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Ali HI, Al Ketbi LB, Platat C, Abdl El Baki H, Elmi F, Ibrahim W, Zoubeidi T, Al Dhaheri AS, Cheikh Ismail L, Tariq MNM, Souka U, Yasin J, Stojanovska L. Impact of Skills for Change Program on metabolic control, diet and physical activity levels in adults with type 2 diabetes: A cluster randomized trial. PLoS One 2024; 19:e0304639. [PMID: 38820345 PMCID: PMC11142497 DOI: 10.1371/journal.pone.0304639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region. METHODS In this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20-70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation. RESULTS The mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 - -0.60) and 246 kcal (95% CI: -419.52 - -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 - -11.14). CONCLUSIONS This community-based lifestyle intervention for patients with baseline HbA1c <8% did not result in a significant decrease of HbA1c but reduced caloric intake, body weight, and weekend inactivity after controlling for the covariates. TRIAL REGISTRATION This trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793).
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Affiliation(s)
- Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Carine Platat
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hanan Abdl El Baki
- Ambulatory Health Care Services, Abu Dhabi Healthcare Services, Al, Ain, United Arab Emirates
| | - Fadima Elmi
- Department of Medicine, Lincoln Medical Center, New York, NY, United States of America
| | - Wissam Ibrahim
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Taoufik Zoubeidi
- Department of Analytics in the Digital Era, College of Business and Economics, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Maryam N. M. Tariq
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Usama Souka
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Javed Yasin
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Wang Y, Zhang Y, Guo T, Han J, Fu G. Knowledge level and health information-seeking behavior of people with diabetes in rural areas: a multicenter cross-sectional study. Front Public Health 2024; 12:1285114. [PMID: 38751583 PMCID: PMC11094202 DOI: 10.3389/fpubh.2024.1285114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction There is a lack of research on the current level of diabetes knowledge and health information-seeking behaviors among patients with diabetes in rural areas of China's economically underdeveloped regions during COVID-19, as well as a lack of up-to-date evidence on glycemic control and the incidence of complications among rural patients with diabetes. Objectives To investigate the prevalence of glycemic control and complications among patients with diabetes in rural areas, to explore the current status and correlation of diabetes knowledge level and health information-seeking behavior, and to analyze the factors affecting diabetes knowledge level. Methods From January 2022 to July 2022, we conducted a screening on diabetic complications and a questionnaire survey among 2,178 patients with diabetes in 15 county hospitals in rural areas of Guangxi Zhuang Autonomous Region. The patients' knowledge level and health information-seeking behavior were investigated. Spearman correlation analysis was used to assess the correlation between diabetes knowledge and health information-seeking behavior. Multiple linear regression analysis was used to test how demographic information and health information-seeking behavior influenced the level of diabetes knowledge. Results Of 2,178 patients with diabetes in rural areas, 1,684 (77.32%) had poor glycemic control, and the prevalence of diabetic complications was estimated to be 72.13%. Patients with diabetes had poor diabetes knowledge and health information-seeking behavior, and there is a strong positive correlation between them. Diabetes knowledge level was influenced by per capita household disposable income, occupational status, gender, age, ethnicity, family history of diabetes, insulin use, glycated hemoglobin, education level, number of complications and health information-seeking behavior. Conclusion Patients with diabetes in rural areas have poor glycemic control and a high incidence of diabetic complications. Patients with diabetes in rural areas have poor knowledge and inadequate health information-seeking behavior. Systematic and standardized education should be provided to improve patients' diabetes knowledge and thus improve their self-management ability.
