The impact of Multimedia Software Support on the Knowledge and Self-Care Behaviors of Patients with Type 2 Diabetes: a Randomized Clinical Trial

Intervention Effect of Pender's Model on Mental Health of Patients With Diabetes Mellitus: A Meta-analysis

OBJECTIVE

Our aim in this study was to better understand the intervention effect of Pender's model on the physical and mental health of patients with diabetes mellitus.

METHODS

According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, various databases, including CNKI, Wanfang Data, SinoMed, VIP, Web of Science, Cochrane, PubMed and ScienceDirect, were searched to collect and select relevant reports for the implementation of a meta-analysis.

RESULTS

Ten randomized controlled trials in 6 foreign reports and 4 Chinese reports were included in this study. A total of 863 participants were involved, including 439 in the experimental group and 424 in the control group. Results of the meta-analysis show that Pender's model has a good intervention effect on the health knowledge (Z=3.371, p<0.050), self-management behaviour (Z=3.781, p<0.050) and psychological function (Z=2.902, p<0.050) of patients with diabetes mellitus as compared to the control group. The subgroup analysis showed that the intervention effect on self-management behaviour would not be affected by the measurement tool used (Z=3.295, p=0.001).

CONCLUSIONS

Pender's model showed a good intervention effect on the health knowledge, self-management behaviour and psychological function of patients with diabetes mellitus.

Effectiveness of the Use of Animation and Gamification in Online Distance Education During Pandemic

The study aimed to determine the effects on knowledge and motivation of animation and gamification in online distance education for a diabetes nursing course. This study was a randomized, controlled, prospective study implemented with 70 nursing students. The animation and gamification were applied to the experimental group. Data were collected using the "Diabetes Nursing Knowledge Test," "Instructional Materials Motivation Survey," and "Opinion Form on Diabetes Education Supported by Digital Instruments." There was a statistical difference between the Diabetes Nursing knowledge scores of the groups after the course (P < .05). The students in the experimental group had significantly higher attention and satisfaction and total scores from the Motivation Scale for Teaching Material sub-dimensions compared with the control group (P < .001). The results of our study in generation Z nursing students demonstrated that the use of animation and gamification in online distance learning in nursing students increased their knowledge as well as motivation.

Quality of Life and Self-care Activities in Diabetic Ulcer Patients, Grade 3: Gender Differences

Introduction: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus associated with increased morbidity and mortality and diminished quality of life (QoL). This study aimed to explore the effect of gender differences on QoL and adherence to self-care activities.

Methods: In this cross-sectional study, we enrolled 135 male and 135 female patients with DFU. Data was collected using the Short Form Health Survey (SF-36) and a questionnaire that measured self-care activities (Diet, Exercise, Blood Examination, and Foot Check). Data analysis was performed using SPSS version 20.

Results: In terms of QoL, male participants had moderate to high levels in the categories of energy/fatigue, emotional well-being, social functioning, and bodily pain, whereas they had low levels in physical functioning, physical role, and emotional role. Female patients had moderate QoL in the categories of energy/fatigue and social functioning, whereas they had low QoL in physical functioning, physical role, emotional role, emotional well-being, and bodily pain. Finally, regarding general health, male participants had moderate QoL and females had moderate to low QoL. Both males and females had low adherence to exercise and high in blood-examinations. For both genders, adherence to exercise had a statistically significant association with all sub-categories of QoL apart from those of role (physical and emotional).

Conclusion: It is essential for health care professionals to provide gender-specific approaches in treatment of ulceration.

Asthma self-management app for Indonesian asthmatics: A patient-centered design

BACKGROUND

A proper education on asthma self-management helps asthmatics to improve health outcomes, such as better asthma knowledge and self-efficacy, increased frequency of symptom-free days, reduced unscheduled healthcare visits and absence from school or work days. In this modern digital era, the use of smartphone apps is increasing rapidly and reaching almost all aspects of our life, including health promotion and patient education on asthma self-management. Studies found that the apps make it easier for asthmatics to receive the education.

OBJECTIVE

The aim of this study was to describe the systematic design, development, and implementation process of a Google Android OS asthma self-management smartphone app according to the Patient-Centered Design approach.

METHODS

The design, development, and implementation process of the app adopted the Patient-Centered Design approach, including: (1) user needs assessment, (2) design of the app prototype, (3) development of the app prototype, (4) usability test, and (5) product launch. For better results, the study involved end-users (asthmatics and health professionals) during the development of the app.

RESULTS

The study resulted in a Google Android OS asthma self-management app, namely AsmaDroid. The app was developed to feature 8 contents and functions, namely: asthma education, a list of asthma medications, asthma diary or journal, peak flow record, asthma control test, asthma action plan, a chat box, and a map of nearest local hospitals or health centers. It was also found that the average success rate of the app was as follow: "completed with ease" was 88.15%, "completed with difficulty" was 7.78%, and "failed to complete" was 4.07%. It means that the success rate of app was "very high".

CONCLUSION

The implementation of Patient-Centered Design approach has been successfully completed for the development of AsmaDroid. However, additional research into the use of the app in the actual clinical world is highly required to demonstrate its effectiveness in improving the level of asthma knowledge, the quality of asthma control, and other health outcomes.

Restrictors of the effectiveness of diabetes self-management education: A qualitative content analysis

BACKGROUND

A key step for improving the effectiveness of diabetes self-management education (DSME) is to identify its restrictors.

OBJECTIVES

The aim of this study was to explore the restrictors of the effectiveness of DSME.

