Mazzuca S A, Moorman N H, Wheeler M L, Norton J A, Fineberg N S, Vinicor F, Cohen S J, Clark C M
Diabetes Care. 1986 Jan-Feb;9(1):1-10. doi: 10.2337/diacare.9.1.1.
The Diabetes Education Study (DIABEDS) was a randomized, controlled trial of the effects of patient and physician education. This article describes a systematic education program for diabetes patients and its effects on patient knowledge, skills, self-care behaviors, and relevant physiologic outcomes. The original sample consisted of 532 diabetes patients from the general medicine clinic at an urban medical center. Patients were predominantly elderly, black women with non-insulin-dependent diabetes mellitus of long duration. Patients randomly assigned to experimental groups (N = 263) were offered up to seven modules of patient education. Each content area module contained didactic instruction (lecture, discussion, audio-visual presentation), skill exercises (demonstration, practice, feedback), and behavioral modification techniques (goal setting, contracting, regular follow-up). Two hundred seventy-five patients remained in the study throughout baseline, intervention, and postintervention periods (August 1978 to July 1982). Despite the requirement that patients demonstrate mastery of educational objectives for each module, postintervention assessment 11-14 mo after instruction showed only rare differences between experimental and control patients in diabetes knowledge. However, statistically significant group differences in self-care skills and compliance behaviors were relatively more numerous. Experimental group patients experienced significantly greater reductions in fasting blood glucose (-27.5 mg/dl versus -2.8 mg/dl, P less than 0.05) and glycosylated hemoglobin (-0.43% versus + 0.35%, P less than 0.05) as compared with control subjects. Patient education also had similar effects on body weight, blood pressure, and serum creatinine. Continued follow-up is planned for DIABEDS patients to determine the longevity of effects and subsequent impact on emergency room visits and hospitalization.
糖尿病教育研究（DIABEDS）是一项关于患者和医生教育效果的随机对照试验。本文描述了一项针对糖尿病患者的系统教育计划及其对患者知识、技能、自我护理行为和相关生理指标的影响。最初的样本包括来自城市医疗中心普通内科诊所的532名糖尿病患者。患者主要是患有长期非胰岛素依赖型糖尿病的老年黑人女性。随机分配到实验组（N = 263）的患者接受了多达七个模块的患者教育。每个内容领域模块都包含讲授指导（讲座、讨论、视听演示）、技能练习（示范、实践、反馈）和行为改变技术（目标设定、契约、定期随访）。275名患者在整个基线期、干预期和干预后期（1978年8月至1982年7月）都参与了研究。尽管要求患者掌握每个模块的教育目标，但在授课后11 - 14个月的干预后评估显示，实验组和对照组患者在糖尿病知识方面仅有很少的差异。然而，在自我护理技能和依从行为方面，具有统计学意义的组间差异相对较多。与对照组相比，实验组患者的空腹血糖（-27.5mg/dl对-2.8mg/dl，P < 0.05）和糖化血红蛋白（-0.43%对+0.35%，P < 0.05）显著降低。患者教育对体重、血压和血清肌酐也有类似影响。计划对DIABEDS患者进行持续随访，以确定效果的持久性以及随后对急诊就诊和住院的影响。
