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基于心理因素的教育干预对2型糖尿病患者实现健康结局的有效性。

Effectiveness of educational intervention based on psychological factors on achieving health outcomes in patients with type 2 diabetes.

作者信息

Salahshouri Arash, Zamani Alavijeh Fereshteh, Mahaki Behzad, Mostafavi Firoozeh

机构信息

1Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.

2Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, 8174673461 Iran.

出版信息

Diabetol Metab Syndr. 2018 Sep 3;10:67. doi: 10.1186/s13098-018-0368-8. eCollection 2018.

Abstract

BACKGROUND

Managing type 2 diabetes (T2D) is assumed to be heavily dependent on patients' active participation in their own self-care behaviors including prescribed diets.

OBJECTIVES

The purpose of the present study was to investigate the effectiveness of educational intervention based on psychological factors on nutritional behaviors as well as levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in patients with T2D referring to diabetes clinics and healthcare centers in the city of Izeh, Iran.

METHODS

A total number of 145 patients were recruited in this clinical trial and then randomly assigned to two groups of intervention (n = 73 individuals) and control (n = 72 individuals). After that, a researcher-made multi-part questionnaire including a demographic characteristics information form, a nutritional perceptions and beliefs questionnaire; a scale measuring fears, concerns, and discomforts associated with diabetic diet, as well as the valid and reliable Perceived Dietary Adherence Questionnaire were used to collect the required data before and 3 months after the completion of the educational intervention. To this end, the patients in the intervention group attended an educational program for eight sessions but the individuals in the control group only received routine services. Data analysis was also conducted using the SPSS Statistics (Version 18) and via descriptive and inferential statistics.

RESULTS

The findings revealed that the mean scores of the sub-groups of nutritional perceptions and beliefs (but not exaggerated ones) in the patients assigned to the intervention group were significantly higher than those in the control group after 3 months (p = 0.001). As well, the mean scores of the sub-groups of fears, concerns, and discomforts in patients as well as exaggerated beliefs witnessed a significant decrease in the intervention group compared to those in the control group (p = 0.001) 3 months after the educational intervention. Furthermore, the mean scores of adherence to a healthy diet in the intervention group had significantly increased compared to those in the control group. There was correspondingly a significant descending trend in the average levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in the intervention group compared to those obtained in the control group (p = 0.001).

CONCLUSION

The results of this study shed light on the importance of the effectiveness of psychological factors on achieving health outcomes in patients with type 2 diabetes (T2D). Moreover, a new combination of diet-related psychological factors in patients with diabetes was introduced in the present study. IRCT. IRCT20180308039008N1. Registered 15 April 2018, http://www.irct.ir.

摘要

背景

2型糖尿病(T2D)的管理被认为在很大程度上依赖于患者积极参与自身的自我护理行为,包括规定的饮食。

目的

本研究的目的是调查基于心理因素的教育干预对伊朗伊泽市糖尿病诊所和医疗中心的2型糖尿病患者营养行为以及空腹血糖(FBS)和糖化血红蛋白(HbA1c)水平的有效性。

方法

在这项临床试验中总共招募了145名患者,然后将他们随机分为干预组(n = 73人)和对照组(n = 72人)。之后,使用研究人员制作的多部分问卷,包括人口统计学特征信息表、营养认知和信念问卷;测量与糖尿病饮食相关的恐惧、担忧和不适的量表,以及有效且可靠的感知饮食依从性问卷,在教育干预完成前和完成3个月后收集所需数据。为此,干预组的患者参加了为期八节的教育课程,而对照组的个体只接受常规服务。还使用SPSS Statistics(版本18)并通过描述性和推断性统计进行数据分析。

结果

研究结果显示,3个月后,干预组患者营养认知和信念子组(而非夸大的认知和信念)的平均得分显著高于对照组(p = 0.001)。同样,教育干预3个月后,干预组患者恐惧、担忧和不适子组以及夸大信念的平均得分与对照组相比显著降低(p = 0.001)。此外,干预组健康饮食依从性的平均得分与对照组相比显著提高。与对照组相比,干预组空腹血糖(FBS)和糖化血红蛋白(HbA1c)的平均水平相应地有显著下降趋势(p = 0.001)。

结论

本研究结果揭示了心理因素对2型糖尿病(T2D)患者实现健康结果有效性的重要性。此外,本研究引入了糖尿病患者饮食相关心理因素的新组合。IRCT. IRCT20180308039008N1。于2018年4月15日注册,http://www.irct.ir。

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