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希腊 2 型糖尿病和肥胖患者的现代基于网络的健康促进计划:一项干预研究。

A modern web-based health promotion program for patients in Greece with diabetes 2 and obesity: an interventional study.

机构信息

Intensive Care Unit, Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece.

2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian Athens University Medical School, Athens, 12462, Greece.

出版信息

BMC Public Health. 2023 Apr 3;23(1):639. doi: 10.1186/s12889-023-15557-3.

Abstract

BACKGROUND

Health promotion programs are most beneficial in chronic diseases such as diabetes and morbid obesity, which can be positively affected by changes in attitudes, beliefs, and lifestyle.

OBJECTIVES

This study aimed to develop an internet-based modern Health Promotion model using interactive online applications through continuing education and participation.

METHODS

The goal was to positively impact knowledge, behavior, and quality of life for patients with obesity and/or diabetes. This is a prospective interventional study on patients with obesity or type 2 diabetes. Seventeen two patients who met the inclusion criteria were distributed randomly into two groups (control and intervention) from 2019 to 2021 in Greece. All the participants were given questionaries concerning quality of life anxiety and depression (HADS) attitudes and beliefs, knowledge about their condition and general questions to establish a baseline. A traditional health promotion model was followed for the control group. For participants in the intervention group, a web-based health promotion program was created according to the goals of the research. Participants were instructed to log on 1-2 times a week for 5-15 min, with the understanding that the research team would be monitoring their activities. The website included two knowledge games and personalized educational material based on their needs.

RESULTS

The sample comprised 72 patients (36 in control and 36 in the intervention groups). The mean age was 47.8 years for the control group and 42.7 years for the intervention group (p = 0.293). Both study groups had a significant increase in knowledge score on diabetes (Control group:3,24, Intervention group 11,88 p < 0,001) and obesity (Control group:4,9, Intervention group 51,63 p < 0,001) along with a positive attitude score towards fighting obesity (Control group: 1,8, Intervention group 13,6 p < 0,001). Still, the overall change was more remarkable for the intervention group, as indicated by the significant interaction effect of the analysis. Anxiety was decreased only in the intervention group (Control group:0,11, Intervention group - 0,17 p < 0,005). Analysis for QOL during follow-up showed that Physical Health and Level of Independence was improved in both study groups but the degree of improvement was more significant in the intervention group (Control group 0,31,Intervention group 0,73 p < 0,001). Psychological Health was improved only in the intervention group, with better scores at 6 and 12 months compared to controls (Control group 0,28,Intervention group 1,42 p < 0,001). Furthermore, Social relationships were improved only in the intervention group (Control group 0,02, Intervention group 0,56 p < 0,001).

CONCLUSIONS

The results of the present study showed that the participants in the intervention group showed significant improvement in knowledge, attitudes, and beliefs after using the internet as a learning tool. The intervention group also showed significantly reduced anxiety and depression arising from chronic illness. All of this resulted in an improved quality of life regarding physical Health, mental Health, and social relationships. Technology and online-based health promotion programs can revolutionize how we approach the prevention and management of chronic and terminal illnesses by improving accessibility, personalizing care, increasing engagement and motivation, improving data analysis, and disease management.

摘要

背景

健康促进计划在糖尿病和病态肥胖等慢性病中最有益,这些疾病的态度、信念和生活方式的改变可以产生积极影响。

目的

本研究旨在通过继续教育和参与,使用互动在线应用程序开发基于互联网的现代健康促进模式。

方法

目标是积极影响肥胖和/或糖尿病患者的知识、行为和生活质量。这是一项针对肥胖或 2 型糖尿病患者的前瞻性干预研究。从 2019 年到 2021 年,在希腊,172 名符合纳入标准的患者被随机分为两组(对照组和干预组)。所有参与者都填写了关于生活质量焦虑和抑郁(HADS)态度和信念、对自身状况的了解以及一般问题的问卷,以建立基线。对照组遵循传统的健康促进模式。对于干预组的参与者,根据研究目标创建了一个基于网络的健康促进计划。参与者被指导每周登录 1-2 次,每次 5-15 分钟,同时研究团队将监控他们的活动。该网站包括两个知识游戏和基于他们需求的个性化教育材料。

结果

该样本包括 72 名患者(对照组 36 名,干预组 36 名)。对照组的平均年龄为 47.8 岁,干预组的平均年龄为 42.7 岁(p=0.293)。两组的糖尿病知识评分均显著增加(对照组:324,干预组:1188,p<0.001)和肥胖知识评分(对照组:49,干预组:5163,p<0.001),同时对肥胖的态度评分也呈积极趋势(对照组:18,干预组:136,p<0.001)。然而,干预组的整体变化更为显著,这表明分析中的交互效应具有统计学意义。焦虑仅在干预组中降低(对照组:0.11,干预组:-0.17,p<0.005)。随访期间的生活质量分析显示,两组的身体健康和独立水平均有所改善,但干预组的改善程度更为显著(对照组:0.31,干预组:0.73,p<0.001)。心理健康仅在干预组中得到改善,与对照组相比,6 个月和 12 个月时的评分更好(对照组:0.28,干预组:1.42,p<0.001)。此外,仅在干预组中社会关系得到改善(对照组:0.02,干预组:0.56,p<0.001)。

结论

本研究结果表明,使用互联网作为学习工具的干预组参与者在知识、态度和信念方面有显著提高。干预组也显著减轻了由慢性疾病引起的焦虑和抑郁。所有这些都导致身体健康、心理健康和社会关系方面的生活质量得到改善。技术和基于网络的健康促进计划可以通过提高可及性、个性化护理、增加参与度和动力、改善数据分析和疾病管理,彻底改变我们预防和管理慢性病和终末期疾病的方式。

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