Al Lenjawi Badriya, Mohamed Hashim, Amuna Paul, Zotor Francis, Ziki Maen D Abou
1Department of Nursing, Hamad Medical Corporation, Doha, Qatar.
2Department of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar.
Diabetol Int. 2016 Sep 22;8(1):95-103. doi: 10.1007/s13340-016-0286-7. eCollection 2017 Mar.
This study assessed whether a structured nurse-led diabetes educational program underpinned by the theories of the health belief model, change in locus of control, and patient empowerment is effective in improving glycemic and metabolic parameters among South Asians with type II diabetes compared to regular outpatient care.
This was a parallel-group randomized trial in South Asian adult patients with type II diabetes living in Qatar. 460 subjects were randomized to a nurse-led, group-based diabetes educational program ( = 230) or to usual care ( = 230). The primary outcome was the improvement in HbA1c and other metabolic parameters, including lipid profile, albumin/creatinine ratio, blood pressure, and body mass index. Patients in the intervention group were invited to attend four 2-h sessions of self-efficacy improvement education once weekly. Outcomes were assessed at baseline and 12 months later. An intention-to-treat analysis was performed using repeated measures ANOVA (analysis of variance) for each of the clinical outcome variables.
After 12 months, 290 patients completed the study. Subjects in the intervention group had statistically significant improvements in HbA1c (-0.55 %, = 0.012), fasting blood sugar (-16.6 mg/dl, = 0.022), albumin/creatinine ratio (-3.09, < 0.001), and HDL cholesterol (+6.08 mg/dl, < 0.0001).
The inclusion of South Asian patients with type II diabetes in a structured, theory-based diabetes educational program that is led by nurses improves glycemic and metabolic parameters after 12 months.
本研究评估了一项由护士主导的结构化糖尿病教育项目,该项目以健康信念模型、控制点变化及患者赋权理论为基础,与常规门诊护理相比,在改善南亚II型糖尿病患者的血糖和代谢参数方面是否有效。
这是一项针对居住在卡塔尔的南亚成年II型糖尿病患者的平行组随机试验。460名受试者被随机分为护士主导的、基于小组的糖尿病教育项目组(n = 230)或常规护理组(n = 230)。主要结局是糖化血红蛋白(HbA1c)及其他代谢参数的改善,包括血脂谱、白蛋白/肌酐比值、血压和体重指数。干预组患者被邀请每周参加一次,共四次、每次2小时的自我效能感提升教育课程。在基线和12个月后评估结局。对每个临床结局变量使用重复测量方差分析(ANOVA)进行意向性分析。
在12个月后,290名患者完成了研究。干预组受试者的糖化血红蛋白(-0.55%,P = 0.012)、空腹血糖(-16.6mg/dl,P = 0.022)、白蛋白/肌酐比值(-3.09,P < 0.001)和高密度脂蛋白胆固醇(+6.08mg/dl,P < 0.0001)有统计学显著改善。
将南亚II型糖尿病患者纳入由护士主导的、基于理论的结构化糖尿病教育项目,12个月后可改善血糖和代谢参数。