提高1型糖尿病青少年的自我效能感、生活质量和血糖控制水平：评估以家庭为中心的赋权模式的随机对照试验

Improving Self-Efficacy, Quality of Life, and Glycemic Control in Adolescents With Type 1 Diabetes: Randomized Controlled Trial for the Evaluation of the Family-Centered Empowerment Model.

作者信息

Alzawahreh Salah, Ozturk Candan

机构信息

Ministry of Health, Amman, Jordan.

Faculty of Nursing, Near East University, Cyprus, Turkey.

出版信息

JMIR Form Res. 2024 Dec 10;8:e64463. doi: 10.2196/64463.

DOI:10.2196/64463

PMID:39658013

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11668983/

Abstract

BACKGROUND

Poor glycemic management in adolescents with type 1 diabetes mellitus (T1DM) increases complications. Enhanced control is associated with other factors, such as cultural, socioeconomic, and health care system disparities specific to the Middle East, which can greatly influence individuals' ability to get and use health care services as well as their reaction to treatment approaches.

OBJECTIVE

This study aims to evaluate the impact of the family-centered empowerment model on Jordanian adolescents with T1DM, focusing on their glycosylated hemoglobin levels, self-efficacy, and quality of life (QOL).

METHODS

A randomized controlled trial involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participant groups were created: control (n=34) and intervention (n=34). Participants were randomly assigned to either the intervention group, receiving the family-centered empowerment model intervention, or the control group, receiving standard care. Data were collected through face-to-face interviews and medical records.

RESULTS

From April to October 2023, a total of 68 adolescents with T1DM participated in the study at the Jordanian Royal Medical Services. QOL had significant improvement among 13 (38%) of the 34 participants in the intervention group, and the program significantly improved moderate self-efficacy levels in 12 (35%) patients (P<.001). In addition, the average glycosylated hemoglobin levels dropped from 11.25% to 10.23% (P<.001). Additionally, improvements were seen in stress management, communication, and treatment adherence, with a substantial decrease in treatment obstacles. The intervention was successful in improving both clinical and psychosocial outcomes, as evidenced by the fact that the control group showed no noticeable improvements in these parameters.

CONCLUSIONS

The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate this training into treatment plans and educational programs for adolescents to enhance their QOL.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06694467; https://clinicaltrials.gov/study/NCT06694467.

摘要

背景

1型糖尿病（T1DM）青少年患者血糖管理不善会增加并发症风险。强化控制与其他因素相关，如中东地区特有的文化、社会经济和医疗保健系统差异，这些因素会极大影响个体获取和使用医疗保健服务的能力以及他们对治疗方法的反应。

目的

本研究旨在评估以家庭为中心的赋权模式对约旦T1DM青少年患者的影响，重点关注他们的糖化血红蛋白水平、自我效能感和生活质量（QOL）。

方法

一项随机对照试验纳入了68名前往约旦皇家医疗服务诊所就诊的T1DM青少年患者。创建了两组参与者：对照组（n = 34）和干预组（n = 34）。参与者被随机分配到干预组，接受以家庭为中心的赋权模式干预，或对照组，接受标准护理。通过面对面访谈和医疗记录收集数据。

结果

2023年4月至10月，共有68名T1DM青少年患者在约旦皇家医疗服务机构参与了该研究。干预组34名参与者中有13名（38%）的生活质量有显著改善，该项目使12名（35%）患者的中度自我效能水平显著提高（P <.001）。此外，糖化血红蛋白平均水平从11.25%降至10.23%（P <.001）。此外，在压力管理、沟通和治疗依从性方面也有改善，治疗障碍大幅减少。干预成功改善了临床和心理社会结局，事实证明对照组在这些参数上没有明显改善。