NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands.
PLoS One. 2019 Jun 27;14(6):e0218242. doi: 10.1371/journal.pone.0218242. eCollection 2019.
To evaluate the immediate and six-month effectiveness of a group-based self-management support program for people diagnosed with type 2 diabetes (1-3 years post diagnosis) on diabetes self-care, distress and cognitions.
People with type 2 diabetes were randomized into the intervention (four group-based interactive sessions) or the control group (a single educational lecture) with their partners. Outcomes were measured at baseline, immediately after the third course session and six months later using validated questionnaires on diabetes self-care, distress, illness perceptions, diabetes-related attitudes, empowerment and partner support. Multilevel analyses were conducted according to the intention-to-treat principle using the data from 82 intervention and 86 control group participants, to test for differences in changes over time between the two groups.
The intervention group showed a significantly higher increase in physical activity and fruit and vegetable intake immediately after the program, whereas the low baseline levels of diabetes distress remained unaffected. Furthermore, the intervention group believed their illness to be more likely to be caused by chance/bad luck, but also felt more empowered to handle their condition and its treatment immediately after the program compared with the control group. Six months later, only the differences in empowerment had persisted.
Group-based self-management support results in favorable short-term behavioral changes and more persistent alterations in (perceived) empowerment in people living in the first years of type 2 diabetes. In order to achieve more sustainable behavioral changes, more prolonged support is necessary. This could be achieved by integrating attention to patients' illness perceptions and continuous self-management support in regular diabetes care.
Netherlands Trial Registry NL3158.
评估基于小组的自我管理支持计划对 1-3 年内被诊断为 2 型糖尿病患者的糖尿病自我护理、痛苦和认知的即时和六个月效果。
将 2 型糖尿病患者随机分为干预组（四次小组互动课程）或对照组（一次教育讲座），并与他们的伴侣一起参与。使用经过验证的糖尿病自我护理、痛苦、疾病认知、糖尿病相关态度、授权和伴侣支持问卷，在基线、第三次课程结束后立即和六个月后进行评估。根据意向治疗原则，使用 82 名干预组和 86 名对照组参与者的数据进行多层次分析，以检验两组之间随时间变化的差异。
干预组在项目结束后立即显著增加了体力活动和水果及蔬菜摄入量，而糖尿病痛苦的低基线水平则不受影响。此外，干预组认为他们的疾病更有可能是由偶然/运气不佳引起的，但与对照组相比，他们在项目结束后立即感到更有能力处理自己的病情及其治疗。六个月后，只有授权方面的差异仍然存在。
基于小组的自我管理支持可导致短期行为改变更有利，并且在 2 型糖尿病患者的（感知）授权方面更持久的改变。为了实现更可持续的行为改变，需要更长时间的支持。这可以通过在常规糖尿病护理中关注患者的疾病认知和持续的自我管理支持来实现。
荷兰试验注册 NL3158。
