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Baenas I, Camacho-Barcia L, Granero R, Razquin C, Corella D, Gómez-Martínez C, Castañer-Niño O, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem JL, Cano-Ibáñez N, Tur JA, Martín-Sánchez V, Pintó X, Gaforio JJ, Matía-Martín P, Vidal J, Vázquez C, Daimiel L, Ros E, Jiménez-Murcia S, Dalsgaard S, Garcia-Arellano A, Babio N, Sorli JV, Lassale C, García-de-la-Hera M, Gómez-García E, Zulet MA, Konieczna J, Martín-Peláez S, Tojal-Sierra L, Basterra-Gortari FJ, de Las Heras-Delgado S, Portoles O, Muñoz-Pérez MÁ, Arenas-Larriva AP, Compañ-Gabucio L, Eguaras S, Shyam S, Fitó M, Baños RM, Salas-Salvadó J, Fernández-Aranda F. Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population. J Endocrinol Invest 2024; 47:1405-1418. [PMID: 38218741 PMCID: PMC11142971 DOI: 10.1007/s40618-023-02278-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. METHODS n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. RESULTS The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. CONCLUSIONS This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.
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Affiliation(s)
- I Baenas
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona, 08007, Barcelona, Spain
| | - L Camacho-Barcia
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
| | - R Granero
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Department de Psicobiologia I Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
| | - C Razquin
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - D Corella
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - C Gómez-Martínez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - O Castañer-Niño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), 08003, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - J A Martínez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049, Madrid, Spain
| | - Á M Alonso-Gómez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Cardiovascular, Respiratory and Metabolic Area, Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - J Wärnberg
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29590, Málaga, Spain
| | - J Vioque
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - D Romaguera
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, 07120, Palma, Spain
| | - J López-Miranda
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - R Estruch
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - F J Tinahones
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29590, Málaga, Spain
| | - J Lapetra
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Seville, Spain
| | - J L Serra-Majem
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016, Las Palmas de Gran Canaria, Spain
| | - N Cano-Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (IBS.GRANADA), 18012, Granada, Spain
| | - J A Tur
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122, Palma, Spain
| | - V Martín-Sánchez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, 24071, León, Spain
| | - X Pintó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Universidad de Barcelona, 08908, Barcelona, Spain
| | - J J Gaforio
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, 23071, Jaén, Spain
| | - P Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - J Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - C Vázquez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, 28024, Madrid, Spain
| | - L Daimiel
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28668, Madrid, Spain
| | - E Ros
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Lipid Clinic, Hospital Clínic, 08036, Barcelona, Spain
| | - S Jiménez-Murcia
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907, Barcelona, Spain
| | - S Dalsgaard
- NCRR-National Centre for Register-Based Research, Aarhus University, 8210, Aarhus, Denmark
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, 8210, Aarhus, Denmark
- CIRRAU-Centre for Integrated Register-Based Research, Aarhus University, 8210, Aarhus, Denmark
| | - A Garcia-Arellano
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - N Babio
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - J V Sorli
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - C Lassale
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - M García-de-la-Hera
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - E Gómez-García
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29590, Málaga, Spain
| | - M A Zulet
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049, Madrid, Spain
| | - J Konieczna
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, 07120, Palma, Spain
| | - S Martín-Peláez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
| | - L Tojal-Sierra
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Cardiovascular, Respiratory and Metabolic Area, Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - F J Basterra-Gortari
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario de Navarra, IdiSNA, Universidad Pública de Navarra, 31008, Pamplona, Spain
| | - S de Las Heras-Delgado
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - O Portoles
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - M Á Muñoz-Pérez
- Unitat de Suport a la Recerca en Atenció Primaria de Barcelona. IDIAP Jordi Gol. Primary Care Division, Institut Català de La Salut, 08007, Barcelona, Spain
| | - A P Arenas-Larriva
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - L Compañ-Gabucio
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - S Eguaras
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - S Shyam
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - M Fitó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), 08003, Barcelona, Spain
| | - R M Baños
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatment of the University of Valencia, 46010, Valencia, Spain
| | - J Salas-Salvadó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain.
| | - F Fernández-Aranda
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907, Barcelona, Spain.
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Yap JM, Tantono N, Wu VX, Klainin-Yobas P. Effectiveness of technology-based psychosocial interventions on diabetes distress and health-relevant outcomes among type 2 diabetes mellitus: A systematic review and meta-analysis. J Telemed Telecare 2024; 30:262-284. [PMID: 34825839 DOI: 10.1177/1357633x211058329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Poor management of type 2 diabetes mellitus may affect individuals' physical and emotional health. Access to ongoing psychosocial interventions through technological platforms may potentially minimise diabetes complications and improve health-related outcomes. However, little is known about the effectiveness of such interventions on diabetes distress and health-related outcomes. OBJECTIVE To synthesise the best available evidence concerning the effectiveness of technology-based psychosocial interventions on diabetes distress, self-efficacy, health-related quality of life, and HbA1c level in adults with type 2 diabetes mellitus. METHODS A search of eleven databases was conducted to identify randomised controlled trials that examined the effects of technology-based psychosocial interventions on the outcomes. Randomised controlled trials reported in English from 2010 to 2020 were included. Selection of studies, quality appraisal, and data extraction were conducted by two reviewers independently. Meta-analyses, subgroup analyses and sensitivity analysis were performed using Review Manager. Intervention effects was measured using standardise mean difference. RESULTS Twenty randomised controlled trials fulfilled the eligibility criteria and 18 randomised controlled trials were included in meta-analysis. technology-based psychosocial interventions improved diabetes distress, self-efficacy and HbA1c levels with significant and small effect sizes. Subgroup analyses revealed greater improvement in health-related quality of life for participants with comorbid depression and lower HbA1c levels for studies with lesser than 100 participants. CONCLUSION The findings of this review increase knowledge on the effectiveness of technology-based psychosocial interventions on diabetes distress and self-efficacy. However, evidence to support the effects of technology-based psychosocial interventions on HbA1c and health-related quality of life was not strong. More research is needed to examine the effectiveness of the psychosocial interventions delivered through mobile applications or virtual reality.
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Affiliation(s)
| | | | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik JO, Amaddeo F, Arcari L, Churchill R, Jordans MJ, Lund C, Papola D, Uphoff E, van Ginneken N, Tol WA, Barbui C. Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries. Cochrane Database Syst Rev 2023; 10:CD014722. [PMID: 37873968 PMCID: PMC10594594 DOI: 10.1002/14651858.cd014722.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. OBJECTIVES To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. SELECTION CRITERIA Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. DATA COLLECTION AND ANALYSIS Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. MAIN RESULTS Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants). AUTHORS' CONCLUSIONS The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.
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Affiliation(s)
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Caterina Ceccarelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Jd Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Nadja van Ginneken
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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4
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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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Droske CA, Pearson TN, Velkovich SJ, Cohn H, Kanoon JM, Baig AA, Press VG. Variations in the Design and Use of Attention Control Groups in Type 2 Diabetes Randomized Controlled Trials: a Systematic Review. Curr Diab Rep 2023; 23:217-229. [PMID: 37294512 PMCID: PMC10527690 DOI: 10.1007/s11892-023-01514-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE OF REVIEW In type 2 diabetes (T2D) research, the phrase "attention control group" (ACGs) has been used with varying descriptions. We aimed to systematically review the variations in the design and use of ACGs for T2D studies. RECENT FINDINGS Twenty studies utilizing ACGs were included in the final evaluation. Control group activities had the potential to influence the primary outcome of the study in 13 of the 20 articles. Prevention of contamination across groups was not mentioned in 45% of the articles. Eighty-five percent of articles met or somewhat met the criteria for having comparable activities between the ACG and intervention arms. Wide variations in descriptions and the lack of standardization have led to an inaccurate use of the phrase "ACGs" when describing the control arm of trials, indicating a need for future research with focus on the adoption of uniform guidelines for use of ACGs in T2D RCTs.
