。

结果

研究结束时(9 个月随访),干预组患者的糖化血红蛋白(HbA)下降幅度大于对照组(分别为-1.37%和-0.21%;P<0.001)。两组患者在低密度脂蛋白胆固醇(LDL-C)和血压改善方面存在差异(P<0.05)。干预组患者的糖尿病知识、家庭支持、药物依从性、自我管理和自我效能评分均高于对照组(P<0.05)。多变量分析显示,配偶或女性家庭成员是改善血糖控制的有力预测因素。

结论

家庭参与干预有助于糖尿病管理,特别是有配偶或女性作为照顾者。

实践意义

应鼓励家庭参与糖尿病护理。

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