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在初级医疗保健中,针对2型糖尿病移民开展文化适宜性小组教育的效果:前后测试设计。

Effects of culturally-appropriate group education for migrants with type 2 diabetes in primary healthcare: pre-test-post-test design.

作者信息

Hjelm Katarina, Hadziabdic Emina

机构信息

Department of Public Health and Caring Sciences, Uppsala University, P O Box 564, Uppsala, S-751 22, Sweden.

Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.

出版信息

BMC Prim Care. 2025 Jan 4;26(1):2. doi: 10.1186/s12875-024-02689-7.

Abstract

BACKGROUND

The global incidence of type 2 diabetes is rapidly rising, particularly among migrants in developed countries. Migrants bear a significant burden of diabetes. However, this study is the only to evaluate the effects of a culturally appropriate diabetes intervention for these migrants on diabetes knowledge and health outcomes, adding a novel perspective to the existing literature. The aim of the study was to evaluate the effects on diabetes knowledge, HbA1c, and self-rated health of a previously developed, culturally appropriate diabetes education model, based on individual beliefs about health and illness, underpinned by knowledge, and conducted through focus group discussions.

METHODS

Observational study evaluating the intervention using a pre-test-post-test design. It involved structured interviews and HbA1c measurements before, immediately after, and three months post-participation in the group-based intervention. The study included 22 migrants from the Middle East and Africa, divided into eight focus groups. The group education was conducted by a multi-professional team, led by a diabetes specialist nurse, in primary healthcare settings. Descriptive and analytical statistics applied in analysing data.

RESULTS

The findings showed that participation in the diabetes education significantly improved the knowledge levels, led to an initial change and possible short-term improvement in HbA1c (better immediate post-intervention), albeit statistically insignificant, but no change in glycaemic control over time and in self-rated health (SRH).

CONCLUSIONS

The findings supported the hypothesis of improved knowledge. Moreover, the findings showed a possible initial change in glycaemic control, but no overall effect. The study showed no change in self-rated (perceived) health. Further studies involving other populations and long-term follow-ups are needed. This study highlights the importance of culturally tailored diabetes educational programmes in our multicultural society. By recognising individual beliefs about health and illness, this education programme can significantly increase knowledge and thereby contribute to improved self-care and thus, overall health. Furthermore, it is recommended for daily practice in primary healthcare, supporting healthcare professionals with a proven strategy to increase knowledge.

摘要

背景

2型糖尿病的全球发病率正在迅速上升,尤其是在发达国家的移民中。移民承受着糖尿病的重大负担。然而,本研究是唯一一项评估针对这些移民的具有文化适宜性的糖尿病干预措施对糖尿病知识和健康结果影响的研究,为现有文献增添了新的视角。该研究的目的是评估一种先前开发的、基于个人对健康和疾病的信念、以知识为基础并通过焦点小组讨论实施的具有文化适宜性的糖尿病教育模式对糖尿病知识、糖化血红蛋白(HbA1c)和自我评估健康的影响。

方法

采用前后测试设计的观察性研究来评估干预措施。研究包括在参与基于小组的干预之前、之后立即以及参与后三个月进行的结构化访谈和HbA1c测量。该研究纳入了22名来自中东和非洲的移民,分为八个焦点小组。小组教育由一个多专业团队在初级卫生保健机构中进行,由一名糖尿病专科护士领导。运用描述性和分析性统计方法分析数据。

结果

研究结果表明,参与糖尿病教育显著提高了知识水平,导致HbA1c出现初步变化并可能在短期内有所改善(干预后立即改善情况较好),尽管在统计学上不显著,但随着时间推移血糖控制和自我评估健康(SRH)没有变化。

结论

研究结果支持了知识得到改善的假设。此外,研究结果显示血糖控制可能出现了初步变化,但没有总体效果。研究表明自我评估(感知)健康没有变化。需要对其他人群进行进一步研究并进行长期随访。本研究强调了在我们多元文化社会中开展具有文化针对性的糖尿病教育项目的重要性。通过认识到个人对健康和疾病的信念,这个教育项目可以显著增加知识,从而有助于改善自我护理,进而提高整体健康水平。此外,建议将其应用于初级卫生保健的日常实践中,为医护人员提供一种经证实的增加知识的策略。

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Development of a group-based diabetes education model for migrants with type 2 diabetes, living in Sweden.
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