Gehlawat Mamta, Lakshminarayanan Subitha, Kar Sitanshu Sekhar
Department of Preventive and Social Medicine, JIPMER, Puducherry, India.
Indian J Community Med. 2019 Apr-Jun;44(2):107-112. doi: 10.4103/ijcm.IJCM_192_18.
Diabetes self-management education plays a critical role in improving patients' clinical outcome and quality of life.
This study aims to study the effectiveness of a structured diabetes educational program on improvement of self-care behavior among type 2 diabetics in urban Primary Health Centres (PHCs) of Puducherry.
A community-based open-label parallel-arm randomized controlled trial was conducted in two randomly selected urban PHCs of Puducherry during December 2015-February 2017.
Using systematic random sampling, 157 eligible participants were recruited in intervention and control PHCs each. Sociodemographic, disease characteristics, and anthropometric measures were captured using a pretested questionnaire at baseline. Self-care behavior was recorded with Summary of Diabetes Self-Care Activities scale. Intervention consisted of structured diabetes education sessions with distribution of information leaflets and self-care kits to the intervention-arm participants, while control arm received standard care. At the end of 6 months, endline assessment was done for both groups. Data were analyzed by intention-to-treat, per-protocol, and difference-in-difference analysis using STATA.
Footcare increased significantly by 1.95 days/week compared to control arm, while a moderate change of 0.49 days/week in diet compliance and a minimal change of 0.10 days/week in physical activity were observed. Medication adherence, regular blood sugar testing, and smoking behavior also showed improvement in intervention arm.
A structured education program that is culturally tailored showed an overall improvement in self-care behavior. This research supports the need for structured education program for diabetics to empower them and improve self-care practices.
CTRI/2017/06/008772.
糖尿病自我管理教育在改善患者临床结局和生活质量方面发挥着关键作用。
本研究旨在探讨一项结构化糖尿病教育计划对提高本地治里市城市初级卫生保健中心（PHC）2型糖尿病患者自我护理行为的效果。
2015年12月至2017年2月期间，在本地治里市随机选取的两家城市初级卫生保健中心进行了一项基于社区的开放标签平行臂随机对照试验。
采用系统随机抽样方法，在干预组和对照组初级卫生保健中心各招募了157名符合条件的参与者。在基线时使用预先测试的问卷收集社会人口统计学、疾病特征和人体测量数据。使用糖尿病自我护理活动总结量表记录自我护理行为。干预措施包括为干预组参与者提供结构化糖尿病教育课程，并分发信息传单和自我护理工具包，而对照组接受标准护理。在6个月结束时，对两组进行终末评估。使用STATA软件通过意向性分析、符合方案分析和差异分析对数据进行分析。
与对照组相比，足部护理每周显著增加1.95天，饮食依从性有适度变化，每周增加0.49天，身体活动有微小变化，每周增加0.10天。干预组的药物依从性、定期血糖检测和吸烟行为也有所改善。
一项根据文化定制的结构化教育计划显示自我护理行为总体上有所改善。本研究支持为糖尿病患者开展结构化教育计划的必要性，以增强他们自身能力并改善自我护理实践。
CTRI/2017/06/008772。