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Affiliation(s)
- Yudong Wang
- Department of Nursing, Liaocheng People’s Hospital, Liaocheng, China
- Department of Geriatric Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanping Zhang
- Department of Geriatric Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Tingting Guo
- Department of Nursing, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
| | - Jiaxia Han
- Department of Endocrinology and Metabolism, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Department of Nursing, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Allory E, Scheer J, De Andrade V, Garlantézec R, Gagnayre R. Characteristics of self-management education and support programmes for people with chronic diseases delivered by primary care teams: a rapid review. BMC PRIMARY CARE 2024; 25:46. [PMID: 38297228 PMCID: PMC10829293 DOI: 10.1186/s12875-024-02262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Primary care actors can play a major role in developing and promoting access to Self-Management Education and Support (SMES) programmes for people with chronic disease. We reviewed studies on SMES programmes in primary care by focusing on the following dimensions: models of SMES programmes in primary care, SMES team's composition, and participants' characteristics. METHODS For this mixed-methods rapid review, we searched the PubMed and Cochrane Library databases to identify articles in English and French that assessed a SMES programme in primary care for four main chronic diseases (diabetes, cancer, cardiovascular disease and/or respiratory chronic disease) and published between 1 January 2013 and 31 December 2021. We excluded articles on non-original research and reviews. We evaluated the quality of the selected studies using the Mixed Methods Appraisal Tool. We reported the study results following the PRISMA guidelines. RESULTS We included 68 studies in the analysis. In 46/68 studies, a SMES model was described by focusing mainly on the organisational dimension (n = 24). The Chronic Care Model was the most used organisational model (n = 9). Only three studies described a multi-dimension model. In general, the SMES team was composed of two healthcare providers (mainly nurses), and partnerships with community actors were rarely reported. Participants were mainly patients with only one chronic disease. Only 20% of the described programmes took into account multimorbidity. Our rapid review focused on two databases and did not identify the SMES programme outcomes. CONCLUSIONS Our findings highlight the limited implication of community actors and the infrequent inclusion of multimorbidity in the SMES programmes, despite the recommendations to develop a more interdisciplinary approach in SMES programmes. This rapid review identified areas of improvement for SMES programme development in primary care, especially the privileged place of nurses in their promotion. TRIAL REGISTRATION PROSPERO 2021 CRD42021268290 .
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Affiliation(s)
- Emmanuel Allory
- Department of General Practice, Univ Rennes, 2 Av. du Professeur Léon Bernard, Rennes, 35000, France.
- CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, 35000, France.
- LEPS (Laboratoire d'Education Et Promotion en Santé), University of Sorbonne Paris Nord, Villetaneuse, UR, 3412, F-93430, France.
| | - Jordan Scheer
- Department of General Practice, Univ Rennes, 2 Av. du Professeur Léon Bernard, Rennes, 35000, France
- CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, 35000, France
| | - Vincent De Andrade
- LEPS (Laboratoire d'Education Et Promotion en Santé), University of Sorbonne Paris Nord, Villetaneuse, UR, 3412, F-93430, France
| | - Ronan Garlantézec
- CHU de Rennes, Univ Rennes, Inserm, EHESP (Ecole Des Hautes Etudes en Santé Publique), Irset - UMR_S 1085, Rennes, 35000, France
| | - Rémi Gagnayre
- LEPS (Laboratoire d'Education Et Promotion en Santé), University of Sorbonne Paris Nord, Villetaneuse, UR, 3412, F-93430, France
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Li F, Guo S, Gong W, Xie X, Liu N, Zhang Q, Zhao W, Cao M, Cao Y. Self-management of Diabetes for Empty Nest Older Adults: A Randomized Controlled Trial. West J Nurs Res 2023; 45:921-931. [PMID: 37615083 DOI: 10.1177/01939459231191599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND Despite much evidence showing the effectiveness of structured self-management education for diabetes, poor glycemic control remains a challenge among empty nest older adults. OBJECTIVE We explored the effect of a health education intervention based on the PRECEDE-PROCEED model on the self-management of empty nest older adults with type 2 diabetes in Lanzhou, China. METHODS We conducted a 2-armed, randomized controlled trial using a multistage sampling method. A total of 100 patients were randomly assigned to receive either community nurse-led diabetes education based on the PRECEDE-PROCEED model or general community diabetes education. Self-management scores and blood glucose were compared at baseline and at 3 and 6 months after the intervention. RESULTS Analyses were conducted on the 98 patients completing follow-up. In the experimental group, diabetes self-management knowledge (t = 7.578, P < .001), self-management attitude (t = 9.155, P < .001), self-management behavior (t = 7.809, P < .001), and overall self-management scores (t = 7.626, P < .001) improved, with hemoglobin A1c (t = -2.825, P = .006), fasting plasma glucose (t = -3.100, P = .003), 2-hour postprandial blood glucose (t = -3.812, P < .001), and diastolic blood pressure (t = -2.104, P = .038) decreasing compared with the control group at 6 months postintervention. CONCLUSIONS This study demonstrated that education based on the PRECEDE-PROCEED model was more effective than general health education in improving diabetes self-management and glycemic control among empty nest older adults.
