Chronic Care and Family Nursing, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan.
Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
BMJ Open. 2021 Sep 21;11(9):e045783. doi: 10.1136/bmjopen-2020-045783.
To investigate the efficacy and feasibility of a self-management programme incorporating a sleep intervention for improving diabetes outcomes.
A single-arm pre-test and post-test study was conducted within a community setting in Hiroshima, Japan.
Participants were aged 52-74 years and diagnosed with type 2 diabetic nephropathy stages 1-3.
Participants received self-management education from nurses for 6 months. First, the nurses assessed their sleep conditions using insomnia scales and a sleep metre. Then, the participants learnt self-management to increase their physical activity and improve their sleep condition. They also implemented diet therapy and medication adherence.
Physiological indicators, subjective and objective indicators of sleep quality, self-management indicators, quality of life (QOL) and feasibility were evaluated. To confirm the efficacy of intervention, Freidman tests, analysis of variance, Wilcoxon signed-rank test and t-test were performed. Pearson's correlations were analysed between activities and sleep condition.
Of the 26 enrolled participants, 24 completed the programme and were analysed. Among them, 15 participants (62.5%) had sleep disorders caused by multiple factors, such as an inappropriate lifestyle and physical factors that interfere with good sleep. Although insomnia scales did not change for the sleep disorders, their subjective health status improved. Regarding indicators related to diabetes management, lifestyles improved significantly. Haemoglobin A1c, body mass index, systolic blood pressure, non-high-density lipoprotein-cholesterol and QOL also improved. All participants except one were satisfied with the programme. However, use of the sleep metre and nurses' consultation about sleep disturbance were not well evaluated.
This programme was effective in improving diabetes status, lifestyle and behaviour changes. However, its effect on sleep condition was limited because of its complexity. A simple and novel approach is needed to strengthen the motivation for sleep behaviour change and to increase programme efficacy and feasibility.
UMIN000025906.
研究纳入睡眠干预的自我管理方案对改善糖尿病结局的疗效和可行性。
在日本广岛的社区环境中进行了单臂预测试和后测试研究。
参与者年龄在 52-74 岁之间，被诊断患有 1-3 期 2 型糖尿病肾病。
参与者接受了护士 6 个月的自我管理教育。首先，护士使用失眠量表和睡眠仪评估他们的睡眠状况。然后，参与者学习自我管理，以增加身体活动并改善睡眠状况。他们还实施了饮食疗法和药物依从性。
在 26 名入组的参与者中，有 24 名完成了方案并进行了分析。其中，15 名参与者（62.5%）患有由多种因素引起的睡眠障碍，如不适当的生活方式和影响良好睡眠的身体因素。尽管失眠量表没有改变睡眠障碍，但他们的主观健康状况有所改善。关于与糖尿病管理相关的指标，生活方式有了显著改善。糖化血红蛋白、体重指数、收缩压、非高密度脂蛋白胆固醇和生活质量也有所改善。除了一名参与者外，所有参与者都对该方案表示满意。然而，睡眠仪的使用和护士对睡眠障碍的咨询并没有得到很好的评价。
该方案在改善糖尿病状况、生活方式和行为改变方面是有效的。然而，由于其复杂性，它对睡眠状况的影响有限。需要一种简单而新颖的方法来加强对睡眠行为改变的动机，以提高方案的疗效和可行性。
UMIN000025906。
