Self-care competence in the case of Brazilian patients with diabetes mellitus in a multiprofessional educational programme

Towards a better understanding of self-management interventions in type 2 diabetes: A meta-regression analysis

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.

People with diabetes do not learn and recall their diabetes foot education: a cohort study

PURPOSE

Diabetes education for those patients at risk of diabetes complications remains a mainstay of diabetes treatment. This study aimed primarily to determine the retention of foot health information 6 months post delivery of education. The secondary aim was to determine the type and delivery method of diabetes-specific foot health information during a podiatry consultation.

METHODS

This study was a prospective cohort study with two groups: patients with diabetes and their treating podiatrist. Baseline data collection included educational topics and delivery methods discussed during the consultation. The Problem Areas in Diabetes Questionnaire (PAID) and perceived key educational message were collected from each group's perspective at baseline and 6 months afterwards.

RESULTS

Three podiatrists and 24 participants with diabetes provided information at the two time points. At baseline, the key messages of 14 (58%) patient participant responses differed from their podiatrists and 15 (63%) differed 6 months later. Education covered up to seven separate topics, including neurological impact of diabetes, vascular supply and general foot care. The majority of consultations (n = 23, 96%) covered three or more topics.

CONCLUSIONS

Education is vital to effective treatment of people with diabetes. Current common approaches used in individual consultations such as verbal explanations appear ineffective in aiding the learning and retention of podiatry-specific diabetes education. This study highlights the need for research investigating more effective methods to deliver key education to this population to aid retention and therefore assist behaviour change.

The Construction of the Psycho-sociological Knowledge on Diabetes Mellitus

Abstract This study aims to analyze the social representations elaborated by diabetic’s people on diabetes mellitus and your treatment. The sample was composed of 80 participants with ages between 21 and 83 years old (M= 55.92, SD = 12.06), who answered to a sociodemographic questionnaire and the Word Association Test. The data were submitted to SPSS - 19.0 and Tri-deux-mots software and analyzed using descriptive statistics and factorial correspondence analysis. The results showed that the psychosocial knowledge construction of diabetes doesn´t differ from scientific knowledge, while chronic disease, related to blood sugar problems, mood swing and life danger. The treatment, emerged associated as a food control, adherence and follow medical guidelines. It is hoped, that these results will contribute to enlarge the this disease visibility and with the therapeutic practices development in the context of diabetes, targeting both the physical and emotional aspects.

The effect of educational program based on the precede-proceed model on improving self-care behaviors in a semi-urban population with type 2 diabetes referred to health centers of Bavi, Iran

AIMS

Self-care in patients with diabetes reduces the number of hospital admissions, costs and improves their quality of life so that just by training self-care to them can reduce 80 percent of diabetic complications. Therefore, this study aimed to investigate the effect of educational program based on precede-proceed model on improving self-care behaviors in patients with type 2 diabetes referred to health centers in city Bavi in 2016-2017.

MATERIALS AND METHODS

This quasi-experimental study, conducted on 110 patient women with type 2 diabetes referred to health centers in Bavi city in 2016-2017. The training program was designed based on Precede-Proceed Model. Data collection tools included the Precede researcher-made questionnaire and the Glasgow questionnaire. The duration of the training course was three months. After one month, the effect of this program, and the amount of improvement of the patients' self-care behavior were evaluated. Independent t-test, paired t-test, Chi-square and Fisher's exact tests were carried was used for data analysis.

RESULTS

After the intervention, the average score of predisposing factors (knowledge, attitude and self-efficacy), reinforcing factors, enabling factors and self-care behaviors, in the intervention group compared to the control group, significantly increased (P<0.05). After the training, the fasting blood sugar (FBS) and body mass index (BMI) decreased in the experimental group, but this reduction was not statistically significant (P>0.05).

CONCLUSION

The findings of this research showed that Precede-Proceed Model would be an appropriate framework to educate patients with type 2 diabetes as well as promote self-care behaviors.

Effectiveness of self-management programmes in diabetes management: A systematic review

BACKGROUND

Diabetes is a major noncommunicable disease, which is increasing, and approximately 415 million people are affected around the globe. Since diabetes is a lifelong disease, patients require better understanding and knowledge of the condition to become self-reliant in making diabetes-related decisions.

AIMS

This systematic review was performed to assess the effectiveness of diabetes self-management programs in people with type 2 diabetes.

METHODS

A comprehensive literature search was undertaken to identify all published English language articles through EBSCO discovery services in the following electronic database: Science Direct, CINAHL Plus with Full Text, MEDLINE, and Access Medicine. Studies were published from January 2000 to October 2015. The initial search retrieved 37 566 studies and based on the inclusion criteria, 14 studies were selected for review.

RESULTS

Of 14 studies, most findings favoured diabetes self-management. But the overall effectiveness of individual interventions was not conclusive. A wide variety of interventions was used including diabetes education as a major component in self-management programs.

CONCLUSION

Interventions used varied strategies in differing composition, and further work is needed to find out the effectiveness of individual interventions.

Predictors of Self-care among the Elderly with Diabetes Type 2: Using Social Cognitive Theory

INTRODUCTION

Diabetes is one of the most common chronic diseases among the elderly and is also a very serious health problem. Adopting theory-based self-care behaviors is an effective means in managing such diseases. This study aimed to determine the predictors of diabetes self-care in the elderly in Kerman based on a social cognitive theory.

MATERIAL AND METHODS

In this cross-sectional study, 384 elderly diabetic patients who had referred to health screening centers in Kerman were chosen via cluster sampling. To collect information about self-care and its predictors, Toobert Glasgow's diabetes self-efficacy scale as well as a questionnaire was used which was based on social cognitive theory constructs. The validity and reliability of the questionnaire was confirmed. The data were analyzed using Pearson correlation and linear regression analysis in SPSS software 17.