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Affiliation(s)
- Fang Li
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Shaofan Guo
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Wenhuan Gong
- School/Hospital of Stomatology of Lanzhou University, Lanzhou, China
| | - Xuejuan Xie
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Na Liu
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Qingjing Zhang
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Wenjing Zhao
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Mengjie Cao
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yuzhong Cao
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
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Wang Y, Zhang Y, Han J, Chen Y, Li L, Wei X, Fu G. Diabetes knowledge and training needs among non-endocrinology nurses. Heliyon 2023; 9:e15985. [PMID: 37215767 PMCID: PMC10196786 DOI: 10.1016/j.heliyon.2023.e15985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/24/2023] Open
Abstract
Background It is necessary to determine the diabetes knowledge level among non-endocrinology nurses in primary care hospitals to develop continuing education strategies. Method A questionnaire survey was conducted among 6819 non-endocrinology nurses in 70 primary hospitals in the Guangxi Zhuang Autonomous Region to assess their diabetes knowledge level and training needs. Factors affecting knowledge level were analyzed using multiple linear regression models. Results Diabetes knowledge was low, particularly for diabetes monitoring. Knowledge was higher in nurses who had in-service education and training in diabetes; most believed that training was necessary and hoped to improve their ability to care for diabetic patients. The most suitable training method was considered to be each nurse was taught by an assigned person after centralized specialized education and training. Conclusion Non-endocrinology nurses in primary care hospitals lack knowledge of diabetes and have a strong need for training. Systematic training is required to ensure that patients receive high-quality and comprehensive care.
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Affiliation(s)
- Yudong Wang
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Department of Nursing, Liaocheng People's Hospital, Liaocheng, China
| | - Yanping Zhang
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiaxia Han
- Department of Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yongfeng Chen
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Lirong Li
- Clinical Tumor Center, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaohui Wei
- School of Nursing, Youjiang Medical University for Nationalities, Baise, China
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Lamptey R, Amoakoh-Coleman M, Barker MM, Iddi S, Hadjiconstantinou M, Davies M, Darko D, Agyepong I, Acheampong F, Commey M, Yawson A, Grobbee DE, Adjei GO, Klipstein-Grobusch K. Change in glycaemic control with structured diabetes self-management education in urban low-resource settings: multicentre randomised trial of effectiveness. BMC Health Serv Res 2023; 23:199. [PMID: 36829179 PMCID: PMC9957611 DOI: 10.1186/s12913-023-09188-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND In high-resource settings, structured diabetes self-management education is associated with improved outcomes but the evidence from low-resource settings is limited and inconclusive. AIM To compare, structured diabetes self-management education to usual care, in adults with type 2 diabetes, in low-resource settings. RESEARCH DESIGN AND METHODS DESIGN Single-blind randomised parallel comparator controlled multi-centre trial. Adults (> 18 years) with type 2 diabetes from two hospitals in urban Ghana were randomised 1:1 to usual care only, or usual care plus a structured diabetes self-management education program. Randomisation codes were computer-generated, and allotment concealed in opaque numbered envelopes. The intervention effect was assessed with linear mixed models. MAIN OUTCOME Change in HbA1c after 3-month follow-up. Primary analysis involved all participants. CLINICALTRIAL gov identifier:NCT04780425, retrospectively registered on 03/03/2021. RESULTS Recruitment: 22nd until 29th January 2021. We randomised 206 participants (69% female, median age 58 years [IQR: 49-64], baseline HbA1c median 64 mmol/mol [IQR: 45-88 mmol/mol],7.9%[IQR: 6.4-10.2]). Primary outcome data was available for 79 and 80 participants in the intervention and control groups, respectively. Reasons for loss to follow-up were death (n = 1), stroke(n = 1) and unreachable or unavailable (n = 47). A reduction in HbA1c was found in both groups; -9 mmol/mol [95% CI: -13 to -5 mmol/mol], -0·9% [95% CI: -1·2% to -0·51%] in the intervention group and -3 mmol/mol [95% CI -6 to 1 mmol/mol], -0·3% [95% CI: -0·6% to 0.0%] in the control group. The intervention effect was 1 mmol/mol [95%CI:-5 TO 8 p = 0.726]; 0.1% [95% CI: -0.5, 0.7], p = 0·724], adjusted for site, age, and duration of diabetes. No significant harms were observed. CONCLUSION In low-resource settings, diabetes self-management education might not be associated with glycaemic control. Clinician's expectations from diabetes self-management education must therefore be guarded.
