一项基于网络的2型糖尿病结构化教育项目的可行性、可接受性及影响：真实世界研究
Feasibility, Acceptability, and Impact of a Web-Based Structured Education Program for Type 2 Diabetes: Real-World Study.
作者信息
Poduval Shoba, Marston Louise, Hamilton Fiona, Stevenson Fiona, Murray Elizabeth
机构信息
Research Department of Primary Care and Population Health, University College London, London, United Kingdom.
University College London, London, United Kingdom.
出版信息
JMIR Diabetes. 2020 Jan 6;5(1):e15744. doi: 10.2196/15744.
BACKGROUND
Structured education for people with type 2 diabetes improves outcomes, but uptake is low globally. In the United Kingdom in 2016, only 8.3% of people who were referred to education programs attended the program. We have developed a Web-based structured education program named Healthy Living for People with type 2 Diabetes (HeLP-Diabetes): Starting Out (HDSO), as an alternative to face-to-face courses. A Web-based program gives people more options for accessing structured education and may help improve overall uptake.
OBJECTIVE
The aim was to explore the feasibility and acceptability of delivering a Web-based structured education program (named HeLP-Diabetes: Starting Out) in routine primary health care and its potential impact on self-efficacy and diabetes-related distress.
METHODS
HDSO was delivered as part of routine diabetes services in primary health care in the United Kingdom, having been commissioned by local Clinical Commissioning Groups. Quantitative data were collected on uptake, use of the program, demographic characteristics, self-reported self-efficacy, and diabetes-related distress. A subsample of people with type 2 diabetes and health care professionals were interviewed about acceptability of the program.
RESULTS
It was feasible to deliver the program, but completion rates were low: of 791 people with type 2 diabetes registered, only 74 (9.0%) completed it. Completers improved their self-efficacy (change in median score 2.5, P=.001) and diabetes-related distress (change in median score 6.0, P=.001). Interview data suggested that the course was acceptable, and that uptake and completion may be related to nonprioritization of structured education.
CONCLUSIONS
The study provides evidence of the feasibility and acceptability of a Web-based structured education. However, uptake and completion rates were low, limiting potential population impact. Further research is needed to improve completion rates, and to determine the relative effectiveness of Web-based versus face-to-face education.
背景
针对2型糖尿病患者的结构化教育可改善治疗效果，但全球范围内的参与率较低。2016年在英国，被转介至教育项目的患者中只有8.3%参加了该项目。我们开发了一个名为“2型糖尿病患者健康生活：起步”（HeLP-Diabetes: Starting Out，简称HDSO）的基于网络的结构化教育项目，作为面对面课程的替代方案。基于网络的项目为人们提供了更多获取结构化教育的选择，可能有助于提高总体参与率。
目的
探讨在常规初级卫生保健中提供基于网络的结构化教育项目（名为“2型糖尿病患者健康生活：起步”）的可行性和可接受性，以及其对自我效能感和糖尿病相关困扰的潜在影响。
方法
HDSO作为英国初级卫生保健中常规糖尿病服务的一部分提供，由当地临床委托小组委托开展。收集了关于参与率、项目使用情况、人口统计学特征、自我报告的自我效能感和糖尿病相关困扰的定量数据。对2型糖尿病患者和医疗保健专业人员的一个子样本进行了访谈，了解该项目的可接受性。
结果
实施该项目是可行的，但完成率较低：在791名登记的2型糖尿病患者中，只有74人（9.0%）完成了该项目。完成项目的患者提高了自我效能感（中位数得分变化2.5，P = 0.001）和糖尿病相关困扰（中位数得分变化6.0，P = 0.001）。访谈数据表明该课程是可接受的，参与率和完成率可能与未将结构化教育列为优先事项有关。
结论
该研究提供了基于网络的结构化教育的可行性和可接受性的证据。然而，参与率和完成率较低，限制了对潜在人群的影响。需要进一步研究以提高完成率，并确定基于网络的教育与面对面教育的相对有效性。
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