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Effects of a theory-based training program with follow-up home visits on self-management behavior, glycemic index, and quality of life among Iranian patients with type 2 diabetes mellitus. BMC Public Health 2022; 22:1559. [PMID: 35974352 PMCID: PMC9379227 DOI: 10.1186/s12889-022-13959-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus. Methods This is a quasi-experimental study with a pretest–posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n1 = n2 = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60–80-min sessions was run, followed by 2–3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19. Results Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476]. Conclusions The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes.
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Shahabi N, Kolivand M, Salari N, Abbasi P. The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial. BMC Endocr Disord 2022; 22:36. [PMID: 35139832 PMCID: PMC8830007 DOI: 10.1186/s12902-022-00953-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/03/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2. METHODS This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22. RESULTS There was no significant difference among the two intervention and control groups before the study regarding demographic variables (p > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention (p = 0.001). CONCLUSIONS Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.
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Affiliation(s)
- Negar Shahabi
- Department of Nursing, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Kolivand
- Department of Midwifery, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Nursing & Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parvin Abbasi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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The self-efficacy improvement in adolescent girls with type 1 diabetes mellitus with self-care education through mobile-based social networking. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00929-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Tan SM, Han E, Quek RYC, Singh SR, Gea-Sánchez M, Legido-Quigley H. A systematic review of community nursing interventions focusing on improving outcomes for individuals exhibiting risk factors of cardiovascular disease. J Adv Nurs 2019; 76:47-61. [PMID: 31588578 DOI: 10.1111/jan.14218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/06/2019] [Accepted: 08/13/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals exhibiting risk factors of cardiovascular disease (CVD). DESIGN A systematic review and narrative synthesis. DATA SOURCES Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR, and WPRIM) were searched from inception to 16 March 2018. REVIEW METHODS This review included outcomes from studies that were led by or delivered primarily by nurses for individuals exhibiting risk factors of CVD in community settings. At least two independent reviewers performed study selection, data extraction and risk of bias. RESULTS 46 studies met the eligibility criteria. Community nursing interventions were found to be effective in improving clinical outcomes of symptom control, symptom awareness, symptom management, and social outcomes. Effective interventions were found to be facilitated by a community-centric approach, participant empowerment, reinforcement strategies, a targeted approach towards underserved populations, and home visits. These resulted in positive outcomes such as significant reductions in HbA1c for diabetic patients, attainment of blood pressure targets for hypertensive patients and greater improvement in self-reported dietary intake for patients with hyperlipidaemia. CONCLUSION Community-based nurse-led interventions can result in positive outcomes for patients with risk factors of CVD. However, the success of such interventions needs to be facilitated by appropriate funding, thoughtful intervention design and training opportunities for nurses. IMPACT Community-based nursing interventions are largely effective in improving clinical and social outcomes for community-dwelling individuals with risk factors of CVD.
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Affiliation(s)
- See M Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rina Yu Chin Quek
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Montserrat Gea-Sánchez
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Group for the Study of Society Health Education and Culture, GESEC, University of Lleida, Lleida, Spain.,Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
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Selçuk‐Tosun A, Zincir H. The effect of a transtheoretical model–based motivational interview on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial. Int J Nurs Pract 2019; 25:e12742. [DOI: 10.1111/ijn.12742] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/31/2018] [Accepted: 04/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Handan Zincir
- Faculty of Health SciencesErciyes University Kayseri Turkey
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Janati A, Sarabchian MA, Mohaghegh B, Aghmohamadzadeh N, Seyedin H, Gholizadeh M, Hasanpoor E. Health Economic Evaluation of Home and Hospital-Based Care in T2D Patients on Insulin Therapy. Ethiop J Health Sci 2018; 27:651-658. [PMID: 29487474 PMCID: PMC5811944 DOI: 10.4314/ejhs.v27i6.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Type 2 Diabetes is a main concern of public health in contemporary world with remarkable mortality, delayed complications and health costs. Governments are obliged to improve the quality of health care and consider appropriate strategies to reduce the costs. An alternative strategy for hospital services is care at home. Therefore, this study was aimed to evaluate the cost-effectiveness of home-based and hospital-based diabetes care. Methods A quasi-experimental, pre-test and post-test design was conducted in Northwest Iran. Sixty subjects who were eligible insulin-treatment type 2 diabetes mellitus were randomly assigned into two equal groups to receive home-based or conventional hospital-based care. Data on glycosylated hemoglobin (HbA1c), hypoglycemia episodes, time needed to achieve glycemic control level, diabetes treatment satisfaction, diabetes knowledge and costs during three months were collected. Results The cost of home-based care in insulin therapy diabetes was 61% less compared with the hospital-based methods. The former strategy was cost-effective in terms of reduction in HbA1C and the time needed to achieve glycemic control. The patients in home care group were more satisfied and knowledgeable. Conclusions The care at home approach for type 2 diabetic patients can be introduced and supported as a cost-effective care method in the country.