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Affiliation(s)
- Casey A Droske
- Section of General Internal Medicine, Center for Chronic Disease Research and Policy, University of Chicago, 5841 S. Maryland Ave. MC 2007B, Chicago, IL, 60637, USA.
| | - Triniece N Pearson
- Department of Medicine, University of Chicago, 900 E. 57th St. #8144, Chicago, IL, 60637, USA
| | - Sharon J Velkovich
- Department of Medicine, University of Chicago, 900 E. 57th St. #8144, Chicago, IL, 60637, USA
| | - Hannah Cohn
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave. MC 2050, Chicago, IL, 60637, USA
| | - Jacqueline M Kanoon
- Section of General Internal Medicine, Center for Chronic Disease Research and Policy, University of Chicago, 5841 S. Maryland Ave. MC 2007B, Chicago, IL, 60637, USA
| | - Arshiya A Baig
- Department of Medicine, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Valerie G Press
- Departments of Medicine and Pediatrics, University of Chicago, 5841 S Maryland Ave, MC 2007, Chicago, Illinois, 60637, USA
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Stepanian N, Larsen MH, Mendelsohn JB, Mariussen KL, Heggdal K. Empowerment interventions designed for persons living with chronic disease - a systematic review and meta-analysis of the components and efficacy of format on patient-reported outcomes. BMC Health Serv Res 2023; 23:911. [PMID: 37626346 PMCID: PMC10463815 DOI: 10.1186/s12913-023-09895-6] [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: 09/12/2022] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Empowerment approaches are essential for building the capacity of individuals with chronic disease to be in control of their health. Reviews of empowerment interventions have been focused on specific chronic diseases, thereby limiting the scope of findings. This study had three aims: 1) to describe the characteristics of empowerment interventions covering a broad range of chronic diseases, 2) to clarify consistency with the World Health Organization`s (WHO) definition of empowerment as a process composed of four fundamental components and 3) to summarize outcome measures and estimate the effects in group and individual intervention formats. METHODS Systematic literature review and meta-analysis. CINAHL, Medline, Embase, PsycINFO, Web of Science, COCHRANE and Central Register of Controlled Trials were searched using Chronic Disease, NCD, Empowerment, as MeSH terms. Eligible randomized and quasi randomized controlled trials were included. Review Manager 5.4 was used to conduct the meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias tool (ROB 2). RESULTS Thirty-nine articles representing 8,011 participants were included in the review. A majority (82%) of studies reported robust evidence for changes on study-defined outcome measures in favor of interventions. Intervention content was assessed against WHO's four fundamental components of empowerment, showing that all studies incorporated one component, but none targeted all components. Components reflecting knowledge acquisition, patient engagement with their health care providers and facilitating environment were scarcely reported. Meta-analyses found evidence for positive effects of group-format interventions measuring empowerment, HbA1c, and self-efficacy. Effects on empowerment were also found in some individual-format interventions. High levels of heterogeneity and variability among the conceptual frameworks were identified. CONCLUSION Empowerment interventions in group-format were most efficient, however, considerable conceptual inconsistencies were identified. Future studies should consolidate conceptual understandings by using WHO's empowerment framework to ensure that fundamental components of empowerment are explicitly included in intervention design. Furthermore, there is a need to clarify the role of empowerment through pathways that include patient activation, self- management, and clinical outcomes. This systematic review will inform the clinicians and researchers who aim to develop novel empowerment interventions to assist patients in the process of gaining control of their health. TRIAL REGISTRATION PROSPERO: International Prospective register of systematic reviews ID=CRD42020178286.
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Affiliation(s)
- Natalie Stepanian
- College of Health Professions, Pace University, One Pace Plaza, New York, NY, 10038, USA
| | | | - Joshua B Mendelsohn
- College of Health Professions, Pace University, One Pace Plaza, New York, NY, 10038, USA
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggaten 15, 0456, Oslo, Norway
| | - Kristin Heggdal
- Faculty of Health, VID Specialized University, Theodor Dahls Vei 10, 0370, Oslo, Norway.
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7
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Kinoshita E, Hashimoto T, Nishimura R, Yotsumoto K. The influence of self-determination on the social functioning of long-term day hospitals users with schizophrenia: A randomized controlled trial. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e72. [PMID: 38868420 PMCID: PMC11114401 DOI: 10.1002/pcn5.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 12/04/2022] [Accepted: 12/28/2022] [Indexed: 06/14/2024]
Abstract
Aim In Japan, day hospitals are a method of rehabilitation for psychiatric disorders, especially for recovering social functioning. Currently, 60% of day hospital users have schizophrenia, the majority of whom are long-term users (for over 1 year). However, they show no progress in community participation. This study aimed to investigate whether people with schizophrenia who use day hospitals can improve their social functioning and recovery levels, and alleviate psychiatric symptoms, when they engage in self-determination regularly. Methods This study employed a multicenter randomized controlled design with a 3-month intervention. Participants were divided into two groups. The intervention group (n = 24) determined their daily goals in life and attended the day hospitals' programs, while the control group (n = 25) only participated in the day hospitals' programs. Participants' social functioning was assessed using the Global Assessment of Functioning (GAF) scale, psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS), and recovery using the Recovery Assessment Scale (RAS), before and after the intervention. Results In the intergroup factors, there were no significant differences in GAF, PANSS, or RAS scores. Conclusion The results suggest that participants' regular self-determination of their daily goals did not lead to significantly positive behavior in improving their social functioning. However, the social functioning and psychiatric symptoms of participants in day hospitals improved after 3 months.
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Affiliation(s)
- Eiko Kinoshita
- Department of Rehabilitation ScienceKobe University Graduate School of Health SciencesKobeJapan
| | - Takeshi Hashimoto
- Department of Rehabilitation ScienceKobe University Graduate School of Health SciencesKobeJapan
| | | | - Kayano Yotsumoto
- Department of Rehabilitation ScienceKobe University Graduate School of Health SciencesKobeJapan
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Ebrahimi H, Sadeghi M, Esmaeili SM, Janmohammadi F, Bahonar E. Effect of Empowerment Model-Based Program on Quality of Life in Patients with Type 2 Diabetes: A Randomized Controlled Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:99-104. [PMID: 37250944 PMCID: PMC10215552 DOI: 10.4103/ijnmr.ijnmr_155_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/10/2021] [Accepted: 10/25/2022] [Indexed: 01/26/2023]
Abstract
Background Type 2 diabetes (T2D) is a chronic disease with a high prevalence globally, which is in the second place of importance for the investigation of chronic diseases. According to previous studies, Quality of Life (QOL) is low in diabetic patients. Hence, this study was conducted with the aim to evaluate the effect of the empowerment model on the QOL of patients with T2D. Materials and Methods A randomized controlled trial was performed on 103 T2D patients over 18 years of age, with a definitive diagnosis of diabetes and medical records in a diabetic center. Patients were randomly assigned to either the intervention or the control groups. Routine education was presented to the control group, and the empowerment model was used for education in the experimental group for 8 weeks. The data collection tools used consisted of a demographic characteristics form and the diabetic clients QOL questionnaire. The one-way analysis of variance, Chi-square test, paired t-test, and independent t-test were used for data analysis. Results After the intervention, there were significant differences between the two groups in terms of the physical (p = 0.003), mental (p = 0.002), social (p = 0.013), economic (p = 0.042), and illness and treatment dimensions of QOL (p = 0.033), as well as the total QOL score (p = 0.011). Conclusions According to the results of this study, the training program based on empowerment significantly increased the QOL of patients with T2D. Therefore, using this method can be recommended in patients with T2D.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdi Sadeghi
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mahdi Esmaeili
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Farahnaz Janmohammadi
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elahe Bahonar
- Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
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Xie Q, Hu X, Wang Y, Peng J, Cheng L. Exploration of the health needs of patients with poorly controlled type 2 diabetes using a user-centred co-production approach in the area of mHealth: an exploratory sequential mixed-method protocol. BMJ Open 2022; 12:e063814. [PMID: 36585151 PMCID: PMC9809268 DOI: 10.1136/bmjopen-2022-063814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Research on the needs and preferences of patients with poorly controlled type 2 diabetes mellitus (T2DM) with mobile health (mHealth) service is limited. With the principles of co-production, this study aims to address this research gap by exploring the health needs of Chinese patients with poorly controlled T2DM. METHODS AND ANALYSIS This study uses a three-phase, exploratory sequential mixed-method design. Phase 1 aims to assess the health needs of patients with poorly controlled T2DM by conducting semi-structured interviews with patients, doctors and nurses. Participants will be recruited by purposive sampling with maximum variation. Content analysis will be employed. Phase 2 will form item generation and develop the mHealth need scale. The scale will be subject to pilot testing and psychometric evaluation, including content validity, construct validity, discriminant validity, internal validity and test-retest reliability. Phase 3 will explore the priority of health needs perceived by patients with poorly controlled T2DM through a cross-sectional study. The measurement tools include an mHealth needs scale, the Summary of Diabetes Self-care Activities Questionnaire, the Diabetes Empowerment Scale-Short Form, the Diabetes Health Literacy Scale and the eHealth Literacy Scale. Multiple regression techniques with a hierarchical block design will be used for the model building to identify the factors contributing to the heterogeneity of the perceived mHealth needs. The findings of phase 1 and phase 3 will be integrated using data correlation, comparison and consolidation. ETHICS AND DISSEMINATION The Ethics Committee of the School of Nursing, Sun Yat-sen University, has approved this study (No. 2021ZSLYEC). The results of this study will be disseminated through conference presentations and peer-reviewed publications.
