Zhang Anqi, Wang Jinsong, Wan Xiaojuan, Zhang Ziyi, Zhao Shuhan, Bai Shuo, Miao Yamin, Yang Shuang, Jiang Xue
The Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hanjiang Middle Road, Yangzhou City, Yangzhou, 225009, China, 86 15952771632.
School of Nursing and Public Health, Yangzhou University, Yangzhou, China.
JMIR Mhealth Uhealth. 2025 Jun 19;13:e60227. doi: 10.2196/60227.
The number of older patients with type 2 diabetes (T2D) is increasing, and effective self-management is crucial for controlling disease progression and its complications.
We designed a home telemedicine intervention that combines telemedicine with health education based on the Health Belief Model (HBM). This study evaluated its effectiveness on self-management in older patients with T2D.
Between March and April 2022, we recruited 198 community-dwelling patients with T2D aged 65 years and older. Patients were randomly assigned to either a control group, which received a conventional diabetes management program, or an intervention group, which received a home telemedicine intervention with a health education program based on the HBM. The intervention lasted 6 months. The primary outcome measured was glycosylated hemoglobin (HbA1c); secondary outcomes included diabetes self-management capacity, self-efficacy, and health beliefs. We collected outcome metrics at baseline, 3 months, and 6 months. Generalized estimating equations were used to compare changes in outcomes.
A total of 96.5% (191/198) of patients completed the study. From baseline to 6 months, HbA1c decreased by mean -0.99% (95% CI -1.60% to -0.60%) in the intervention group and mean -0.42% (95% CI -0.90% to 0.90%) in the control group. The intervention group experienced a significantly greater reduction of 0.42% compared to the control group (95% CI 0.12%-0.73%). Furthermore, compared to the control group, the intervention group showed significant improvements in diabetes self-management skills (mean 5.88, 95% CI 4.98-6.79), self-efficacy (mean 9.40, 95% CI 8.15-10.66), and health beliefs (mean 19.54, 95% CI 17.71-21.36) at both 3 and 6 months.
Home telemedicine interventions incorporating health education based on the HBM can provide significant benefits for community-dwelling older patients with T2D, potentially offering new avenues for chronic disease prevention and management. However, future large-scale studies are required to further assess their effectiveness and feasibility.
老年2型糖尿病（T2D）患者数量不断增加，有效的自我管理对于控制疾病进展及其并发症至关重要。
我们设计了一种基于健康信念模型（HBM）将远程医疗与健康教育相结合的家庭远程医疗干预措施。本研究评估了其对老年T2D患者自我管理的有效性。
在2022年3月至4月期间，我们招募了198名年龄在65岁及以上的社区居住T2D患者。患者被随机分配到对照组（接受传统糖尿病管理项目）或干预组（接受基于HBM的健康教育项目的家庭远程医疗干预）。干预持续6个月。测量的主要结局指标是糖化血红蛋白（HbA1c）；次要结局指标包括糖尿病自我管理能力、自我效能感和健康信念。我们在基线、3个月和6个月时收集结局指标。使用广义估计方程比较结局指标的变化。
共有96.5%（191/198）的患者完成了研究。从基线到6个月，干预组的HbA1c平均下降了0.99%（95%CI -1.60%至-0.60%），对照组平均下降了0.42%（95%CI -0.90%至0.90%）。与对照组相比，干预组的下降幅度显著更大，为0.42%（95%CI 0.12%-0.73%）。此外，与对照组相比，干预组在3个月和6个月时的糖尿病自我管理技能（平均5.88，95%CI 4.98-6.79）、自我效能感（平均9.40，95%CI 8.15-10.66）和健康信念（平均19.54，95%CI 17.71-21.36）均有显著改善。
基于HBM的健康教育的家庭远程医疗干预可为社区居住的老年T2D患者带来显著益处，可能为慢性病预防和管理提供新途径。然而，未来需要大规模研究进一步评估其有效性和可行性。
