基于网络的项目对2型糖尿病患者自我护理行为和糖化血红蛋白是否有效:一项随机对照试验

Is Web-Based Program Effective on Self-Care Behaviors and Glycated Hemoglobin in Patients with Type 2 Diabetes: A Randomized Controlled Trial.

作者信息

Eghtedari Maryam, Goodarzi-Khoigani Masoomeh, Shahshahani Maryam Sadat, Javadzade Homamodin, Abazari Parvaneh

机构信息

Department of Community Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Iran J Nurs Midwifery Res. 2023 Nov 9;28(6):723-729. doi: 10.4103/ijnmr.ijnmr_59_22. eCollection 2023 Nov-Dec.

Abstract

BACKGROUND

Diabetes Self-Management Education and Support (DSMES) as a framework focuses on seven self-care behaviors. Moreover, technology-assisted self-care education is increasingly suggested for patients with Type 2 Diabetes Mellitus (T2DM). Therefore, we examined the effect of a web-based program on self-care behaviors and glycated hemoglobin values in patients with diabetes mellitus.

MATERIALS AND METHODS

This randomized controlled clinical trial was conducted at Alzahra Hospital in Isfahan, Iran, between April and November 2020 and included 70 patients with T2DM. Data were collected using a questionnaire that included a demographic information section and a diabetes self-management section with 21 questions on a Likert scale. Fasting blood samples (2.50 ml) were collected before and after the interventions to measure HbA1c levels. The study intervention involved a web-based program that included multimedia educational content (such as videos, lectures, educational motion graphics, text files, posters, and podcasts) presented in seven sections based on DSMES over a 21-day period with monitoring by an instructor.

RESULTS

The mean scores for healthy eating (F = 3.48, = 0.034) and medication adherence (F = 6.70, < 0.001) significantly increased in the interventional group, while the mean scores for being active, monitoring, reducing risks, problem-solving, and healthy coping did not significantly change. Additionally, the mean differences in HbA1c values significantly improved in the interventional group compared to the control (F = 5,1, = 0.026).

CONCLUSIONS

A web-based program in accordance with DSMES improved HbA1c levels and increased scores for healthy eating and medication adherence in patients with T2DM. However, further research with larger sample sizes and qualitative interviews is needed.

摘要

背景

糖尿病自我管理教育与支持(DSMES)作为一个框架,聚焦于七种自我护理行为。此外,越来越多的人建议对2型糖尿病(T2DM)患者采用技术辅助的自我护理教育。因此,我们研究了一个基于网络的项目对糖尿病患者自我护理行为和糖化血红蛋白值的影响。

材料与方法

这项随机对照临床试验于2020年4月至11月在伊朗伊斯法罕的阿尔扎赫拉医院进行,纳入了70例T2DM患者。使用一份问卷收集数据,该问卷包括人口统计学信息部分和糖尿病自我管理部分,其中有21个李克特量表问题。在干预前后采集空腹血样(2.50毫升)以测量糖化血红蛋白水平。研究干预包括一个基于网络的项目,该项目包含多媒体教育内容(如视频、讲座、教育动态图形、文本文件、海报和播客),根据DSMES分为七个部分,在21天内呈现,并由一名指导教师进行监督。

结果

干预组中,健康饮食(F = 3.48,P = 0.034)和药物依从性(F = 6.70,P < 0.001)的平均得分显著提高,而运动、监测、降低风险、解决问题和健康应对的平均得分没有显著变化。此外,与对照组相比,干预组糖化血红蛋白值的平均差异有显著改善(F = 5.1,P = 0.026)。

结论

一个符合DSMES的基于网络的项目改善了T2DM患者的糖化血红蛋白水平,并提高了健康饮食和药物依从性的得分。然而,需要进行更大样本量的进一步研究和定性访谈。

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