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Affiliation(s)
- Qinqin Xie
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiling Hu
- Department of Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Junsheng Peng
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Gastrointestinal Surgery, Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou, Guangdong, China
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
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Liu Y, Jiang J, You W, Gong D, Ma X, Wu M, Li F. Exploring facilitators and barriers to self-management engagement of Chinese people with type 2 diabetes mellitus and poor blood glucose control: a descriptive qualitative study. BMC Endocr Disord 2022; 22:294. [PMID: 36435767 PMCID: PMC9701421 DOI: 10.1186/s12902-022-01214-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/11/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS To explore facilitators and barriers to self-management engagement of Chinese people with poorly controlled type 2 diabetes. METHODS Purposive sampling method was used for recruitment. Semi-structured interview and thematic analysis was used for data collection and analysis. RESULTS Twenty-six semi-structured interviews were conducted. Poor blood glucose control introduced awareness of susceptibility to complications, while mental disorders could be concomitant. General knowledge about healthy lifestyle and unhealthy habits impeded lifestyle management. Temporary remission of hyperglycemia and no perceived symptoms interfered engagement of medication therapy and regular blood glucose monitoring. Family and work environments could impact self-management engagement. Accessibility to reliable diabetes-related information influenced self-management engagement. CONCLUSIONS Awareness of susceptibility to complications motivated self-management engagement, while the awareness could cause mental disorders that need to be addressed. Customized lifestyle plans and behavior change technologies were crucial for lifestyle management. The progression of diabetes, importance of continuity of medication therapy, and the value of blood glucose monitoring should be clarified in diabetes education. Building diabetes-friendly social environments and providing reliable diabetes-related information were essential.
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Affiliation(s)
- Yuan Liu
- National Metabolic Management Center, Institute for Chronic Disease Management, Jining No. 1 People's Hospital, Jining, China.
| | - Jiajia Jiang
- National Metabolic Management Center, Institute for Chronic Disease Management, Jining No. 1 People's Hospital, Jining, China
| | - Wenjun You
- Department of Endocrinology, Jining No. 1 People's Hospital, Jining, China
| | - Dandan Gong
- Department of Endocrinology, Jining No. 1 People's Hospital, Jining, China
| | - Xiaoqing Ma
- Department of Endocrinology, Jining No. 1 People's Hospital, Jining, China
| | - Min Wu
- Department of Endocrinology, Jining No. 1 People's Hospital, Jining, China
| | - Feng Li
- Department of Endocrinology, Jining No. 1 People's Hospital, Jining, China
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Asmat K, Dhamani K, Gul R, Froelicher ES. The effectiveness of patient-centered care vs. usual care in type 2 diabetes self-management: A systematic review and meta-analysis. Front Public Health 2022; 10:994766. [PMID: 36388341 PMCID: PMC9650641 DOI: 10.3389/fpubh.2022.994766] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/03/2022] [Indexed: 01/26/2023] Open
Abstract
Background Patient-centered care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes, yet the supporting evidence is inadequate. This review aimed at assessing the effectiveness of patient-centered self-management care interventions on glycemic control (HbA1c) and self-care behaviors compared with usual care. Methods CINAHL, PubMed, Cochrane Library, Google Scholar, and the HEC Digital Library were searched for studies in English language that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or older with type 2 diabetes from 2005 to 2020. Interventional studies with at least 3 months of follow-up and reporting on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors including diet control, physical activity, foot care, and medication adherence were included. Results Of 168 identified records, 24 were found eligible comprising 20 RCTs and four QESs with total 4,083 participants. The meta-analysis involved 19 RCTs that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c, -0.56 (95% CI -0.79, -0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components, -0.66 (95% CI -0.97, -0.34); spanned over shorter (<03 months) duration, -0.85 (95% CI -1.28, -0.43); administered by nurses, -0.80 (95% CI -1.44, -0.16); and delivered in community settings -0.70 (95% CI -1.14, -0.26). Conclusion This systematic review provided evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing toward success.
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Affiliation(s)
- Kainat Asmat
- Shifa College of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan,*Correspondence: Kainat Asmat
| | - Khairunnisa Dhamani
- Shifa College of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Raisa Gul
- Shifa College of Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing and Department of Epidemiology & Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
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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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Yu X, Chau JPC, Huo L, Li X, Wang D, Wu H, Zhang Y. The effects of a nurse-led integrative medicine-based structured education program on self-management behaviors among individuals with newly diagnosed type 2 diabetes: a randomized controlled trial. BMC Nurs 2022; 21:217. [PMID: 35932073 PMCID: PMC9354282 DOI: 10.1186/s12912-022-00970-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background International guidelines advocate providing prompt structured education to individuals with diabetes at diagnosis. However, among the few eligible structured education programs, heterogeneous intervention regimens and inconsistent findings were reported. Eligible programs for Chinese individuals with diabetes are lacking. This study aimed to investigate the effects of a nurse-led integrative medicine-based structured education program on self-management behaviors, glycemic control and self-efficacy among individuals with newly diagnosed type 2 diabetes. Methods Employing a randomized controlled trial, 128 individuals with type 2 diabetes diagnosed in the preceding three to nine months were recruited from four university-affiliated tertiary hospitals in Xi’an City, Northwest China, and randomly allocated to the intervention or control groups after baseline assessments. Participants in the intervention group received a 4-week nurse-led integrative medicine-based structured education program, which is theoretically based on the Health Belief Model and Self-Efficacy Theory, in line with updated diabetes management guidelines, and informed by relevant systematic reviews. Participants in the control group received routine care. Self-management behaviors and self-efficacy were measured with the Summary of Diabetes Self-Care Activities and the Diabetes Management Self-Efficacy Scale at baseline, immediate post-intervention and 12 weeks following the intervention while Glycated Hemoglobin A was measured at baseline and the 12th-week follow-up. The intervention effects were estimated using the generalized estimating equation models. Results Participants in the intervention group exhibited significantly better self-management performance in specific diet regarding intake of fruits and vegetables at both follow-ups (β = 1.02, p = 0.011 and β = 0.98, p = 0.016, respectively), specific diet regarding intake of high-fat foods at the immediate post-intervention follow-up (β = 0.83, p = 0.023), blood glucose monitoring at the 12th-week follow-up (β = 0.64, p = 0.004), foot care at both follow-ups (β = 1.80, p < 0.001 and β = 2.02, p < 0.001, respectively), and medication management at both follow-ups (β = 0.83, p = 0.005 and β = 0.95, p = 0.003, respectively). The intervention also introduced significant improvements in Glycated Hemoglobin A (β = − 0.32%, p < 0.001), and self-efficacy at both follow-ups (β = 8.73, p < 0.001 and β = 9.71, p < 0.001, respectively). Conclusions The nurse-led integrative medicine-based structured education program could produce beneficial effects on multiple diabetes self-management behaviors, glycemic control and self-efficacy. Trial registration This study was retrospectively registered in the ClinicalTrials.gov. on 25/08/2017; registration number: NCT03261895. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00970-7.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, People's Republic of China.,The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territory, Hong Kong
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territory, Hong Kong
| | - Lanting Huo
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xiaomei Li
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, People's Republic of China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Hongjuan Wu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, People's Republic of China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710068, People's Republic of China.