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Affiliation(s)
- Ali Janati
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohamad Ali Sarabchian
- Department of Internal Medicine, Faculty of Medicine, Endocrinology Research Center, Clinical Sciences Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Mohaghegh
- Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran
| | - Naser Aghmohamadzadeh
- Department of Internal Medicine, Faculty of Medicine, Endocrinology Research Center, Clinical Sciences Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hesam Seyedin
- Department of School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masumeh Gholizadeh
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Edris Hasanpoor
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Afable A, Karingula NS. Evidence based review of type 2 diabetes prevention and management in low and middle income countries. World J Diabetes 2016; 7:209-229. [PMID: 27226816 PMCID: PMC4873312 DOI: 10.4239/wjd.v7.i10.209] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 01/28/2016] [Accepted: 03/09/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To identify the newest approaches to type 2 diabetes (T2DM) prevention and control in the developing world context.
METHODS: We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries, as defined by the World Bank. We searched PubMed using Medical Subject Headings terms. Studies needed to satisfy four criteria: (1) Must be experimental; (2) Must include patients with T2DM or focusing on prevention of T2DM; (3) Must have a lifestyle intervention component; (4) Must be written in English; and (5) Must have measurable outcomes related to diabetes.
RESULTS: A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014. India contributed the largest number of trials (11/66). Of the total 66 studies reviewed, all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes. The overwhelming majority of studies reported on diabetes management (56/66), and among these more than half were structured lifestyle education programs. The evidence suggests that lifestyle education led by allied health professionals (nurses, pharmacists) were as effective as those led by physicians or a team of clinicians. The remaining diabetes management interventions focused on diet or exercise, but the evidence to recommend one approach over another was weak.
CONCLUSION: Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.
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Shivashankar R, Kirk K, Kim WC, Rouse C, Tandon N, Narayan KMV, Ali MK. Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993-2012): 20-year systematic review. Diabetes Res Clin Pract 2015; 107:203-23. [PMID: 25529849 DOI: 10.1016/j.diabres.2014.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/07/2014] [Accepted: 11/23/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the extent to which people with diabetes in low- and middle-income countries (LMIC) of Asia and the Middle East met evidence-based care recommendations through a systematic review of published literature. METHODS Electronic searches of Medline and Embase were carried out for studies assessing quality of care among people with diabetes in Asia and the Middle East between 1993 and 2012. Benchmarking against American Diabetes Association guidelines, we reported level and proportions meeting recommended risk factor control (glycated hemoglobin [HbA1c], blood pressure, and low density lipoprotein-cholesterol [LDL]) and preventive care processes across different settings. RESULTS One hundred and fifteen publications met eligibility for inclusion (91 reported risk factor control, 7 reported preventive processes, and 17 reported both). Only China, Thailand, Malaysia and Philippines had nationally representative data. Mean HbA1c (6.5-11% or 48-97 mmol/mol), SBP (120-152 mm Hg), and LDL (2.4-3.8 mmol/l) varied greatly. Despite variation in availability of data, studies consistently showed that recommended care goals were not being achieved. CONCLUSIONS The practice of auditing and benchmarking against evidence-based guidelines appears to be uncommon in Asia and the Middle East and there was heterogeneity of reporting across studies, populations, and methods used. The available data showed inadequate care.
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Affiliation(s)
- Roopa Shivashankar
- Centre for Chronic Disease Control, New Delhi, India; Public Health Foundation of India, New Delhi, India.
| | - Katy Kirk
- Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Woon Cho Kim
- Emory University School of Medicine, Atlanta, GA, USA
| | - Chaturia Rouse
- Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Mahammed K Ali
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Shao S, Guo T, Aebersold R. Mass spectrometry-based proteomic quest for diabetes biomarkers. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2014; 1854:519-27. [PMID: 25556002 DOI: 10.1016/j.bbapap.2014.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/06/2014] [Accepted: 12/10/2014] [Indexed: 12/22/2022]
Abstract
Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia, which affects hundreds of millions of individuals worldwide. Early diagnosis and complication prevention of DM are helpful for disease treatment. However, currently available DM diagnostic markers fail to achieve the goals. Identification of new diabetic biomarkers assisted by mass spectrometry (MS)-based proteomics may offer solution for the clinical challenges. Here, we review the current status of biomarker discovery in DM, and describe the pressure cycling technology (PCT)-Sequential Window Acquisition of all Theoretical fragment-ion (SWATH) workflow for sample-processing, biomarker discovery and validation, which may accelerate the current quest for DM biomarkers. This article is part of a Special Issue entitled: Medical Proteomics.