FINDINGS

Among the subjects, 67.37% (252) had poor self-care ability; 29.14% (109) had average ability, and 3.40% (13) enjoyed a proper level of self- care ability. There was a significant relationship between the constructs of the social cognitive theory (knowledge, self- efficacy, social support, outcome expectations, outcome expectancy and self-regulation) and the self-care score. Furthermore, the mentioned constructs could predict 0.47% of the variance of the self-care behaviors.

CONCLUSION

self-care behaviors in this study were poor. Therefore, it is necessary to develop an educational intervention based on cognitive theory constructs with the goal of properly managing diabetes in the elderly patients.

Adesão ao tratamento do diabetes mellitus e variáveis sociodemográficas, clinicas e de controle metabólico

Objetivo Investigar a associação entre a adesão ao tratamento da diabetes mellitus tipo 2 e variáveis sociodemográficas, clínicas e de controle metabólico. Métodos Estudo transversal que incluiu 417 pacientes com diabetes mellitus. O instrumento de pesquisa foi um questionário contendo as variáveis do estudo; Medida de Adesão ao tratamento; Questionário de Frequência de Consumo Alimentar e Questionário Internacional de Atividade Física. Para análise dos dados utilizou-se o Teste Exato de Fisher. Resultados Cerca de 98,3% apresentaram não adesão ao plano alimentar, 41,9% à atividade física e 15,8% ao tratamento medicamentoso. Conclusão Não houve associação entre a adesão ao tratamento da diabetes mellitus tipo 2 e o sexo, idade, anos de estudo, tempo de diagnóstico e as variáveis de controle metabólico.

Determinants of Self-Care in Diabetic Patients Based on Health Belief Model

Introduction:

The aim of this study was to determine self-care predictors in diabetic patients based on health belief model.

Materials and Methods:

The cross-sectional study was conducted on 110 diabetic patients referred to health service centers in Ardakan city, Yazd, Iran. The data was collected by a questionnaire including perceived benefits, barriers, severity, susceptibility, self-efficacy, social support, self-care behaviors and demographic variables.

Results:

Regularly medicine use (mean= 6.48 times per week) and shoes checking (mean= 1.17 times per week) were reported as the highest and the lowest self-care behaviors respectively. Health belief model constructs including perceived benefits, barriers, severity, susceptibility, self-efficacy and social support predicted 33.5% of the observed variance of self-care behaviors. Perceived susceptibility and self-efficacy had positive effect on self-care behavior; whereas perceived barrier’s has negative effect. Self-efficacy, perceived susceptibility and barriers were most powerful predictor respectively.

Conclusion:

The findings approved the efficiency of health belief model in prediction of self-care behaviors among diabetic patients. The findings realized the health belief model structure; therefore, it can be used as a framework for designing and implementing educational interventions in diabetes control plans.

Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans

AIMS

Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes.

METHODS

Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression.

RESULTS

People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors.

CONCLUSION

Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management.

Patients' knowledge of Diabetes five years after the end of an educational program

We present a cross-sectional study that aims to describe the sociodemographic and clinical conditions of individuals with diabetes mellitus and to analyze their knowledge of treatment five years after the end of an educational program in which they took part. In 2010, 40 individuals who had participated in a diabetes educational program for 12 months in 2005 at a primary care service were interviewed. A form was used for data collection that included their knowledge of the notion, physiopathology, and treatment of the disease; exercise; nutrition; foot care; self-monitoring of capillary blood glucose at home; hypoglycemia; chronic complications; special situations; and family support. The results showed that the volunteers incorporated the information about the notion, physiopathology, and treatment of the disease; exercise; foot care; self-monitoring; care associated with hypoglycemia; chronic complications; and special situations. In contrast, nutrition and family support require further reinforcement. It is concluded that five years after the end of the educational program, the participants kept most of the information provided.

Avaliação da competência de idosos diabéticos para o autocuidado

Estudo descritivo, de corte transversal e correlacional, que objetivou avaliar as competências de idosos com diabetes para o autocuidado, por meio da utilização da Escala para Identificação da Competência do Diabético para o Autocuidado, e os fatores pessoais associados ao resultado. A população do estudo foi composta por idosos cadastrados nas unidades básicas de saúde de Fortaleza, CE, Brasil. Da amostra, apenas 6% dos idosos foram considerados competentes para o autocuidado em diabetes e os fatores que se destacaram como influenciadores de baixa pontuação foram a baixa escolaridade e a diminuição da acuidade visual. Conforme os resultados, devido ao reduzido número de idosos considerados competentes para a prática do autocuidado, verifica-se a importância do desenvolvimento de ações de promoção da saúde direcionados para essa parcela da população, devendo-se estimular a prática do autocuidado, bem como avaliar as competências para execução da mesma, de modo a facilitar o direcionamento de ações de saúde.

Percepção de pacientes com diabetes mellitus tipo 1 sobre o transplante de células-tronco hematopoéticas

O objetivo deste estudo foi investigar a percepção de pacientes com diabetes mellitus tipo 1 acerca do transplante de células-tronco hematopoéticas (TCTH). Participaram do estudo 12 pacientes, com idades entre 16 e 24 anos. Foi aplicado um roteiro de entrevista semiestruturada antes e um ano após o TCTH. Os relatos foram submetidos à análise de conteúdo temática e agrupados em três categorias: impacto do adoecimento, vivência do TCTH e retomada do cotidiano. Os resultados evidenciaram que os participantes foram capazes de identificar ganhos e refletir sobre as perdas advindas dessa situação-limite. Puderam perceber possibilidades de se beneficiarem do TCTH e vislumbraram no transplante uma oportunidade para além das inevitáveis dificuldades e limitações impostas pela terapêutica.