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斯洛文尼亚针对患有或未患有合并高血压的2型糖尿病同伴支持者开展的由专科护士主导的结构化自我管理培训评估。

Evaluation of a specialist nurse-led structured self-management training for peer supporters with type 2 diabetes mellitus with or without comorbid hypertension in Slovenia.

作者信息

Virtič Potočnik Tina, Mihevc Matic, Zavrnik Črt, Mori Lukančič Majda, Ružić Gorenjec Nina, Poplas Susič Antonija, Klemenc-Ketiš Zalika

机构信息

Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova 9, 1000, Ljubljana, Slovenia.

Faculty of Medicine, Department of Family Medicine, University of Maribor, Taborska 8, 2000, Maribor, Slovenia.

出版信息

BMC Nurs. 2024 Aug 15;23(1):567. doi: 10.1186/s12912-024-02239-7.

Abstract

BACKGROUND

The training of peer supporters is critical because the success of the entire peer support intervention depends on the knowledge and experience that peer supporters can share with other patients. The objective of this study was to evaluate the pilot implementation of a specialist nurse-led self-management training programme for peer supporters with type 2 diabetes mellitus (T2DM) with or without comorbid hypertension (HTN) at the primary healthcare level in Slovenia, in terms of feasibility, acceptability, and effectiveness.

METHODS

A prospective pre-post interventional pilot study was conducted in two Community Health Centres (CHC) in Slovenia from May 2021 to August 2022. Purposive sampling was employed to recruit approximately 40 eligible volunteers to become trained peer supporters. A specialist nurse-led structured training lasting 15 h over a 2-month period was delivered, comprising four group and two individual sessions. The comprehensive curriculum was based on interactive verbal and visual learning experience, utilising the Diabetes Conversation Maps™. Data were collected from medical records, by clinical measurements, and using questionnaires on sociodemographic and clinical data, the Theoretical Framework of Acceptability, knowledge of T2DM and HTN, and the Appraisal of Diabetes Scale, and evaluation forms.

RESULTS

Of the 36 participants, 31 became trained peer supporters (retention rate of 86.1%). Among them, 21 (67.7%) were women, with a mean age of 63.9 years (SD 8.9). The training was evaluated as satisfactory and highly acceptable. There was a significant improvement in knowledge of T2DM (p < 0.001) and HTN (p = 0.024) among peer supporters compared to baseline. Six months post-training, there was no significant improvement in the quality of life (p = 0.066), but there was a significant decrease in body mass index (BMI) (p = 0.020) from 30.4 (SD 6.2) at baseline to 29.8 (SD 6.2).

CONCLUSION

The pilot implementation of a specialist nurse-led self-management training for peer supporters was found to be feasible, acceptable, and effective (in the study group). It led to improvements in knowledge, maintained disease control, and promoted positive self-management behaviours among peer supporters, as evidenced by a decrease in their BMI over six months. The study emphasises the need for effective recruitment, training, and retention strategies.

TRIAL REGISTRATION

The research is part of the international research project SCUBY: Scale up diabetes and hypertension care for vulnerable people in Cambodia, Slovenia and Belgium, which is registered in ISRCTN registry ( https://www.isrctn.com/ISRCTN41932064 ).

摘要

背景

同伴支持者的培训至关重要,因为整个同伴支持干预措施的成功取决于同伴支持者能够与其他患者分享的知识和经验。本研究的目的是评估在斯洛文尼亚初级医疗保健层面,由专科护士主导的针对患有或未患有合并高血压(HTN)的2型糖尿病(T2DM)同伴支持者的自我管理培训计划的试点实施情况,包括可行性、可接受性和有效性。

方法

2021年5月至2022年8月在斯洛文尼亚的两个社区健康中心(CHC)进行了一项前瞻性干预前后试点研究。采用目的抽样法招募了约40名符合条件的志愿者成为经过培训的同伴支持者。提供了由专科护士主导的为期2个月、持续15小时的结构化培训,包括四次小组会议和两次个人会议。综合课程基于互动式口头和视觉学习体验,采用《糖尿病对话地图》(Diabetes Conversation Maps™)。通过医疗记录、临床测量以及关于社会人口统计学和临床数据、可接受性理论框架、T2DM和HTN知识、糖尿病量表评估以及评估表的问卷收集数据。

结果

36名参与者中,31人成为经过培训的同伴支持者(保留率为86.1%)。其中,21人(67.7%)为女性,平均年龄为63.9岁(标准差8.9)。培训被评估为令人满意且高度可接受。与基线相比,同伴支持者对T2DM(p < 0.001)和HTN(p = 0.024)的知识有显著提高。培训后六个月,生活质量无显著改善(p = 0.066),但体重指数(BMI)从基线时的30.4(标准差6.2)显著下降至29.8(标准差6.2)(p = 0.020)。

结论

由专科护士主导的针对同伴支持者的自我管理培训试点实施被认为是可行、可接受且有效的(在研究组中)。它提高了知识水平,维持了疾病控制,并促进了同伴支持者积极的自我管理行为,六个月内BMI下降证明了这一点。该研究强调了有效招募、培训和保留策略的必要性。

试验注册

该研究是国际研究项目SCUBY的一部分:扩大柬埔寨、斯洛文尼亚和比利时弱势群体的糖尿病和高血压护理,已在ISRCTN注册中心注册(https://www.isrctn.com/ISRCTN41932064)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/765e/11328385/0d3e1bb84449/12912_2024_2239_Fig1_HTML.jpg

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