Whitehead Lisa, Glass Courtney C, Abel Sally L, Sharp Kiri, Coppell Kirsten J
School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027 Australia.
Kaupapa Consulting Ltd, Napier, 4110 New Zealand.
BMC Nurs. 2020 Jul 15;19:67. doi: 10.1186/s12912-020-00462-6. eCollection 2020.
The management of prediabetes in the community setting is a global priority. We evaluated the feasibility of a 6-month multilevel practice nurse-led prediabetes dietary intervention which involved goal setting. The aim of this paper is to explore the weight loss goals and strategies reported by participants to achieve their weight loss goals as recorded by practice nurses, and report on factors that influenced dietary behaviours.
This study used a convergent mixed-methods design. A six-month pragmatic non-randomised pilot study with a qualitative process evaluation was conducted in two neighbouring provincial cities in New Zealand. A structured dietary intervention delivered by practice nurses was implemented in four practices in 2014-2016. Content analysis of the text and descriptive statistics were used to analyse the data.
One hundred and fifty seven people with prediabetes were enrolled (85 intervention, 72 control). The intervention group lost a mean 1.3 kg more than the control group ( < .0.001). The majority of the intervention group indicated either a high level of readiness ( = 42, 53%) or some readiness ( = 31, 39%) to make food changes. The majority of weight loss goals aligned with clinical guidelines (between 5 and 10% of body weight). While just over half ( = 47, 55%) demonstrated weight loss at the end of the six month period, the majority of participants did not achieve their predetermined weight loss goal ( = 78, 83%). Gender, ethnicity and budget were not related to weight loss at six months. Readiness to change and reported challenges to making dietary changes were related to weight loss at six months. Negative factors or set-backs included sporadic adherence to diet due to other health problems, change in context or environment and coping with ill health, most notably stress and low mood.
The data relating to weight loss and dietary goals provided insight into the challenges that people faced in making dietary changes for weight loss across a six month period. Simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the person, in a socially supportive environment, may increase the success of goal achievement.
ANZCTR ACTRN1261500080656. Registered 3 August 2015 (Retrospectively registered). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366560&isReview=true.
社区环境中糖尿病前期的管理是一项全球重点工作。我们评估了由执业护士主导的为期6个月的糖尿病前期饮食干预（包括设定目标）的可行性。本文旨在探讨参与者报告的减肥目标及为实现这些目标所采取的策略（由执业护士记录），并报告影响饮食行为的因素。
本研究采用了收敛性混合方法设计。在新西兰两个相邻的省级城市进行了一项为期6个月的实用非随机试点研究，并进行了定性过程评估。2014 - 2016年，在四家医疗机构实施了由执业护士提供的结构化饮食干预。采用文本内容分析和描述性统计方法对数据进行分析。
共招募了157名糖尿病前期患者（85名干预组，72名对照组）。干预组比对照组平均多减重1.3千克（<0.001）。干预组中的大多数人表示有很高的意愿（n = 42，53%）或有一定意愿（n = 31，39%）做出饮食改变。大多数减肥目标符合临床指南（体重的5%至10%）。虽然略超过一半（n = 47，55%）的人在六个月结束时体重减轻，但大多数参与者未达到预定的减肥目标（n = 78，83%）。性别、种族和预算与六个月时的体重减轻无关。改变的意愿以及报告的饮食改变挑战与六个月时的体重减轻有关。负面因素或挫折包括因其他健康问题导致的饮食偶尔不规律、环境变化以及应对健康不佳状况，最明显的是压力和情绪低落。
与减肥和饮食目标相关的数据揭示了人们在六个月期间为减肥而进行饮食改变时所面临的挑战。在社会支持的环境中，将目标设定简化为具有最大潜在临床影响或对个人最重要的目标，可能会提高目标实现的成功率。
澳大利亚和新西兰临床试验注册中心（ANZCTR）注册号：ACTRN1261500080656。于2015年8月3日注册（追溯注册）。https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366560&isReview=true。