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14
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Othman MM, Khudadad H, Dughmosh R, Furuya-Kanamori L, Abou-Samra AB, Doi SAR. Towards a better understanding of self-management interventions in type 2 diabetes: A concept analysis. Prim Care Diabetes 2022; 16:142-149. [PMID: 34556438 DOI: 10.1016/j.pcd.2021.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/22/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Diabetes self-management educational (DSME) interventions can vary considerably, and it is unclear what is the operational conceptualization of the ideal delivery to individuals with type 2 diabetes (T2D). DESIGN From a search conducted concurrently we extracted and evaluated the 50 most recently published DSME intervention studies. Based on an analysis of these studies, we undertook a concept analysis using the Walker and Avant framework. RESULTS Five attributes describing the concept were recognized and organized into two groups. Group (a): skills related attributes that included (1) decision making, (2) problem solving and (3) taking action. Group (b): information related attributes that included (4) patient-provider interaction and (5) resource utilization. CONCLUSIONS The outcomes of this study make the operational conceptualization of the ideal DSME intervention measurable through its attributes and hence clarifies its delivery. This will improve the implementation of the key attributes in diabetes self-management intervention programs for T2D.
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Affiliation(s)
- Manal M Othman
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; Medicine Department, Hamad General Hospital, Doha, Qatar.
| | - Hanan Khudadad
- Department of Clinical Research, Primary Health Care Corporation, Doha, Qatar.
| | - Ragae Dughmosh
- Medicine Department, Hamad General Hospital, Doha, Qatar.
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute and Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
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15
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Othman MM, Khudadad H, Dughmosh R, Syed A, Clark J, Furuya-Kanamori L, Abou-Samra AB, Doi SAR. Towards a better understanding of self-management interventions in type 2 diabetes: A meta-regression analysis. Prim Care Diabetes 2021; 15:985-994. [PMID: 34217643 DOI: 10.1016/j.pcd.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/31/2021] [Accepted: 06/17/2021] [Indexed: 01/15/2023]
Abstract
AIMS Attributes that operationally conceptualize diabetes self-management education (DSME) interventions have never been studied previously to assess their impact on relevant outcomes of interest in people with type 2 diabetes (T2D). The aim of this study was to determine the impact of existing interventions classified by their delivery of skills or information related attributes on immediate (knowledge), intermediate (physical activity), post-intermediate (HbA1c), and long-term (quality of life) outcomes in people with T2D. METHODS PubMed, Embase, PsycINFO, and Cochrane Library/Cochrane CENTRAL as well as the grey literature were searched to identify interventional studies that examined the impact of DSME interventions on the four different outcomes. Eligible studies were selected and appraised independently by two reviewers. A meta-regression analysis was performed to determine the impact of delivery of the skills- and information-related attributes on the chosen outcomes. RESULTS 142 studies (n = 25,511 participants) provided data, of which 39 studies (n = 5278) reported on knowledge, 39 studies (n = 8323) on physical activity, 99 studies (n = 17,178) on HbA1c and 24 studies (n = 5147) on quality of life outcomes. Meta-regression analyses demonstrated that skills-related attributes had an estimated effect suggesting improvement in knowledge (SMD [standardized mean difference] increase of 0.80; P = 0.025) and that information-related attributes had an estimated effect suggesting improvement in quality of life (SMD increase of 0.96; P = 0.405). Skill- and information-related attributes did not have an estimated effect suggesting improvement in physical activity or in HbA1c. CONCLUSIONS The study findings demonstrate that the skills and information related attributes contribute to different outcomes for people with T2D. This study provides, for the first time, preliminary evidence for differential association of the individual DSME attributes with different levels of outcome.
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Affiliation(s)
- Manal M Othman
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Hanan Khudadad
- Department of Clinical Research, Primary Health Care Corporation, Doha, Qatar.
| | - Ragae Dughmosh
- Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Asma Syed
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
| | - Justin Clark
- The Centre for Research into Evidence Based Practice, Bond University, Gold Coast, Queensland, Australia.
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute and Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
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Heine M, Lategan F, Erasmus M, Lombaard CM, Mc Carthy N, Olivier J, van Niekerk M, Hanekom S. Health education interventions to promote health literacy in adults with selected non-communicable diseases living in low-to-middle income countries: A systematic review and meta-analysis. J Eval Clin Pract 2021; 27:1417-1428. [PMID: 33749092 DOI: 10.1111/jep.13554] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/15/2021] [Accepted: 02/21/2021] [Indexed: 12/17/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Health illiteracy is an important contributor to the burden of non-communicable diseases (NCDs); in particular in settings where health illiteracy is part of a perpetuating system of risk factors. Interventions that promote health literacy may provide an important tool in the primary and secondary prevention of NCDs. The objective of this systematic review was to evaluate the effectiveness of health literacy interventions on health literacy in the management of patients with selected NCDs living in low-to-middle income countries (LMIC). METHODS Seven electronic databases were searched (October 29, 2020) for RCTs aimed at improving health literacy in adults with NCDs in LMICs. Eligible NCDs included those pertaining to cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD) or Diabetes. Studies were included that explicitly focussed on improving health literacy, and reported comprehensive measures of health literacy, or components thereof (ie, knowledge, attitude or behaviour). Random-effect meta-analyses were conducted for continuous outcome measures (Hedges-g). RESULTS The completed search yielded 2573 unique results of which 53 unique studies met the inclusion criteria. Studies included patients with cancer (n = 1, 2%), CRD (n = 8, 15%), CVD (n = 11, 21%) or Diabetes (n = 33, 62%). A significant (P < .01) summary effect was found for disease knowledge (SES = 1.27 [n = 23, 95%CI = 1.05-1.49]), attitude (SES = 1.17 [n = 20, 95%CI = 0.88-1.47]), and behaviour (SES = 1.20 [n = 31, 95%CI = 0.94-1.46]). CONCLUSIONS These results support the conclusion that there is compelling evidence, in particular, for patients with Diabetes, that health-literacy interventions are effective in promoting disease knowledge, attitude and behaviour across four chronic conditions that drive the burden of NCDs.
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Affiliation(s)
- Martin Heine
- Institute of Sport and Exercise Medicine, Division of Orthopaedics, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Frandene Lategan
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Misha Erasmus
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Chris-Mari Lombaard
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nina Mc Carthy
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jeandri Olivier
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marnus van Niekerk
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Zhu L, Shi Q, Zeng Y, Ma T, Li H, Kuerban D, Hamal S, Li M. Use of health locus of control on self-management and HbA1c in patients with type 2 diabetes. Nurs Open 2021; 9:1028-1039. [PMID: 34841737 PMCID: PMC8859056 DOI: 10.1002/nop2.1140] [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: 04/12/2021] [Revised: 10/10/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022] Open
Abstract
Aim To assess the effects of health locus of control‐based education programme (HLCEP) on self‐management, health locus of control and glycated haemoglobin (HbA1c) among type 2 diabetes mellitus (T2DM). Design Quasi‐experimental study. Methods The study recruited 120 T2DM participants from May–September 2020. The control group received one‐week in‐hospital care and 12‐week follow‐up. The intervention group received additional HLCEP. The self‐management and the health locus of control were measured by using the Summary of Diabetes Self‐care Activities and the Multidimensional Health Locus of Control at baseline and the 4th and 12th week after discharge. The HbA1c was collected at baseline and the 12th week after discharge. The generalized estimating equation analysis was performed to assess the intervention effects. Results The intervention group has statistically significantly higher scores on the overall level of self‐management, dietary management, foot care, medication management and internal health locus of control, while a lower HbA1c level than the control group.