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Affiliation(s)
- Roberta Lamptey
- Polyclinic/ Family Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana. .,Department of Community Health, University of Ghana Medical School, Accra, Ghana. .,Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Korle Bu Teaching Hospital, Guggisberg avenue, Accra, Ghana.
| | - Mary Amoakoh-Coleman
- grid.5477.10000000120346234Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands ,grid.462644.60000 0004 0452 2500Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Mary Moffett Barker
- grid.9918.90000 0004 1936 8411Diabetes Research Centre, University of Leicester, Leicester, UK ,grid.511501.1NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Samuel Iddi
- grid.8652.90000 0004 1937 1485Department of Statistics and Actuarial Science, University of Ghana, Legon, Ghana
| | - Michelle Hadjiconstantinou
- grid.9918.90000 0004 1936 8411Diabetes Research Centre, University of Leicester, Leicester, UK ,grid.511501.1NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Melanie Davies
- grid.9918.90000 0004 1936 8411Diabetes Research Centre, University of Leicester, Leicester, UK ,grid.511501.1NIHR Leicester Biomedical Research Centre, Leicester, UK ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, University of Leicester, Leicester, UK ,grid.511501.1NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel Darko
- Family Medicine Department, Nyaho Medical Center, Accra, Ghana ,grid.442866.a0000 0004 0442 9971Department of Physician Assistantship Studies, Central University, Prampram, Ghana
| | - Irene Agyepong
- grid.512819.60000 0004 0556 3750Faculty of Public Health, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Franklyn Acheampong
- grid.415489.50000 0004 0546 3805Office of Research, Korle Bu Teaching Hospital, Accra, Ghana
| | - Mary Commey
- grid.434994.70000 0001 0582 2706Non-Communicable Diseases Control Programme, Ghana Health Service, Accra, Ghana
| | - Alfred Yawson
- grid.8652.90000 0004 1937 1485Department of Community Health, University of Ghana Medical School, Accra, Ghana ,grid.8652.90000 0004 1937 1485Divison of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Ghana, Accra, Ghana
| | - Diederick E. Grobbee
- grid.5477.10000000120346234Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - George Obeng Adjei
- grid.8652.90000 0004 1937 1485Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, Accra, Ghana ,grid.8652.90000 0004 1937 1485Office of Research Innovation and Development, University of Ghana, Legon, Ghana
| | - Kerstin Klipstein-Grobusch
- grid.5477.10000000120346234Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands ,grid.11951.3d0000 0004 1937 1135Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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AlHaqwi AI, Amin MM, AlTulaihi BA, Abolfotouh MA. Impact of Patient-Centered and Self-Care Education on Diabetes Control in a Family Practice Setting in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1109. [PMID: 36673862 PMCID: PMC9859274 DOI: 10.3390/ijerph20021109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Background: Diabetes mellitus is a chronic and complex medical disease that leads to significant morbidity and mortality. Patient-centered diabetes education that emphasizes active patient involvement, self, and shared care constitutes a substantial and essential component of the comprehensive diabetes management approach. Objectives: To assess the impact of patient-centered diabetes education sessions on the prescribed treatment plan in controlling diabetes and other related cardiovascular risk factors. Methods: In a pre-experimental pretest-posttest one group study design, all referred patients with type 2 diabetes (T2DM) to the diabetes educator clinic (n = 130 patients) during the period of 6 months from January to July 2021 were subjected to multiple and consecutive patient-centered diabetes education sessions, based on the framework published by the Association of Diabetes Care and Education Specialties (ADCES), in addition to their usual treatment plan. Demographic, social, and biological data were obtained at the baseline, three months, and six months after the intervention. Nonparametric Friedman and Cochran’s Q tests for related samples were applied to examine the impact of this educational intervention on glycosylated hemoglobin (HbA1c) and other associated cardiovascular risks. The results of 130 patients with T2DM showed a significant reduction of mean systolic blood pressure “SBP” (p = 0.015), glycosylated hemoglobin (HbA1c) (p < 0.001), fasting blood sugar “FBS” (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein (p < 0.001), and triglyceride (p < 0.001), and significant rise of mean high-density lipoprotein (p = 0.011). At three and six months after the intervention, 43% and 58% of patients showed improved HbA1c levels. The mean HbA1c was reduced from 10.2% at the beginning of the study to 8.7% (p < 0.001) after six months. Moreover, a significant reduction in the prevalence of obesity (p = 0.018), high FBS (p = 0.011), and high SBP (p = 0.022) was detected. Conclusions: This study showed a considerable positive impact of diabetes education and patient-centered care on optimizing glycemic and other cardiovascular risk control. The needs of certain patients with T2DM should be addressed individually to achieve the best possible outcomes. Further research is needed to explore the long-term benefits of this intervention.
