School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
School of Nursing, Tung Wah College, Hong Kong, Hong Kong SAR, China.
Sci Rep. 2023 Nov 27;13(1):20867. doi: 10.1038/s41598-023-48049-w.
Support from family and peers may enhance the outcomes of diabetes management. This study reported the preliminary effect of a family-based diabetes self-management education and support (DSMES) programme on the perceived support status of people with diabetes and the family's caregiver support behaviour amongst dyads living in Western Ethiopia. A 1:1 two-armed pilot randomised controlled trial (RCT) was conducted. A total of 76 dyads were recruited using the convenience sampling method and randomly assigned to either intervention or control groups. The control group continued the usual care, whereas the intervention group continued the usual care and additionally received a 12-h social cognitive theory (SCT)-guided, family-supported DSMES programme in the community. Generalised estimating equations models were computed to test the preliminary effects of the DSMES programme on the outcomes. P-value < 0.05 was set as statistically significant. The pilot RCT shows a statistically significant between-group difference in the changes in support needed at T1 (d = 0.88) and T2 (d = 1.35) and support received at T1 (d = 0.88) and T2 (d = 1.44). The DSMES programme has outperformed usual care with a medium effect size at T1 (d = 0.54) and a large effect size at T2 (d = 0.97) on the family's supportive behaviour. Although the intervention group was not statistically significant at T1 (d = 0.43), a large effect size was obtained at T2 (d = 0.97) on the family's non-supportive behaviour. A SCT-guided, family-supported DSMES programme produced a promising positive effect on enhancing the support needed and support received from their family/friends, and it also improved the family's supportive behaviour. Thus, family support could be incorporated into DSMES programmes for diabetes management in Western Ethiopia. The trial was registered by the Chinese Clinical Trial Registry ( http://www.chictr.org.cn ); Registration number: ChiCTR2000040292.
家庭和同伴的支持可能会增强糖尿病管理的效果。本研究报告了一项基于家庭的糖尿病自我管理教育和支持（DSMES）计划对居住在埃塞俄比亚西部的糖尿病患者及其家庭照顾者感知支持状况和家庭照顾者支持行为的初步影响。采用 1:1 双臂随机对照试验（RCT）进行。采用便利抽样法招募了 76 对患者，并将其随机分配到干预组或对照组。对照组继续接受常规护理，而干预组则继续接受常规护理，并在社区中额外接受 12 小时的社会认知理论（SCT）指导、家庭支持的 DSMES 计划。使用广义估计方程模型来检验 DSMES 计划对结果的初步影响。P 值<0.05 被认为具有统计学意义。该试点 RCT 显示，在 T1（d=0.88）和 T2（d=1.35）时需要的支持以及在 T1（d=0.88）和 T2（d=1.44）时获得的支持方面，干预组和对照组之间存在统计学上的显著差异。在 T1（d=0.54）和 T2（d=0.97）时，DSMES 计划对家庭支持行为的效果大小均为中等，而对照组的效果大小均为小。尽管在 T1 时，干预组的效果大小无统计学意义（d=0.43），但在 T2 时，效果大小为大（d=0.97）。在 T1 时，干预组的效果大小为小（d=0.43），在 T2 时，效果大小为大（d=0.97）。一项以 SCT 为指导、以家庭为支撑的 DSMES 计划对增强家庭/朋友的支持需求和获得的支持产生了积极的影响，同时也改善了家庭的支持行为。因此，家庭支持可以纳入埃塞俄比亚西部的糖尿病管理的 DSMES 计划中。该试验在中国临床试验注册中心（http://www.chictr.org.cn）注册；注册号：ChiCTR2000040292。