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Affiliation(s)
- Lingxiao Zhu
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qifang Shi
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Zeng
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Tong Ma
- The First People's Hospital of Lianyungang, Lianyungang, China
| | - Haomiao Li
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dilihumaer Kuerban
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Sarita Hamal
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Meng Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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18
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Verma D, Bahurupi Y, Kant R, Singh M, Aggarwal P, Saxena V. Effect of mHealth Interventions on Glycemic Control and HbA1c Improvement among Type II Diabetes Patients in Asian Population: A Systematic Review and Meta-Analysis. Indian J Endocrinol Metab 2021; 25:484-492. [PMID: 35355920 PMCID: PMC8959192 DOI: 10.4103/ijem.ijem_387_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Due to the high prevalence of diabetes mellitus, it is pertinent to educate and inform diabetes patients about their self-management. It can be done effectively using innovative methods like mobile health (mHealth), which includes mobile applications, phone calls, and text messages. Thus, this meta-analysis was conducted to summarize the effectiveness of mHealth interventions for the management of diabetes compared with usual care in the Asian population. Materials and Methods Searches were performed in electronic databases, namely PubMed, Scopus, Embase, and Cochrane Library, in August and September 2020. Search terms used were "Diabetes Mellitus," "mHealth," "glycemic control", "HbA1c levels," and "Blood glucose levels." The primary outcome was glycated hemoglobin and blood glucose levels. Trials were pooled, and heterogeneity was quantified using the I2 statistic. Results The search yielded 3980 abstracts, of which 18 trials met the inclusion criteria. Lowering of Hba1c levels was reported in the majority of trials, which aided in Glycemic control. For post prandial blood glucose (PPBG) levels, a statistically significant reduction of value -20.13 (95%CI -35.16 to -5.10, P = 0.009, I2 = 59%) was seen in the mean in the intervention group, whereas for HbA1c levels the mean reduction in the intervention group was -0.44 (95%CI, -0.79 to 0.10, P = 0.01, I2 = 87%). Although these interventions proved beneficial for these outcomes, there was a difference in the amount of effects caused by different mHealth interventions. Conclusion This study acknowledged the effects of different mHealth interventions as per their accessibility and availability in recent years. There is a need to include more studies in future reviews to generate a larger body of evidence for the reported outcomes. The researchers should give the utmost priority to the transparency while reporting the interventions for effective interpretation of the retrieved data.
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Affiliation(s)
- Divya Verma
- School of Public Health, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Yogesh Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mahendra Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pradeep Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vartika Saxena
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Kim J, Hur MH. The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168439. [PMID: 34444187 PMCID: PMC8393495 DOI: 10.3390/ijerph18168439] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022]
Abstract
As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review examines the evidence for the efficacy of dietary education interventions on diabetes control. The study subjects were patients with type 2 diabetes, and the main outcome variable was glycosylated hemoglobin level (HbA1c). The target studies were randomized controlled trials. Thirty-six studies were included in the analysis, of which 33 were included in the meta-analysis. The effect size between dietary education and general interventions was -0.42 (n = 5639, MD = -0.42; 95% CI -0.53 to -0.31) and was significantly different (Z = 7.73, p < 0.001). When subgroup analyses were performed following the application periods, intervention methods, and intervention contents, the mean differences in 4-6-month application, individual education, and diet-exercise-psychosocial intervention were -0.51, (n = 2742, 95% CI -0.71 to -0.32), -0.63 (n = 627, 95% CI -1.00 to -0.26), and -0.51 (n = 3244, 95% CI -0.71 to -0.32), respectively. Dietary education interventions provided for at least 3 months were highly effective in controlling HbA1c levels. Regarding the education method, individualized education was more effective, and contact or non-contact education may be applied for this. Combining diet, exercise, and psychosocial intervention is more effective than diet education alone.
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Affiliation(s)
- Juri Kim
- Department of Nursing, University of Kyungmin, 545 Seobu-ro, Uijeongbu-si 11618, Korea;
| | - Myung-Haeng Hur
- College of Nursing, Eulji University, 712 Dongil-ro, Uijeongbu-si 11759, Korea
- Correspondence: ; Tel.: +82-31-951-3868
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Kang E, Kim MY, Lipsey KL, Foster ER. Person-Centered Goal Setting: A systematic review of intervention components and level of active engagement in rehabilitation goal setting interventions. Arch Phys Med Rehabil 2021; 103:121-130.e3. [PMID: 34375632 DOI: 10.1016/j.apmr.2021.06.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 06/15/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This systematic review aims to examine 1) what components are used in current person-centered goal setting interventions for adults with health conditions in rehabilitation and 2) the extent to which the engagement of people in their rehabilitation goal setting is encouraged. DATA SOURCES PubMed/MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health Literature, SCOPUS, and Web of Science from inception to November 2020. STUDY SELECTION Primary inclusion criteria were peer-reviewed articles that evaluated person-centered goal setting interventions for adults with health conditions in rehabilitation. Two independent reviewers screened 28,294 records, and 22 articles met inclusion criteria. DATA EXTRACTION Two reviewers independently completed data extraction and quality assessment using the Physiotherapy Evidence Database (PEDRo) scale based on the original authors' descriptions, reports, and protocol publications. Any discrepancies were resolved by consensus or in consultation with another senior reviewer. DATA SYNTHESIS Using narrative synthesis, we found that current person-centered goal setting has variability in their inclusion of intervention components. A considerable number of components are under-implemented in current practice, with formulation of coping plan and follow-up being most commonly left out. The active engagement of people does appear to be promoted within the components that are included in the interventions. Nine studies were high-quality defined as a total PEDro scale score of 6 or above. CONCLUSIONS Although current person-centered goal setting encourages the active engagement of people, many of these interventions lack components considered important for supporting goal achievement and optimal outcomes. Future practice may be improved by incorporating a comprehensive set of goal setting components and encouraging the active engagement of people throughout the entire goal setting process. Together, these practices may facilitate the achievement of meaningful rehabilitation goals and improve rehabilitation outcomes for adults with health conditions.
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Affiliation(s)
- Eunyoung Kang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Moon Young Kim
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Kim L Lipsey
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA.
| | - Erin R Foster
- Program in Occupational Therapy, Department of Neurology, & Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
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21
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He Q, Zhao X, Wang Y, Xie Q, Cheng L. Effectiveness of smartphone application-based self-management interventions in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2021; 78:348-362. [PMID: 34324218 DOI: 10.1111/jan.14993] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/24/2021] [Accepted: 07/11/2021] [Indexed: 01/09/2023]
Abstract
AIMS To synthesize evidences on smartphone application-based intervention and determine its effectiveness on glycaemic control, self-management behaviours, psychological well-being, quality of life and cardiometabolic risk factors. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES Major English and Chinese electronic databases were searched from January 2008 to January 2021, including PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang and Sinomed. REVIEW METHODS RCTs were screened and selected if they used smartphone applications to support patients in the self-management of diabetes. Data extraction and methodological assessment were performed by two reviewers independently. Meta-analysis was performed to pool the intervention effect on outcomes of interest using RevMan 5.3. RESULTS Across 19 included trials involving 2585 participants, smartphone application-based interventions were associated with a clinically and statistically significant reduction of glycated haemoglobin (HbA1c). Beneficial effects were also observed in participants' behavioural performance, especially in medication adherence. Intervention effects on psychological status, quality of life and cardiometabolic risk factors were nonsignificant. Subgroup analysis showed interactive approach with medium frequency or flexible facilitator-patient interaction induced a larger effect on HbA1c reduction. Besides, patients with baseline HbA1c ≥9% benefited more than those with HbA1c <9% from the use of smartphone applications. CONCLUSIONS Smartphone application-based diabetes self-management intervention could optimize patients' glycaemic control and enhance participants' self-management performance. Further endeavour is required to examine the long-term effects and cost-effectiveness of smartphone application-based intervention before promoting the adoption and dissemination of such intervention. IMPACT This review supports the potential of smartphone application-based intervention as effective approach to optimize glycaemic control and promote self-management engagement among patients with type 2 diabetes. Suggestions for future research and practice are provided and discussed.
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Affiliation(s)
- Qianyu He
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoyan Zhao
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qinqin Xie
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
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Pramita R, Nasution SS, Marlindawani J. Effect of Family Empowerment on Self Care of Patients with Type-2 Diabetes Mellitus: A Systematic Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Diabetes Mellitus Type 2 (T2DM) is a chronic disease that will be suffered for life, so it is necessary to provide education to patients and families so that it is easy to understand the course of the disease, prevention and obstacles in the management of T2DM. Family empowerment can be started by optimizing family functions to help patients with T2DM to adapt and comply with self-care actions through four dimensions, empathic (emotional), encouragement (reward), facilitative (instrumental), and participatory (participation). This systematic review aims to identify and evaluate the effect of family empowerment interventions on self-care for T2DM patients.
Methods: The database used for article searches consisted of EBSCO, PubMed and ProQuest using relevant keywords based on the topic and title of the study. The selection of articles used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram method, the overall results were 2,635 articles and 8 articles that fit the inclusion criteria and were analyzed descriptively narrative and had met the methodological quality study according to JBI guidelines (Joanna Briggs Critical Appraising Methodology).