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Affiliation(s)
- Ali I. AlHaqwi
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Marwa M. Amin
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
| | - Bader A. AlTulaihi
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Mostafa A. Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
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Kumar R, Rehman S, Baloch GM, Vankwani M, Somrongthong R, Pongpanich S. Effectiveness of health education intervention on diabetes mellitus among the teachers working in public sector schools of Pakistan. BMC Endocr Disord 2022; 22:194. [PMID: 35907838 PMCID: PMC9338632 DOI: 10.1186/s12902-022-01110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is considered as one of the major public health problems globally. Health education strategies can help in managing blood glucose level and complications among DM patients. Health education intervention is effective to manage and control the blood glucose levels among diabetic patients. This study explored the effectiveness of health education intervention on DM among school teachers in public sector schools of Pakistan. METHODS This was quasi-experimental study where baseline & end line assessments were conducted on teachers of public sector schools of Sindh province, Pakistan, from October to December 2019. Pretested structured questionnaire was used in this study. Participants (n = 136). were randomly selected from the list of government schools registered with district education department An intervention comprised of health education sessions with DM patients was undertaken after conducting baseline assessment followed by end line assessment. The institutional review board of Health Services Academy Pakistan ethically approved this study. RESULTS All the respondents completed post-test with mean ± SD age of participants being 39.2 ± 1.34 years. Female teachers comprised 65% out of which 70% were living in rural areas. Knowledge on DM pre-test score was 20.03 ± 3.31 that increased in post-test to 49.11 ± 2.21 (p < 0.05). Mean score of information on symptoms and causes of DM was 1.98 ± 0.21 for pre-test whereas for post-test it was 4.78 ± 0.12 (p < 0.05). The effect of intervention was significant on diabetes related complications (p < 0.05), symptoms (p < 0.05), overall score (p < 0.05) and preventive practices (p < 0.05). CONCLUSIONS The study provides evidence of the importance and effectiveness of health education intervention related to diabetes among school teachers, which has a positive impact on the knowledge and practices. We concluded that the health education session sensitized the teachers and they can bring cogent changes to enhance their knowledge about diabetes and its risks.
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Affiliation(s)
- Ramesh Kumar
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sidra Rehman
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | | | | | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Self-Management Nursing Intervention for Controlling Glucose among Diabetes: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312750. [PMID: 34886488 PMCID: PMC8657503 DOI: 10.3390/ijerph182312750] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 01/14/2023]
Abstract
As the diabetic population increases, self-management of diabetes, a chronic disease, is important. Given that self-management nursing interventions using various techniques have been developed, an analysis of their importance is crucial. This study aimed to identify the overall effects of self-management nursing interventions on primary (HbA1c) and secondary (self-care, self-efficacy, fasting blood sugar level blood pressure, lipid, body mass index, waist circumference, distress, anxiety, depression, and quality of life) outcomes in diabetes. Systematic review and meta-analysis were used. The meta-analysis involved the synthesis of effect size; tests of homogeneity and heterogeneity; trim and fill plot; Egger’s regression test; and Begg’s test for assessing publication bias. The overall effect on HbA1c was −0.55, suggesting a moderate effect size, with HbA1c decreasing significantly after nursing interventions. Among the nursing interventions, the overall effect on HbA1c of nurse management programs, home visiting, and customized programs was −0.25, −0.61, and −0.65, respectively, a small or medium effect size, and was statistically significant. Healthcare professionals may encourage people with diabetes to engage in self-management of their glucose levels, such as patient-centered customized intervention. Interventions that reflect the individual’s characteristics and circumstances are effective in enabling self-management.
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