Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
Clinical Epidemiological Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
BMC Med Educ. 2024 Nov 18;24(1):1323. doi: 10.1186/s12909-024-06288-z.
Individuals with diabetes and co-existing psychiatric disorders have more diabetes complications and lower life expectancy than those with diabetes but no co-existing psychiatric disorders. Psychiatric health professionals may have a role in improving these outcomes but often lack diabetes knowledge and skills. This study aims to examine the effectiveness of a diabetes training course for psychiatric health professionals on their diabetes knowledge and skills and clinical outcomes, diabetes support and diabetes distress among individuals with diabetes and psychiatric disorders treated in psychiatric outpatient clinics.
A pragmatic non-randomized controlled cluster trial was conducted in eight psychiatric outpatient clinics in Denmark. All psychiatric health professionals from four clinics participated in the diabetes training course (the intervention) and completed a questionnaire on experience of the training course and a 20-item pre- and post-test to measure diabetes knowledge and skills. Difference in pre- and post-tests were analyzed using t-tests. From August 2018 - June 2019, individuals with diabetes were recruited from the intervention clinics (n = 49) and from four control clinics continuing usual clinical practice (n = 57). Differences in clinical outcomes, diabetes support and diabetes distress between the intervention and control groups at six and 12 months after the training course, were analyzed using logistic and linear regression models adjusted for baseline levels.
Psychiatric health professionals (n = 64) had more correct answers after completing the course, with a mean increase of 6.3 [95% CI 5.6 to 7.0] correct answers. A total of 49 and 57 individuals were recruited for the intervention and control group, respectively. At follow-up, individuals treated in the intervention group had lower levels (clinical improvement) of systolic blood pressure, but had lower receipt of annual assessment of blood pressure, and body mass index (BMI) (worsening of process measures). While there were observed differences in odds and means for several other outcomes, none of these received statistical significance (see Table 2 and Fig. 2).
Training psychiatric health professionals in diabetes care improved their diabetes knowledge and skills and improved clinical levels of systolic blood pressure in individuals treated in the intervention group. However, this training intervention was associated with a lower likelihood of receiving annual assessment of blood pressure and BMI.
ISRCTN registry registration number ISRCTN15523920, registration date: 02/10/2019.
患有糖尿病和并存精神障碍的个体比患有糖尿病但无并存精神障碍的个体有更多的糖尿病并发症和更低的预期寿命。精神健康专业人员可能在改善这些结果方面发挥作用，但他们往往缺乏糖尿病知识和技能。本研究旨在检验针对精神健康专业人员的糖尿病培训课程对其糖尿病知识和技能以及临床结果、糖尿病支持和糖尿病困扰的有效性，这些个体患有糖尿病且在精神科门诊接受治疗。
在丹麦的 8 家精神科门诊进行了一项实用的非随机对照群组试验。来自 4 家诊所的所有精神健康专业人员参加了糖尿病培训课程（干预组），并完成了关于培训课程体验的问卷和 20 项糖尿病知识和技能预测试和后测试。采用 t 检验分析前后测试的差异。从 2018 年 8 月至 2019 年 6 月，从干预诊所（n=49）和 4 家继续常规临床实践的对照诊所（n=57）招募患有糖尿病的个体。使用逻辑回归和线性回归模型，在调整基线水平后，分析培训课程后 6 个月和 12 个月干预组和对照组之间的临床结果、糖尿病支持和糖尿病困扰的差异。
精神健康专业人员（n=64）在完成课程后有更多的正确答案，平均增加了 6.3 [95%置信区间 5.6 至 7.0]个正确答案。分别有 49 名和 57 名个体被招募到干预组和对照组。在随访时，接受干预组治疗的个体的收缩压水平较低（临床改善），但接受年度血压评估和体重指数（BMI）评估的比例较低（过程措施恶化）。虽然在其他几个结果的比值和平均值方面观察到差异，但这些结果均未达到统计学意义（见表 2 和图 2）。
对精神健康专业人员进行糖尿病护理培训可提高其糖尿病知识和技能，并改善干预组接受治疗的个体的收缩压临床水平。然而，这种培训干预与接受年度血压和 BMI 评估的可能性降低有关。
ISRCTN 注册号 ISRCTN82656562，注册日期：2019 年 10 月 2 日。