Results: 8 articles with the Family Empowerment Process Model intervention program and the Diabetes Mellitus Education Program which is a family-oriented program that includes education classes, group discussions, home visits, and telephone follow-up. Education is provided to families through direct discussion and through telephone calls with a duration of each call of approximately 15 to 20 minutes scheduled for 9 am to 12 noon. Follow-up was done by telephone in the intervention group for approximately 3 months to 12 months.
Conclusion: The findings of this systematic review indicate that family empowerment interventions based on health education can have a good effect on improving self-care for patients with type 2 diabetes mellitus
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Lee LY, Hsieh CJ, Lin YT. Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function. J Clin Nurs 2021; 30:2673-2682. [PMID: 33655571 DOI: 10.1111/jocn.15740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 01/24/2021] [Accepted: 02/25/2021] [Indexed: 10/22/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationships among emotional distress, cognitive function and life satisfaction in people living with type 2 diabetes mellitus (T2DM), and to verify the mediating role of cognitive function. BACKGROUND People with T2DM face cognitive decline caused by age and disease complications. Emotional distress will reduce their life satisfaction, and cognitive function will also affect the life satisfaction, but whether cognitive function mediates the effect of emotional distress on life satisfaction has not been verified. DESIGN A cross-sectional study. METHODS A total of 200 people living with T2DM in the community by convenience sampling were enrolled from November-December 2018. Data collection involved a demographic and disease characteristic questionnaire, Problem Areas in Diabetes Scale, Subjective and Objective Cognitive Function Evaluation and Life Satisfaction Questionnaire. Data analysis included descriptive statistics and structural equation modelling. This report followed the STROBE guideline. RESULTS The emotional distress and subjective memory complaints of cognitive function had a significant positive correlation, while both emotional distress and cognitive function showed significant negative correlations with life satisfaction. In addition, cognitive function completely mediated the relationship between emotional distress and life satisfaction. CONCLUSION The cognitive function played a mediating role in life satisfaction and explains how emotional distress affects life satisfaction of people with T2DM. Therefore, it is suggested that diabetes nurses should early identify the decline of cognitive function, and to intervene at an early stage. RELEVANCE TO CLINICAL PRACTICE This study provides opinions on the mediating factors of cognitive function. Coping strategies and supporting resources to help the T2DM people to improve their life satisfaction are suggested.
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Affiliation(s)
- Li-Yen Lee
- School of nursing, College of Nursing, Lecturer of Cardinal Tien Junior of Healthcare and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ya-Ting Lin
- School of nursing, College of Nursing, Lecturer of St. Mary's Junior College of Medicine, Nursing and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Frakking T, Michaels S, Orbell-Smith J, Le Ray L. Framework for patient, family-centred care within an Australian Community Hospital: development and description. BMJ Open Qual 2021; 9:bmjoq-2019-000823. [PMID: 32354755 PMCID: PMC7213886 DOI: 10.1136/bmjoq-2019-000823] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/31/2020] [Accepted: 04/18/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital. METHODS A scoping review of scientific and grey literature and community hospital stakeholder discussions were used to identify and design a conceptual framework for PFCC across five core pillars of leadership, engagement, service delivery, learning and environment. RESULTS 107 publications were identified and 76 were included for data extraction. A draft framework was constructed and modified following consultation with hospital stakeholders across a small Australian Community Hospital. The 'Caring Together' framework outlines three core layers: (1) the focus of our care is the experiences of our consumers and staff; (2) concepts of leadership, environment, service delivery, engagement and learning; and (3) the overarching fundamental values of being heard, respected, valued and supported by staff and consumers at all levels in an organisation. CONCLUSIONS The conceptual Caring Together framework structures key PFCC concepts across organisational priority areas within an Australian healthcare setting and can be used to guide implementation of PFCC at other small hospital facilities. Changes to national and state healthcare funding may help facilitate improved hospital facility implementation of PFCC, and ultimately improve consumer healthcare satisfaction and clinical outcomes.
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Affiliation(s)
- Thuy Frakking
- Research Development Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia .,School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Suzanne Michaels
- Engagement & Integration, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Jane Orbell-Smith
- Education & Training, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Lance Le Ray
- Executive Management, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
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Chen Y, Ran X, Chen Y, Jiang K. Effects of Health Literacy Intervention on Health Literacy Level and Glucolipid Metabolism of Diabetic Patients in Mainland China: A Systematic Review and Meta-Analysis. J Diabetes Res 2021; 2021:1503446. [PMID: 35005027 PMCID: PMC8739182 DOI: 10.1155/2021/1503446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/06/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To systematically evaluate the effects of health literacy intervention on health literacy level and glycolipid metabolism of people with diabetes in mainland China. METHODS A systematic review of journal articles discussing diabetes and health literacy was performed by searching PubMed, Embase, the Science Citation Index Expanded (SCIE) database of Web of Science, the China National Knowledge Infrastructure (CNKI) database, the Chinese Scientific and Technical Journals database (CQVIP), and the Wanfang database. Cochrane Effective Practice and Organization of Care Review Group (EPOC) standards were applied for quality assessment. A meta-analysis was performed using Stata 12.0 software. RESULTS A total of 44 articles, including seven controlled before-and-after trials (CBAs), 27 randomized controlled trials (RCTs), and 10 nonrandomized controlled trials (non-RCTs), were included. The results showed that (1) health literacy level in the intervention group was improved compared with the preintervention and the control group; (2) fasting plasma glucose (FPG) (standardized mean difference (SMD) = -1.85, 95% CI: -2.28, -1.42), 2-hour plasma glucose (2hPG) (SMD = -2.18, 95% CI: -2.68, -1.68), and HbA1c (weighted mean difference (WMD) = -1.21, 95% CI: -1.48, -0.94) were significantly reduced in the intervention group; (3) total cholesterol (TC) (WMD = -0.43, 95% CI: -0.64, -0.23) was significantly reduced in the intervention group, although there were no statistically significant differences for triglycerides (TG) (WMD = -0.34, 95% CI: -0.73, 0.05), low-density lipoprotein cholesterol (LDL-C) (WMD = -0.20, 95% CI: -0.46, 0.07), or high-density lipoprotein cholesterol (HDL-C) (WMD = -0.06, 95% CI: -0.29, 0.17). CONCLUSION Intervention based on health literacy can effectively improve health literacy levels and reduce glucose metabolism and TC level among people with diabetes mellitus, although it has no significant effect on TG, LDL-C, or HDL-C.
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Affiliation(s)
- Yangli Chen
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, China
| | - Xue Ran
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, China
| | - Yalan Chen
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, China
| | - Kui Jiang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, China
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Bekele BB, Negash S, Bogale B, Tesfaye M, Getachew D, Weldekidan F, Balcha B. Effect of diabetes self-management education (DSME) on glycated hemoglobin (HbA1c) level among patients with T2DM: Systematic review and meta-analysis of randomized controlled trials. Diabetes Metab Syndr 2021; 15:177-185. [PMID: 33360516 DOI: 10.1016/j.dsx.2020.12.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Type 2 Diabetes mellitus (T2DM) has been a global public health issue causing in physical, financial and psychosocial crises. The aim of this systematic review and meta-analysis (SRMA) was to evaluate the Diabetes Self-Management Education or Support (DSME/S) on glycosylated hemoglobin (HbA1c) among T2DM patients. METHODS This SRMA was made according to preferred reporting Items for systematic review and Meta-analysis (PRISMA) guidelines. The relevant articles were searched from four databases: Cochrane Library, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Quality assessment was carried out. Pooled standard mean difference in HbA1c were calculated to obtain the effect size with random effect assumption. Subgroup analysis was conducted for assessing heterogeneity among the studies. RESULTS A total of 1312 studies were identified from databases. Among these 25 studies met inclusion criteria. From these 20 were included in the meta-analysis. In meta-analysis a pooled standard mean difference in HbA1c was -0.604 (95% confidence interval = -0.854 -0.353, I2 = 90.3, p < 0.001). In subgroup analysis a significant reduction was seen among studies with less than four months, upper middle followed by lower middle income countries (LMICs), Western Pacific (WP) followed by Middle Eastern and Northern African (MENA) regions with moderate to substantial heterogeneity. CONCLUSION However, there is paucity of studies in underdeveloped countries. Therefore, further studies validated to these contexts are needed to evaluate the DSME effectiveness. TRIAL REGISTRATION PROSPERO database CRD42020124236.
