Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, China.
National Clinical Research Center for Metabolic Diseases, and Key Laboratory of Diabetes Immunology, Ministry of Education, Changsha, China.
BMC Endocr Disord. 2020 Mar 10;20(1):37. doi: 10.1186/s12902-020-0514-9.
Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme-'Type 1 Diabetes Education in Lifestyle and Self Adjustment' (TELSA) that is adapted to medical and cultural practices in China.
TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly.
A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: 'behaviour modification' and 'outcome improvement'; ii) contents: 'living with T1D', 'self-monitoring of blood glucose', 'knowing insulin', 'insulin dose adjustment', 'carbohydrates and carbohydrate counting', 'hypoglycaemia', 'complications of diabetes', 'managing psychological issues', 'physical activity', and 'question-and-answer'; iii) format: 'multidisciplinary team combined with peer support', 'face-to-face education followed by remote learning', and '2-day programme held on weekends'; and iv) quality assurance: 'after-class quiz', 'patients' feedback', and 'long-term evaluation on effectiveness'.
A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.
NCT03610984. Date of registration: August 2, 2018.
各种指南建议，所有确诊为 1 型糖尿病（T1D）的成年人都应接受循证、结构化的教育计划（SEP），以优化自我管理护理。中国每年新增确诊 T1D 病例约 13,000 例，其中 65%为成年人。然而，中国还没有针对 T1D 患者的经过验证的 SEP。本研究旨在建立一种结构化的 T1D 自我管理教育计划——“生活方式和自我调整的 1 型糖尿病教育”（TELSA），使其适应中国的医疗和文化实践。
TELSA 计划是基于 ADDIE 模型开发的，分三个步骤进行：i）对 10 名医疗保健专业人员（HCPs）和 13 名 T1D 患者进行半结构式访谈。针对 HCPs 或患者，设计了不同的主题指南，重点关注 4 个维度，包括目标、内容、交付格式和质量保证。访谈进行了录音和主题分析。ii）根据德尔菲咨询意见修改提取的主题。iii）进行初步课程作为试点研究，评估 TELSA 的效果，并相应优化课程。
方案设计的 4 个维度共确定了 18 个主题：i）目标：“行为改变”和“结果改善”；ii）内容：“与 T1D 共存”、“自我监测血糖”、“了解胰岛素”、“胰岛素剂量调整”、“碳水化合物和碳水化合物计数”、“低血糖”、“糖尿病并发症”、“管理心理问题”、“体育活动”和“问答”；iii）格式：“多学科团队结合同伴支持”、“面授教育后远程学习”和“周末 2 天课程”；iv）质量保证：“课后测验”、“患者反馈”和“对效果的长期评估”。
在中国建立了一种 1 型糖尿病结构化教育计划，该计划在当地医疗、社会和文化环境下适用。
NCT03610984。注册日期：2018 年 8 月 2 日。
