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增强糖尿病患者的自我护理管理:一项探索社会支持、自我效能感和赋权之间相互作用的随机对照试验。

Enhancing self-care management in diabetic patients: a randomized controlled trial exploring the interplay of social support, self-efficacy, and empowerment.

作者信息

Ibrahim Nevin F, Nofal Hanaa A, Ali Hossam Tharwat, El-Rafey Dina S, Almadani Noura, Mahfouz Rasha, Khodary Reda M

机构信息

Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Community, Environmental, and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

出版信息

Acta Diabetol. 2025 Apr 16. doi: 10.1007/s00592-025-02498-z.

Abstract

BACKGROUND

Despite the significant global and Egyptian prevalence of Type 2 Diabetes Mellitus (T2DM), with the recognized importance of self-care and social support in enhancing glycemic control, there is a scarcity of studies on this topic within Egypt's especially interventional studies and role of enhancement program on diabetic self-management practice. Our objective is to evaluate the effect of a health education program on the enhancement of self-care management compared to the usual care and explore factors affecting self-care management as social support, self-efficacy, and empowerment among patients with T2DM.

METHODS

A randomized control trial was conducted on 330 (165:165) T2DM patients confirmed more than one year and had regular visits to the diabetic patient clinic in our hospital. The study outcomes include diabetes knowledge, self-management practice, social support, self-efficacy, and empowerment along with body mass index (BMI), glycated hemoglobin (HbA1c), and fasting blood glucose (FBG).

RESULTS

The intervention group had significant improvements in knowledge and self-practice with post-intervention adequate values (80.0% and 87.8%) compared to the control (40% and 55.1%) respectively (p-value < 0.001). Furthermore, a significant increase in patients with controlled FBG and HbA1c occurred in both groups (p-value < 0.001) with a significantly higher increase in the intervention group (p-value < 0.001). In total, 60.9%, 58.8%, and 25.7% of the patients had satisfactory social support, self-efficacy, and empowerment, respectively.

CONCLUSION

The results indicated that a diabetes self-care management education program was proven to be effective in improving patients' self-care management. Social support, self-efficacy, and empowerment could have positive roles.

摘要

背景

尽管全球和埃及2型糖尿病(T2DM)的患病率都很高,且自我护理和社会支持在改善血糖控制方面的重要性已得到认可,但埃及国内关于这一主题的研究却很匮乏,尤其是干预性研究以及强化项目在糖尿病自我管理实践中的作用。我们的目的是评估健康教育项目与常规护理相比,对自我护理管理强化的效果,并探讨影响自我护理管理的因素,如T2DM患者的社会支持、自我效能感和赋权情况。

方法

对330名(165:165)确诊超过一年且定期到我院糖尿病患者门诊就诊的T2DM患者进行了一项随机对照试验。研究结果包括糖尿病知识、自我管理实践、社会支持、自我效能感、赋权情况以及体重指数(BMI)、糖化血红蛋白(HbA1c)和空腹血糖(FBG)。

结果

干预组在知识和自我实践方面有显著改善,干预后达到了适当的值(分别为80.0%和87.8%),而对照组分别为40%和55.1%(p值<0.001)。此外,两组中FBG和HbA1c得到控制的患者均显著增加(p值<0.001),干预组的增加幅度显著更高(p值<0.001)。总体而言,分别有60.9%、58.8%和25.7%的患者获得了满意的社会支持、自我效能感和赋权。

结论

结果表明,糖尿病自我护理管理教育项目被证明在改善患者自我护理管理方面是有效的。社会支持、自我效能感和赋权可能起到积极作用。

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