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Affiliation(s)
- Bayu Begashaw Bekele
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia; Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, 4028, Hungary.
| | - Samuel Negash
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Biruk Bogale
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Melkamsew Tesfaye
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Dawit Getachew
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Fekede Weldekidan
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260, Mizan Aman, Ethiopia
| | - Behailu Balcha
- School of Public Health, College of Medicine and Health Sciences, Woliata Sodo University, Sodo, Ethiopia
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Lafontaine S, Bourgault P, Girard A, Ellefsen E. Dimensions, application, and outcomes of person-centered self-management interventions for those living with type 2 diabetes: A scoping review. PATIENT EDUCATION AND COUNSELING 2020; 103:1961-1982. [PMID: 32624328 DOI: 10.1016/j.pec.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore which dimensions of the person-centered approach (PCA) are adopted in self-management interventions, how they are applied, and its outcomes. METHODS A review team carried out a scoping review using the methodology of Arksey and O'Malley on diabetes mellitus type 2, person-centered care, and self-management. RESULTS Of the 364 titles identified, 22 articles were included in this review. No study contained all five dimensions described by the person-centered framework. Some dimensions seemed difficult to assess, mainly having a sympathetic presence and engagement. The application of the five PCA dimensions are presented. Although the authors claimed their intervention to be person-centered, none used a specific tool to measure person-centered care in a holistic way. CONCLUSION Although the guidelines recommend a PCA to professionals, there is a gap with practice, professionals having difficulty adopting and measuring this approach. PRACTICE IMPLICATIONS Some strategies to facilitate the adoption of a PCA with people living with type 2 diabetes are proposed. These can help researchers and clinicians develop a PCA, by identifying the care delivery processes necessary to provide it. It seems important for researchers to measure whether their intervention is truly person-centered, using holistic tools and combining different methods (observation, questionnaire, interview).
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Affiliation(s)
- S Lafontaine
- School of Nursing, University of Sherbrooke, Longueuil, Québec, J4K 0A8, Canada.
| | - P Bourgault
- School of Nursing, University of Sherbrooke, Sherbrooke, Québec, J1H 5N4, Canada.
| | - A Girard
- School of Nursing, University of Sherbrooke, Sherbrooke, Québec, J1H 5N4, Canada.
| | - E Ellefsen
- School of Nursing, University of Sherbrooke, Longueuil, Québec, J4K 0A8, Canada.
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Olesen K, Folmann Hempler N, Drejer S, Valeur Baumgarten S, Stenov V. Impact of patient-centred diabetes self-management education targeting people with type 2 diabetes: an integrative review. Diabet Med 2020; 37:909-923. [PMID: 32124483 DOI: 10.1111/dme.14284] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2020] [Indexed: 12/24/2022]
Abstract
AIMS To synthesize primary research into the impact of person-centred diabetes self-management education, and support that targets people with type 2 diabetes, on behavioural, psychosocial and cardiometabolic outcomes and to identify effective mechanisms underlying positive outcomes of person-centred diabetes self-management education and support. METHODS Using Whittemore and Knafl's integrative review method, we conducted a systematic search of peer-reviewed literature published between January 2008 and June 2019 using PubMed, Scopus and CINAHL. After article selection according to established criteria, study quality was assessed using Critical Appraisal Skills Programme checklists for cohort studies, randomized controlled trials and qualitative research. RESULTS From 1901 identified records, 22 (19 quantitative, two qualitative, and one mixed methods) were considered eligible for inclusion. Interventions were categorized by content, medium of delivery, and outcomes. Qualitative studies, quantitative cohort studies and randomized controlled trials demonstrated positive outcomes, with no differences in success rates across study design. Interventions were largely successful in improving HbA1c and patient-reported outcomes such as quality of life but had limited success in lowering cholesterol and weight, or initiating long-term improvements in lifestyle behaviours. Primary objectives were achieved more often than secondary objectives, and studies with fewer outcomes appeared more successful in achieving specific outcomes. CONCLUSIONS Person-centred diabetes self-management education and support has demonstrated a considerable impact on desired diabetes-related outcomes in people with type 2 diabetes. To advance the field further, new studies should take advantage of systematic and transparent approaches to person-centred diabetes self-management education.
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Affiliation(s)
- K Olesen
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | | | - S Drejer
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | | | - V Stenov
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
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Despins LA, Wakefield BJ. Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: A qualitative study. J Clin Nurs 2020; 29:2572-2588. [PMID: 32279366 DOI: 10.1111/jocn.15280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/25/2020] [Accepted: 03/14/2020] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES To describe individuals' with type 2 diabetes mellitus sense-making of blood glucose data and other influences impacting self-management behaviour. BACKGROUND Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self-management regimens is an ongoing healthcare challenge. Examining individuals' sense-making processes can advance staff knowledge of and improve diabetes self-management behaviour. DESIGN A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self-management decisions. METHODS Sixteen one-on-one interviews with adults diagnosed with type 2 diabetes mellitus using a semi-structured interview guide were conducted from March-May 2018. An inductive-deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self-Management was used. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in completing this paper. RESULTS Three main themes described participants' type 2 diabetes mellitus sense-making and influences on self-management decisions: classifying blood glucose data, building mental models and making self-management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. CONCLUSION Individuals use self-monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyse the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycaemic data and influences on diabetes self-management behaviour with periodic reassessment of this understanding can guide the healthcare team in optimising collaborative individualised care plans. RELEVANCE TO CLINICAL PRACTICE Nurses must assess sense-making processes in self-management decisions. Periodic "refresher" diabetes education may be needed for individuals with type 2 diabetes mellitus.
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Affiliation(s)
- Laurel A Despins
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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Empowering Young Persons with Congenital Heart Disease: Using Intervention Mapping to Develop a Transition Program - The STEPSTONES Project. J Pediatr Nurs 2020; 50:e8-e17. [PMID: 31669495 DOI: 10.1016/j.pedn.2019.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE Describe the implementation of intervention mapping in the development of a transition program that aims to empower adolescents with congenital heart disease. DESIGN AND METHODS To gain a better understanding of the problem, we conducted a literature review, focus group and individual interviews, and a cross-sectional survey. This information helped us decide on the scope of the intervention, relevant theories, determinants, formulate performance and change objectives and identify adequate evidence-based change methods. Once the transition program had been designed, effectiveness and process evaluation studies were planned. RESULTS Young persons with congenital heart disease have insufficient disease-related knowledge, self-management skills and high parental involvement. The transition program involves three meetings with a trained transition coordinator over a two-and-a-half-year period and targets young persons with congenital heart disease and their parents. The transition coordinators use change techniques such as goal-setting, modeling and active learning in order to target three personal determinants (knowledge, self-efficacy and self-management). CONCLUSIONS The use of intervention mapping may lead to designing interventions tailored to the needs of the targeted population. The transition program described in this paper is currently being evaluated in a hybrid experimental design with simultaneous undertaking of the process evaluation. PRACTICE IMPLICATIONS This transition program can lead to the empowerment of young persons with congenital heart disease and help them in the process of becoming more responsible for their care. If proven effective, it can be implemented for other chronic conditions.
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Metwally AM, Soliman M, Abdelmohsen AM, Kandeel WA, Saber M, Elmosalami DM, Asem N, Fathy AM. Effect of Counteracting Lifestyle Barriers through Health Education in Egyptian Type 2 Diabetic Patients. Open Access Maced J Med Sci 2019; 7:2886-2894. [PMID: 31844454 PMCID: PMC6901843 DOI: 10.3889/oamjms.2019.624] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Egypt is among the world top 10 countries in diabetes prevalence. It is the first country among the MENA region. Healthy lifestyle education and support help people with diabetes to improve health outcomes. Many physical and psychological barriers can hinder patients from following a healthy lifestyle. AIM This study aimed to examine the effect of lifestyle modification educational sessions in helping Egyptian patients to overcome main barriers of diabetes self-management through improving nutritional behaviours, physical activity, medication compliance, and blood glucose monitoring. METHODS A cohort study included 205 patients with type 2 diabetes. Baseline assessment of patients' lifestyle behaviours and barriers using personal diabetes questionnaire of Louisville University, with both anthropometric and blood glucose assessment. Interventional lifestyle health education was provided weekly through multiple integrated techniques, followed by a post-intervention assessment to evaluate the effect of the health education sessions. Statistical analysis was done to identify any statistically significant difference before and after the health education intervention. RESULTS There was a significant improvement of the post-education mean scores of the studied behaviours when compared with the pre-education scores of the participants' behaviours (p < 0.001). There was also a significant reduction in the barriers facing patients to diabetes self-management including nutritional barriers (P < 0.001), medication compliance barriers (P < 0.001) with a percent change (43%), physical activity barriers (p < 0.001), and blood glucose monitoring (p < 0.001) with a percent change (44%).There was a statistically significant positive correlation between improvement of medication compliance (P = 0.027), blood glucose monitoring(P = 0.045), and glycated haemoglobin of the study participants. CONCLUSION lifestyle modification education of type 2 diabetic patients can overcome the main barriers of following a healthy lifestyle and improve their anthropometric measures and blood glucose level.
