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空巢老年糖尿病患者自我管理的随机对照试验。

Self-management of Diabetes for Empty Nest Older Adults: A Randomized Controlled Trial.

机构信息

School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China.

School/Hospital of Stomatology of Lanzhou University, Lanzhou, China.

出版信息

West J Nurs Res. 2023 Oct;45(10):921-931. doi: 10.1177/01939459231191599. Epub 2023 Aug 24.

DOI:10.1177/01939459231191599
PMID:37615083
Abstract

BACKGROUND

Despite much evidence showing the effectiveness of structured self-management education for diabetes, poor glycemic control remains a challenge among empty nest older adults.

OBJECTIVE

We explored the effect of a health education intervention based on the PRECEDE-PROCEED model on the self-management of empty nest older adults with type 2 diabetes in Lanzhou, China.

METHODS

We conducted a 2-armed, randomized controlled trial using a multistage sampling method. A total of 100 patients were randomly assigned to receive either community nurse-led diabetes education based on the PRECEDE-PROCEED model or general community diabetes education. Self-management scores and blood glucose were compared at baseline and at 3 and 6 months after the intervention.

RESULTS

Analyses were conducted on the 98 patients completing follow-up. In the experimental group, diabetes self-management knowledge ( = 7.578, < .001), self-management attitude ( = 9.155, < .001), self-management behavior ( = 7.809, < .001), and overall self-management scores ( = 7.626, < .001) improved, with hemoglobin A ( = -2.825, = .006), fasting plasma glucose ( = -3.100, = .003), 2-hour postprandial blood glucose ( = -3.812, < .001), and diastolic blood pressure ( = -2.104, = .038) decreasing compared with the control group at 6 months postintervention.

CONCLUSIONS

This study demonstrated that education based on the PRECEDE-PROCEED model was more effective than general health education in improving diabetes self-management and glycemic control among empty nest older adults.

摘要

背景

尽管有大量证据表明结构化自我管理教育对糖尿病有效,但空巢老年患者的血糖控制仍然不佳。

目的

本研究旨在探讨基于 PRECEDE-PROCEED 模式的健康教育干预对中国兰州空巢老年 2 型糖尿病患者自我管理的影响。

方法

采用多阶段抽样方法,进行了一项 2 臂随机对照试验。共纳入 100 例患者,随机分为社区护士主导的基于 PRECEDE-PROCEED 模式的糖尿病教育组和常规社区糖尿病教育组。在干预前、干预 3 个月和 6 个月时,比较两组患者的自我管理评分和血糖水平。

结果

对完成随访的 98 例患者进行了分析。在实验组中,糖尿病自我管理知识( = 7.578, <.001)、自我管理态度( = 9.155, <.001)、自我管理行为( = 7.809, <.001)和总体自我管理评分( = 7.626, <.001)均有所提高,血红蛋白 A1c( = -2.825, =.006)、空腹血糖( = -3.100, =.003)、餐后 2 小时血糖( = -3.812, <.001)和舒张压( = -2.104, =.038)均较对照组在干预 6 个月时有所下降。

结论

本研究表明,基于 PRECEDE-PROCEED 模式的教育比常规健康教育更能有效提高空巢老年患者的糖尿病自我管理和血糖控制水平。

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