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黎巴嫩一家初级医疗保健中心中治疗性教育对2型糖尿病患者自我效能、自我护理活动及血糖控制的影响

Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon.

作者信息

ElGerges Najwa S

机构信息

Faculty of Nursing and Health Sciences, Notre Dame University, P.O.Box72, Zouk Mosbeh, Lebanon.

出版信息

J Diabetes Metab Disord. 2020 Jun 12;19(2):813-821. doi: 10.1007/s40200-020-00567-4. eCollection 2020 Dec.

Abstract

BACKGROUND

Diabetes type 2 is a chronic hyperglycemia, its control depends on the patient's Self-efficacy and self-care activities. Therapeutic Patient Education (TPE) enhances the patient involvement and engagement in managing chronic diseases effectively by improving the health outcomes. It helps the patients developing competencies of self-care, coping with diabetes and controlling glycaemia.

OBJECTIVE

The objectives of this study are to assess the effects of TPE in type 2 Diabetic patients in Lebanon on their glycemic control, Diabetes Management Self-Efficacy Scale (DMSES) and their self-care activities (Summary of Diabetes Self-Care Activities SDSCA).

MATERIALS AND METHODS

A total of 100 diabetic patients (50 experimental, 50 control) were recruited from a primary care center according to inclusion and exclusion criteria. The experimental group followed the TPE by a multidisciplinary team. Glycemic control, DMSES and SDSCA were measured at baseline and after three months. The experimental group (EG) was followed up by phone calls every two weeks after the TPE.

RESULTS

The results revealed that the experimental group showed significant improvement at the level of self-efficacy in managing their disease concerning general nutrition, specific nutrition, control of glycaemia, physical activity, weight control and medical control (α<0.01); the total score of DMSES had significantly increased from 5.02 to 8.28 in the EG (α<0.01) compared to the control group (CG) that has decreased from 4.91 to 4.85 (α<0.05). Moreover, regarding the SDSCA of the EG, the results highlighted that the activities related to general diet, specific diet, physical exercise, foot care, the measurement of glycaemia and the medication-taking had significantly improved (α<0.05), whereas the CG didn't improve his self-care activities (α>0.05). In addition, the glycemic control HbA1c had improved in the EG after the intervention compared to the CG.

CONCLUSION

The findings of this study demonstrated that Therapeutic Patient Education is efficient in contributing to better glycemic control, better DMSES and SDSCA. Health professionals are best suited to help diabetic patients improve their self-efficacy in managing diabetes, controlling glycemia and improving their self-care.

摘要

背景

2型糖尿病是一种慢性高血糖疾病,其控制取决于患者的自我效能感和自我护理活动。治疗性患者教育(TPE)通过改善健康结局,增强患者有效参与和管理慢性病的能力。它有助于患者培养自我护理、应对糖尿病和控制血糖的能力。

目的

本研究的目的是评估黎巴嫩2型糖尿病患者中TPE对其血糖控制、糖尿病管理自我效能量表(DMSES)和自我护理活动(糖尿病自我护理活动总结SDSCA)的影响。

材料与方法

根据纳入和排除标准,从一个初级保健中心招募了总共100名糖尿病患者(50名实验组,50名对照组)。实验组由一个多学科团队进行TPE。在基线和三个月后测量血糖控制、DMSES和SDSCA。TPE后,每两周通过电话对实验组(EG)进行随访。

结果

结果显示,实验组在疾病管理的自我效能感方面,在一般营养、特定营养、血糖控制、体育活动、体重控制和医疗控制水平上有显著改善(α<0.01);与对照组(CG)相比,实验组的DMSES总分从5.02显著增加到8.28(α<0.01),而对照组从4.91下降到4.85(α<0.05)。此外,关于实验组的SDSCA,结果突出显示与一般饮食、特定饮食、体育锻炼、足部护理、血糖测量和服药相关的活动有显著改善(α<0.05),而对照组的自我护理活动没有改善(α>0.05)。此外,与对照组相比,干预后实验组的糖化血红蛋白(HbA1c)血糖控制有所改善。

结论

本研究结果表明,治疗性患者教育有助于更好地控制血糖、改善DMSES和SDSCA。卫生专业人员最适合帮助糖尿病患者提高管理糖尿病、控制血糖和改善自我护理的自我效能感。

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