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Affiliation(s)
- Ammal Mokhtar Metwally
- Department of Community Medicine Research, Medical Division, National Research Centre, Giza, Egypt
| | - Mona Soliman
- Department of Public Health & Community Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aida M. Abdelmohsen
- Department of Community Medicine Research, Medical Division, National Research Centre, Giza, Egypt
| | - Wafaa A. Kandeel
- Biological Anthropology Department, Medical Division, National Research Centre, Giza, Egypt
- Theodor Bilharz Research Institute, Giza, Egypt
| | - Maha Saber
- Department of Complementary Medicine Research, Medical Division, National Research Centre, Giza, Egypt
- Medical Research Centre of Excellence (MRCE), Giza, Egypt
| | - Dalia Mohamed Elmosalami
- Department of Community Medicine Research, Medical Division, National Research Centre, Giza, Egypt
| | - Noha Asem
- Department of Public Health & Community Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Asmaa Mohamed Fathy
- Department of Community Medicine Research, Medical Division, National Research Centre, Giza, Egypt
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Cheng L, Sit JWH, Choi KC, Chair SY, Li X, Wu Y, Long J, Yang H. The effects of an empowerment-based self-management intervention on empowerment level, psychological distress, and quality of life in patients with poorly controlled type 2 diabetes: A randomized controlled trial. Int J Nurs Stud 2019; 116:103407. [PMID: 31679744 DOI: 10.1016/j.ijnurstu.2019.103407] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is considerable interest in advocating empowerment in diabetes care. Health professionals, however, often fail to realize empowerment in clinical practice, especially in patients with poorly controlled type 2 diabetes. OBJECTIVES To evaluate the effectiveness of an empowerment-based intervention on empowerment level, psychological distress, and quality of life among patients with poorly controlled type 2 diabetes. DESIGN An analysis of secondary outcomes of a prospective multi-center, randomized, parallel, investigator-blinded controlled trial. METHODS A total of 242 adult patients with poorly controlled type 2 diabetes [Hemoglobin A1c (HbA1c)≥ 58 mmol/mol in the recent six months] were randomly allocated to either intervention (n = 121) or attentional control (n = 121) groups. The design of the intervention was based on the Empowerment Process Model. The intervention group received a 6-week empowerment-based transitional care program, with significant emphasis on establishing personally meaningful goals, facilitating collaborative partnership and shared decision-making, resolving life-disease conflicts via situational reflection. Participants in the attentional control group received two general health education classes and post-discharge social calls on top of routine care. Outcomes of interest include empowerment level, diabetes distress, and quality of life. Participants were invited to complete a set of questionnaires before randomization, one-week, and three-month post-intervention. Statistical analyses were performed using the generalized estimating equations based on the intention-to-treat principle. RESULTS Comparing with the attention control group, participants in the intervention group showed significant improvements on empowerment level [(β= 0.163; 95% confidence interval (CI): 0.011 to 0.316, p = 0.036) at one-week post-intervention and (β= 0.176; 95% CI: 0.020 to 0.331, p = 0.027) at three-month post-intervention, respectively]. This group of patients also displayed significant reduction in terms of emotional-distress (β= -0.424, 95% CI: -0.798 to -0.049, p = 0.027) and regimen-distress (β= -0.397, 95% CI: -0.702 to -0.091, p = 0.011) at three-month post-intervention and physician-related distress (β= -0.236, 95% CI: -0.466 to -0.006, p = 0.044) at one-week post-intervention. Significant improvement in quality of life (β= 4.151, 95% CI: 1.291, 7.012, p = 0.004) at three-month post-intervention was also observed in the intervention group. CONCLUSIONS Findings provide empirical evidence for the values of an empowerment-based intervention program for patients with poorly controlled type 2 diabetes in increasing the empowerment level and perceived quality of life and reducing diabetes distress. Long-term effects of the intervention and its underlying mechanisms need further investigation.
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Affiliation(s)
- Li Cheng
- School of Nursing, Sun Yat-Sen University, Guangzhou, China.
| | - Janet W H Sit
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Kai-Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Sek-Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Yuning Wu
- The Department of Endocrinology, The Ninth Affiliated Hospital of Xi'an Jiaotong University, China.
| | - Junhong Long
- The Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, China.
| | - Hui Yang
- The Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, China.
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Muscogiuri G, Barrea L, Di Somma C, Altieri B, Vecchiarini M, Orio F, Spinosa T, Colao A, Savastano S. Patient empowerment and the Mediterranean diet as a possible tool to tackle prediabetes associated with overweight or obesity: a pilot study. Hormones (Athens) 2019; 18:75-84. [PMID: 30644069 DOI: 10.1007/s42000-018-0090-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 12/14/2018] [Indexed: 01/02/2023]
Abstract
AIM The objective of this study was to investigate the effect of implementation of short-term patient empowerment as applied to Mediterranean diet (MD) adherence on metabolic and anthropometric parameters in prediabetic overweight or obese subjects. METHODS The sample included 42 subjects with prediabetes, aged 18-75 years and with body mass index (BMI) > 25 kg/m2, who received dietary advice on MD by nutritionists during session groups every 2 weeks for 4 months. Data on energy caloric intake and macronutrient consumption were collected using a 7-day food diary record. Adherence to MD was investigated through the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. No advice was given regarding caloric restriction and physical activity. At baseline and at the end of the study, each subject underwent anthropometric, metabolic, and nutritional assessments. RESULTS Approximately 40.5% of subjects had achieved restoration of normal glucose tolerance by the end of the study. Fasting plasma glucose, glycated hemoglobin (HbA1C), BMI, waist circumference, blood pressure, visceral adiposity index, triglycerides, and total and LDL cholesterol levels were significantly decreased, while HDL cholesterol had significantly increased by the end of the study. The subjects significantly increased adherence to MD, as assessed by the PREDIMED questionnaire at follow-up. A reduction of prevalence of the metabolic syndrome was also reported. Interestingly, the PREDIMED score correlated with HbA1C values at follow-up, after adjusting for BMI and total caloric intake. CONCLUSIONS Implementation of short-term patient empowerment as applied to MD adherence was shown to improve anthropometric and metabolic parameters in prediabetic overweight or obese subjects. This is of considerable importance, given that diet must be the cornerstone of treatment in patients at high risk of developing type 2 diabetes.
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Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy.
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | | | - Barbara Altieri
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | | | | | - Tiziana Spinosa
- U.O. Assistenza Sanitaria di Base ASL Napoli 1 Centro, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, University "Federico II", Via Sergio Pasini 5, 80121, Naples, Italy
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Dahal PK, Hosseinzadeh H. Association of health literacy and diabetes self-management: a systematic review. Aust J Prim Health 2019; 25:526-533. [DOI: 10.1071/py19007] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/04/2019] [Indexed: 12/18/2022]
Abstract
The purpose of this review is to summarise the existing evidence about the association of health literacy (HL) with type 2 diabetes mellitus self-management. The PubMed, Medline, CINHAL, Scopus and Web of Science databases were searched for randomised control trials of type 2 diabetes mellitus (T2DM) self-management and HL published between 2009 and 2018. Fourteen randomised control trials were included in this review. Our findings showed that HL was instrumental in improving diabetes knowledge, physical activity, self-efficacy and quality of life; however, its associations with glycaemic control, self-monitoring of blood glucose, foot care and medication adherence was inconclusive. Customized and community-based HL interventions were more efficient compared to patient-focused HL interventions. This review concludes that HL is key for T2DM self-management, but customised, structured and community-based interventions are more likely to yield better outcomes.
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