动机性访谈对2型糖尿病患者自我管理的影响：一项试点随机对照试验方案

Impact of Motivational Interviewing on Self-Management in Patients With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial.

作者信息

Wong Man Kin, Cheng Sai Yip Ronald, Chu Tsun Kit, Lam Fung Yee, Lai Shiu Kee, Wong Kai Chung, Liang Jun

机构信息

Department of Family Medicine and Primary Health Care, Tuen Mun Hospital, New Territories West Cluster, New Territories, Hong Kong.

出版信息

JMIR Res Protoc. 2020 Mar 31;9(3):e15709. doi: 10.2196/15709.

DOI:10.2196/15709

PMID:32229475

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7157490/

Abstract

BACKGROUND

The nonpharmacological approach to diabetic control in patients with diabetes focuses on a healthy diet, physical activity, and self-management. Therefore, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns and include brief advice and counseling services. Within this context, motivational interviewing (MI) has proven to be effective in changing health behaviors for specific cases. However, stronger evidence is needed on the effectiveness of MI in treating chronic pathologies such as diabetes.

OBJECTIVE

This study will obtain preliminary data on the impact of a nurse-led MI intervention in improving glycemic control, as well as clinical, psychosocial, and self-care outcomes for individuals with type 2 diabetes mellitus when compared with usual care, with the aim of improving diabetic control in patients with diabetes.

METHODS

An open, two-arm, parallel, randomized controlled, pilot exploratory trial will be performed. Two government outpatient clinics in the New Territories West Cluster in Hong Kong will be involved. In total, 20 to 25 participants will be invited in each arm. Intervention participants will receive face-to-face MI interventions in addition to their usual care from the clinic. Control participants will only receive usual care. Outcomes are assessed at baseline, 6 months, and 12 months. The primary outcome measure is glycated hemoglobin levels. Secondary outcomes include blood pressure, BMI, hip and waist circumference, fasting blood, and psychosocial and self-care measures.

RESULTS

This study is currently underway with funding support from the Hong Kong College of Family Physician Research Seed Fund 2017.

CONCLUSIONS

MI skills constitute the main strategies primary care nurses use on their patients. Having economical, simple, effective, and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of MI. It will be performed with strict control over the data collection, ensuring the maintenance of therapeutic integrity.

TRIAL REGISTRATION

Centre for Clinical Research and Biostatistics CUHK_CCRB00614; https://tinyurl.com/v9awzk6.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15709.

摘要

背景

糖尿病患者糖尿病控制的非药物方法侧重于健康饮食、体育活动和自我管理。因此，为帮助患者改变习惯，确定最有效的方法至关重要。人们已付出诸多努力来解释特定健康行为的改变或坚持情况。这些努力促成了一些理论的发展，这些理论已应用于预防运动，包括简短建议和咨询服务。在此背景下，动机性访谈（MI）已被证明在特定案例中能有效改变健康行为。然而，对于MI在治疗糖尿病等慢性疾病方面的有效性，还需要更有力的证据。

目的

本研究将获取初步数据，以了解由护士主导的MI干预对改善血糖控制的影响，以及与常规护理相比，对2型糖尿病患者的临床、心理社会和自我护理结果的影响，旨在改善糖尿病患者的糖尿病控制情况。

方法

将进行一项开放、双臂、平行、随机对照的探索性试验。香港新界西联网的两家政府门诊诊所将参与其中。每组将总共邀请20至25名参与者。干预组参与者除了接受诊所的常规护理外，还将接受面对面的MI干预。对照组参与者仅接受常规护理。在基线、6个月和12个月时评估结果。主要结局指标是糖化血红蛋白水平。次要结局包括血压、体重指数、臀围和腰围、空腹血糖以及心理社会和自我护理指标。