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Affiliation(s)
- Shiying Shao
- Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan 430030, PR China; Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Wolfgang-Pauli-Str. 16, 8093, Switzerland.
| | - Tiannan Guo
- Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Wolfgang-Pauli-Str. 16, 8093, Switzerland
| | - Ruedi Aebersold
- Department of Biology, Institute of Molecular Systems Biology, ETH Zurich, Wolfgang-Pauli-Str. 16, 8093, Switzerland; Faculty of Science, University of Zurich, 8057 Zurich, Switzerland.
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Bencharit S, Baxter SS, Carlson J, Byrd WC, Mayo MV, Border MB, Kohltfarber H, Urrutia E, Howard-Williams EL, Offenbacher S, Wu MC, Buse JB. Salivary proteins associated with hyperglycemia in diabetes: a proteomic analysis. MOLECULAR BIOSYSTEMS 2014; 9:2785-97. [PMID: 24056972 DOI: 10.1039/c3mb70196d] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Effective monitoring of glucose levels is necessary for patients to achieve greater control over their diabetes. However, only about a quarter of subjects with diabetes who requires close serum glucose monitoring, regularly check their serum glucose daily. One of the potential barriers to patient compliance is the blood sampling requirement. Saliva and its protein contents can be altered in subjects with diabetes, possibly due to changes in glycemic control. We propose here that salivary proteomes of subjects with diabetes may be different based on their glycemic control as reflected in A1C levels. A total of 153 subjects with type 1 or 2 diabetes were recruited. Subjects in each type of diabetes were divided into 5 groups based on their A1C levels; <7, 7-8, 8-9, 9-10, >10. To examine the global proteomic changes associated with A1C, the proteomic profiling of pooled saliva samples from each group was created using label-free quantitative proteomics. Similar proteomic analysis for individual subjects (N=4, for each group) were then applied to examine proteins that may be less abundant in pooled samples. Principle component analysis (PCA) and cluster analysis (p<0.01 and p<0.001) were used to define the proteomic differences. We, therefore, defined the salivary proteomic changes associated with A1C changes. This study demonstrates that differences exist between salivary proteomic profiles in subjects with diabetes based on the A1C levels.
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Affiliation(s)
- Sompop Bencharit
- Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
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Beyazit E, Mollaoğlu M. Investigation of effect on glycosylated hemoglobin, blood pressure, and body mass index of diabetes intensive education program in patients with type 2 diabetes mellitus. Am J Mens Health 2011; 5:351-7. [PMID: 21406489 DOI: 10.1177/1557988310394340] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study investigated the effects of a diabetes intensive education program (DIEP) on glycosylated hemoglobin (HbA(1)c), body mass index (BMI), and arterial blood pressure (BP). An 8-week randomized-controlled trial was conducted in Cumhuriyet University Hospital. Diabetes patients were randomized to control group (CG; n = 25) and intervention group (IG; n = 25) who received DIEP, including the factors affecting metabolic control and implementation of diabetes guidelines. Primary outcomes included HbA(1)c, BP, and BMI. After the 8 weeks, there was a significant decrease in HbA(1)c mean values for the intervention group. Also, BP significantly decreased from 143/87 to 130/80 mmHg in the IG as compared with an increase from 137/82 to 137/86 mmHg in the CG. In addition, the results demonstrated that DIEP improved the number of patients at goal for BP (130/80 mmHg). Baseline BMI did not change significantly in either group during the course of the study. These findings show that the DIEP may be effective in decreasing HbA(1)c levels and improving adherence to BP control.
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Song MS, Kim HS. Intensive management program to improve glycosylated hemoglobin levels and adherence to diet in patients with type 2 diabetes. Appl Nurs Res 2009; 22:42-7. [PMID: 19171294 DOI: 10.1016/j.apnr.2007.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2006] [Revised: 05/17/2007] [Accepted: 05/17/2007] [Indexed: 10/21/2022]
Abstract
This study investigated the effects of a diabetes outpatient intensive management program (DOIMP) on glycosylated hemoglobin (HbA(1)c) levels and adherence to diabetes control recommendations over a 12-week follow-up period for patients with diabetes. The DOIMP was composed of multidisciplinary diabetes education, complication monitoring, and telephone counseling. Twenty-five patients in the intervention group participated in the DOIMP, whereas 24 in the control group were briefed on the conventional description of diabetes mellitus by diabetes education nurses. Patients in the intervention group decreased their mean HbA(1)c levels by 2.3%, as compared with 0.4% in the control group. There was a significant increase in adherence to diet for the intervention group as compared with the control group. These findings indicate that the DOIMP can improve HbA(1)c levels and adherence to diet in patients with type 2 diabetes.
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Affiliation(s)
- Min-Sun Song
- Department of Nursing, College of Korean Medicine, Dongshin University, Jeonnam 520-714, Korea
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