Q-Methodology and Psychological Phenotyping to Design Patient-Centered Diabetes Education for Persons With Type 2 Diabetes on Insulin Therapy

Precision Diabetes Education and Support Considering Patients' Behavioral and Psychological Phenotype: A Q-Methodology Study

BACKGROUND

The prevalence of type 2 diabetes is growing, and diabetes burden is increasing. Precision health in diabetes education and support employs different intervention strategies, depending on an individual's viewpoint on diabetes and self-management behaviors, to improve patients' treatment adherence, clinical outcomes, and quality of life.

OBJECTIVE

To classify the behavioral and psychological phenotypes of self-management behaviors in adults taking oral glucose-lowering medications to develop a theory-driven, person-centered group intervention applicable to busy clinical settings.

METHODS

Q-methodology was used. From January to August 2020, 73 participants (48 male, 25 female) were invited to do Q-sorting with 33 statements. The principal component technique, followed by varimax rotation, was used for factor analysis. The Summary of Diabetes Self-Care Activity questionnaire and HbA1c in the past 6 months were included to obtain comprehensive understanding.

RESULTS

Fifty-one sorts (35 male, 16 female) loaded on 1 of 4 factors: factor A (n = 18): Needing emotional support with enhancing problem-solving skills group; factor B (n = 15): Self-help group; factor C (n = 6): Needing personalized coaching group; and factor D (n = 12): Needing basic diabetes education group.

CONCLUSIONS

Each factor demonstrated a different need for diabetes education and support. Younger participants (factor D) had the poorest diabetes self-management behaviors and required basic diabetes education. Further research is warranted to develop a screening tool to classify the typologies and adopt the findings in a busy clinical setting.

Self-management education for children with epilepsy and their caregivers. A scoping review

Self-management education programs have been highly successful in preparing people to manage medical conditions with recurring events. A detailed curriculum for epilepsy patients, and their caretakers, is lacking. Here we assess what is available for patients who have disorders with recurring events and offer an approach to developing a potential self-care curriculum for patients with seizures and their caregivers. Among the anticipated components are a baseline efficacy assessment and training tailored to increasing self-efficacy, medication compliance, and stress management. Those at risk of status epilepticus will also need guidance in preparing a personalized seizure action plan and training in how to decide when rescue medication is appropriate and how to administer the therapy. Peers, as well as professionals, could teach and provide support. To our knowledge, no such programs are currently available in English. We encourage their creation, dissemination, and widespread use.

Identifying, classifying and prioritizing factors affecting human errors in the mine design process: A mixed methods research

BACKGROUND: Mines are often home to many dangers with a high rate of accidents and occupational diseases. One of the most effective ways to prevent these adverse incidents is to identify and control the influential factors causing human error in design and the ensuing negative consequences. OBJECTIVE: This study aimed to explore, categorize and prioritize factors affecting human errors in the mine design process. METHODS: The study has a mixed-method design combining qualitative and quantitative data. In the qualitative phase, the required data were collected by conducting semi-structured interviews with 12 surface mine designers. The causes of errors were extracted and categorized by the latent content analysis using MAXQDA2022 software. The identified causes in the qualitative phase were sent to expert designers in Q tables, and the data were analyzed by factor analysis. RESULTS: Of the identified codes in the qualitative phase, 40 main themes in five different categories (individual, organizational, external, task, and environmental factors) were determined as causes. The results of the quantitative phase suggest the existence of four different mental patterns regarding the causes of design errors (DEs). The data analysis also shows that organizational and personal factors, particularly supervision and inspection, experience, and technical knowledge, were the strongest causes of DEs and environmental (hotness, coldness, indoor air quality, and noise) and external (work-family conflict) factors being the weakest ones. CONCLUSION: This study not only identifies and categorizes the causes of design errors in the mining industry but also suggests some control strategies for these errors based on the mental patterns of the experts.

‘Analogy-Based Comprehensive Diabetes Education’ (ABCDE) Improves Glycemic Control of Diabetic Patients in an Underserved Population: Results of a Retrospective Chart Analysis

Diabetes is the leading global cause for blindness, kidney failure and amputations. Preventing these complications requires optimal glycemic control, and it is imperative that diabetic patients understand the fundamental concepts of diabetes care. Although patients attend formal diabetes education classes, many do not comprehend basic concepts of diabetes, and are often noncompliant with diet, exercise and medications. A novel approach termed ‘analogy-based comprehensive diabetes education’ (ABCDE) was developed to educate HIV-patients with diabetes about basic concepts of diabetes care. The object of this manuscript is to report the results of a retrospective chart review on the impact of ABCDE on glycemic outcomes in 24 patients who had failed usual care (including formal diabetes education, physician visits, and diabetic medications), and were non-adherent with diet and medications. They received only the ABCDE without any changes in pharmacotherapy. The impact on glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) was assessed at subsequent visits. HbA1c was found to decline by 22% and 33% after 3 and 6 months, respectively, with corresponding declines in FBG by 53% and 59%, respectively. These results suggest that ABCDE in outpatient diabetes clinics could be effective in behavior modification toward improving glycemic control, and warrants additional investigation.