METHODS

This descriptive qualitative study was conducted in March 2016-2017. Participants were 16 DSME providers (viz., physicians, nurses, nutritionists, and psychologists) and nine DSME receivers (viz., patients and their family members) - 25 in total. Semi-structured interviews were held for data collection. Interviews were transcribed word by word and analyzed through conventional content analysis approach proposed by Graneheim and Lundman.

RESULTS

The restrictors of the effectiveness of DSME were categorized into three main categories and 11 subcategories, namely patients' limited welcoming of DSME classes (allocating limited time for participation in DSME classes, inadequate knowledge about diabetes mellitus [DM] importance, inappropriate educational environment, and financial problems), unfavorable adherence to treatments: serious challenge (inattention to educations, poor motivation for adherence to medical recommendations, and inattention to the psychological aspects of DM), and the difficulty of adult education (the difficulty of changing health-related attitudes and behaviors, mere information delivery during education, adults' physical and perceptual limitations, and diabetes educators' limited competence in adult education).

CONCLUSION

The findings of the present study provide an in-depth understanding about the restrictors of the effectiveness of DSME. DM management authorities and policymakers can use these findings to develop strategies for improving the effectiveness of DSME.

Relationship between Self Care Management with Glycemic Control in Type 2 Diabetic Patients

Background

The purpose of this study was to investigate the relationship between self-care management and HbA1c level of the patients with type 2 diabetes in YAZD.

Methods

This study was a cross-sectional study. The number of 376 diabetic patients referred to the Diabetes Research Center in Yazd entered the study. The data collection tool was a summary of Diabetes Self Care Activity questionnaire (SDSCA), which was collected through interviews with patients. Data analysis was performed using SPSS software V 16 and kruskalwallis and independent sample t tests.

Results

The results showed that of 376 patients, 218 (%58) were women and 158 (%42) were male. The mean age of the participants in the study was 54.5 ± 10.9 years old and the mean duration of the disease was 9.53 ± 8.39 years. The mean HbA1C in the patients was 7.93% ± 1.38%. The mean of BMI was 28.93 ± 6 kg/ m². The mean of self-care score in the patients under study was 30.53 ± 11.4. There was a significant relationship between the mean of self-care score, BMI, age and HbA1C (P value <0.05).

Conclusions

According to the results of the study, it can be concluded that the level of self-care in patients with controlled diabetes mellitus (HbA1C <7%) is more than patients with uncontrolled diabetes mellitus (HbA1c ≥9%).

The Model of Self Care Behaviour and the Relationship with Quality Of Life, Metabolic Control and Lipid Control of Type 2 Diabetes Mellitus Patients in Binjai City, Indonesia

BACKGROUND

Diabetes is a type of chronic disease with exceptional medical care for a patient's lifetime, which ultimately requires lifestyle and behavioural adjustments to prevent complications to death. Patients with good self-care behaviour will cause diabetes to be controlled to avoid complications to death and make patients have a better quality of life.

AIM

This study aims (1) to determine the model of self-care behaviour in Type 2 diabetes patients in Binjai City (2) to analyse the effect of self-care behaviour on quality of life, metabolic control and lipid control of Type 2 diabetes patients in Binjai City.

METHODS

This type of research is survey-based and explanatory using a cross-sectional approach. The study population was Type 2 Diabetes Mellitus (T2DM) patients who remained patients in 8 primary health centres in Binjai City. The consecutive sampling yielded a sample size of 115 people. Data analysis method uses descriptive statistics and Structural Equation Modeling (SEM) using SPSS and Amos 16.0.

RESULTS

The results showed that all factors that build T2DM patient self-care behaviour were able to be predictors that shape the patient's self-care behaviour. The self-care behaviour model consists of knowledge, attitudes, communication, financing, family support, motivation, and self-efficacy. Motivation is the most significant predictor of its contribution to the self-care behaviour of Type 2 diabetes patients. Self-care behaviour was also known to be significantly related to the quality of life, metabolic control and lipid control of T2DM patients (p < 0.05).

CONCLUSION

Self-care behaviour in T2DM patients can have a substantial and significant impact on quality of life, metabolic control and lipid control possessed by Type 2 Diabetes patients.

Effectiveness of Oral Hygiene Instructions Given in Computer-Assisted Format versus a Self-Care Instructor

Background: This randomized, single-blinded, controlled study compares the effectiveness of two modes of delivering the same set of oral hygiene instructions: those loaded on a computer-assisted teaching format versus those given personally by a self-care instructor. Methods: 60 participants with mild to moderate periodontitis were randomized to either the computer-teaching format or the self-care instructor. Plaque score and bleeding indices were assessed at baseline and at 4 week re-evaluation to compare the instructional modalities. Results: At baseline, there was no difference in the parameters between the two groups. At re-evaluation, all parameters were significantly improved compared to baseline; however, there was no difference between any parameters in the computer group versus the instructor. Plaque score was significantly different between younger and older participants, such that participants under 50 years old had lower plaque scores when they received instructions using the computer format (72.5 ± 12.6 vs. 87.2 ± 10.4; p < 0.001). Additionally, in those under-50 year olds, plaque scores were significantly better in the group using the computer format (87.2 ± 10.4 vs. 78.3 ± 15.6; p = 0.03). Conclusion: Computer teaching formats and self-care instructors are both effective means of communicating oral hygiene instructions. Computer-assisted instruction format effectiveness may amplify as the population ages. Applications of computer formats teaching oral hygiene instructions and cost effectiveness comparison studies warrant significant future investigation.