整体护理指导干预对血糖控制、糖尿病自我管理及赋权的影响：一项随机对照试验

The effect of a holistic nurse coaching intervention on glycemic control, diabetes self-management, and empowerment: a randomized controlled trial.

作者信息

Bilgehan Tuğba, Vardar İnkaya Bahar

机构信息

Department of Internal Medicine Nursing, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Dumlupınar, Esenboğa Campus, Ankara, Çubuk, Türkiye.

出版信息

BMC Nurs. 2025 Jun 2;24(1):627. doi: 10.1186/s12912-025-03252-0.

DOI:10.1186/s12912-025-03252-0

PMID:40457333

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12131424/

Abstract

BACKGROUND

Self-management and empowerment are critical components in the treatment of diabetes, a chronic condition that has become an increasingly significant global health issue. While standard diabetes education is essential for effective disease management, personalized interventions aligned with the patient's preferences are also necessary. One promising solution is the integration of coaching approaches into chronic disease management.

METHODS

This study was designed as a randomized controlled trial with a pretest-posttest design and three parallel arms: a Holistic Nurse Coaching group (n = 34), a Diabetes Education (n = 34) group, and a control group (n = 34). Data were collected through a Sociodemographic Data Collection Form, a Diabetes Data Collection Form, the Type 2 Diabetes Mellitus Self-Management Scale and the Diabetes Empowerment scale. The aim was to evaluate the effect of Holistic Nurse Coaching on glycemic control, diabetes self-management, and empowerment in individuals with type 2 diabetes. The Holistic Nurse Coaching group received nine individualized holistic nurse coaching sessions over a three-month period. The Diabetes Education group participated in nine group-based diabetes education sessions over the same period. The control group received no intervention. Mean comparison tests, correlation tests and multiple regression analysis techniques were employed in the statistical analysis. A 5% margin of error (p < 0.05) was adopted to determine statistical significance.

RESULTS

Following the holistic nurse coaching intervention, statistically significant improvements were observed in participants' diabetes self-management, empowerment, and HbA1c levels (d = 3.752, d = 3.104, and d = 1.147, respectively; p < 0.001). A strong, positive, and statistically significant correlation was identified between posttest diabetes self-management and empowerment scores. Furthermore, the diabetes empowerment scores accounted for approximately 68.5% of the variance in diabetes self-management scores (p < 0.05).

CONCLUSIONS

Holistic nurse coaching was found to significantly enhance diabetes self-management and empowerment. These findings suggest that holistic nurse coaching may serve as an effective, person-centered intervention to support individuals with type 2 diabetes in managing their condition.

TRIAL REGISTRATION

The study was registered in ClinicalTrials NCT05545722. Retrospectively registered. 16/09/2022.

摘要

背景

自我管理和赋权是糖尿病治疗的关键组成部分，糖尿病作为一种慢性病，已成为一个日益重要的全球健康问题。虽然标准的糖尿病教育对于有效的疾病管理至关重要，但与患者偏好相一致的个性化干预措施也是必要的。一个有前景的解决方案是将指导方法整合到慢性病管理中。

方法

本研究设计为一项随机对照试验，采用前测-后测设计，分为三个平行组：整体护士指导组（n = 34）、糖尿病教育组（n = 34）和对照组（n = 34）。通过社会人口统计学数据收集表、糖尿病数据收集表、2型糖尿病自我管理量表和糖尿病赋权量表收集数据。目的是评估整体护士指导对2型糖尿病患者血糖控制、糖尿病自我管理和赋权的影响。整体护士指导组在三个月内接受了九次个性化的整体护士指导课程。糖尿病教育组在同一时期参加了九次基于小组的糖尿病教育课程。对照组未接受干预。统计分析采用均值比较检验、相关性检验和多元回归分析技术。采用5%的误差幅度（p < 0.05）来确定统计学显著性。

结果

在整体护士指导干预后，观察到参与者的糖尿病自我管理、赋权和糖化血红蛋白水平有统计学显著改善（分别为d = 3.752、d = 3.104和d = 1.147；p < 0.001）。在后测糖尿病自我管理和赋权得分之间发现了强的、正的且具有统计学显著性的相关性。此外，糖尿病赋权得分约占糖尿病自我管理得分方差的68.5%（p < 0.05）。