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通过个体化患者咨询改善糖尿病自我管理与控制:一项准实验研究。

Improving diabetes self-management and control through individualized patient counseling: A quasi-experimental study.

作者信息

Yogesh M, Nagda Jay, Babaria Dhruvam L, Misra Swati

机构信息

Department of Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, Gujarat, India.

Intern Doctor, Shri M. P. Shah Government Medical College, Jamnagar, Gujarat, India.

出版信息

J Educ Health Promot. 2024 Oct 28;13:407. doi: 10.4103/jehp.jehp_1951_23. eCollection 2024.

Abstract

BACKGROUND

Diabetes is one of the most common chronic diseases, affecting a large proportion of the global population. This study aims to evaluate the effects of individualized patient counseling on diabetes self-management.

MATERIALS AND METHODS

This quasi-experimental study utilized a non-randomized two-arm pre-post design. It was conducted at the out-patient clinics of a tertiary care hospital, Gujarat, from February 2023 to August 2023. There were 300 type 2 diabetes patients who belonged to an intervention group receiving 3 monthly 30-minute individualized counseling sessions (n = 150) or a control group continuing usual care (n = 150). Assessments at baseline and 3 months post-intervention compared treatment effects. The outcomes measured were diabetes knowledge, attitudes/beliefs, medication/lifestyle adherence, self-reported quality of life, blood pressure (BP), and HbA1c. The intervention covered medication and lifestyle guidance, self-monitoring skills, barrier identification, and problem-solving with a focus on patient empowerment. The analysis compared within- and between-group changes.

RESULTS

At 3 months, counseled patients showed significantly greater improvements in knowledge (difference 13.6 points), self-care abilities (lifestyle adherence difference 6.6 points), 5.9 mmHg extra drop in systolic BP, and 0.6% higher HbA1c reduction versus controls (all < 0.05). Greater knowledge gain is strongly correlated with improved HbA1c (r = 0.42). Patients reported medication counseling as the most useful and cost and cultural dietary habits as key ongoing barriers.

CONCLUSION

Individualized counseling promoted better self-management behaviors, improved clinical measures, and subjective well-being in diabetes patients versus usual care alone. Routine Counseling should be considered to complement medical management in high-risk chronic diseases.

摘要

背景

糖尿病是最常见的慢性病之一,影响着全球很大一部分人口。本研究旨在评估个体化患者咨询对糖尿病自我管理的效果。

材料与方法

本准实验研究采用非随机双臂前后设计。于2023年2月至2023年8月在古吉拉特邦一家三级护理医院的门诊进行。共有300名2型糖尿病患者,其中干预组150名,每月接受3次30分钟的个体化咨询;对照组150名,继续接受常规护理。在基线和干预后3个月进行评估以比较治疗效果。测量的结果包括糖尿病知识、态度/信念、药物/生活方式依从性、自我报告的生活质量、血压(BP)和糖化血红蛋白(HbA1c)。干预内容包括药物和生活方式指导、自我监测技能、障碍识别以及以患者赋权为重点的问题解决。分析比较了组内和组间的变化。

结果

3个月时,接受咨询的患者在知识方面(差异13.6分)、自我护理能力方面(生活方式依从性差异6.6分)、收缩压额外下降5.9 mmHg以及糖化血红蛋白降低幅度比对照组高0.6%方面均有显著更大的改善(均P<0.05)。知识获得的增加与糖化血红蛋白的改善密切相关(r = 0.42)。患者报告药物咨询最有用,成本和文化饮食习惯是主要的持续障碍。

结论

与单纯常规护理相比,个体化咨询促进了糖尿病患者更好的自我管理行为、改善了临床指标和主观幸福感。在高危慢性病中,应考虑将常规咨询作为医疗管理的补充。

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