Aim: This paper aims to evaluate disparities of type 2 diabetes structured health education programmes that is utilised within the communities. Design: systematic review, (a type of secondary research design) aiming t...Aim: This paper aims to evaluate disparities of type 2 diabetes structured health education programmes that is utilised within the communities. Design: systematic review, (a type of secondary research design) aiming to summarize the results of prior primary research studies on available evidence Community type 2 diabetes structured education (CT2DSHE). Methods: Research question: Type 2 diabetic structured health education within a community how effective is it? Qualitative Systematic review, defined as a way to get reliable and objective picture of current available evidence on the specific topic—(CT2DSHE), (Denscombe, 2021) through reflexivity synthesis of available data as an example. This is valuable in time constraints such as project assignments that must be met within specific time and also to bring together available evidence together [1]. Results: This review has shown that CT2DSHE is effective with seven out of the eleven authors supporting, three authors against and one was neutral, further showed that knowledge and skills acquired can last longer with patient activation improved among T2DM patients ideal for sustaining their self-management of T2DM. Conclusion: This research provides suggestive answers to the research question: “Type 2 diabetic structured health education within a community how effective is it?”, This has demonstrated CT2DSHE effectiveness in knowledge acquisition and improving T2DM awareness among T2DM patients, whilst evidencing long effects beyond the study times of 3 - 9 months period in relation to patient activation. Also Identified diabetes education self-management on newly diagnosed (DESMOND) patient as CT2DSHE program for recommendation. Patient or Public Contribution: This work aspires to contribute to CT2DSHE in these areas;Influencing policy decision-making for community diabetes care within the UK and world at large., Contributing to already vast knowledge on diabetes self-management and reasons why?, Influencing educators on how CT2DSHEP are designed, delivered by putting the patient at the Centre and bringing different perspectives on CT2DSHEP in one place that is serving users time of having to consult several resources especially busy clinicians [2] [3].展开更多
Ageing has a close relationship with chronic non-communicable diseases,such as diabetes mellitus and high blood pressure.These pathologies are often associated with changes in eating habits and promote crucial physiol...Ageing has a close relationship with chronic non-communicable diseases,such as diabetes mellitus and high blood pressure.These pathologies are often associated with changes in eating habits and promote crucial physiological changes which act silently in the long term in the elderly population.Due to the speed of urban development and technological advances,there has been an increase in the population's life expectancy.However,it is essential to know the socio-demographic profile and prevalent comorbidities of the elderly population,which can provide a reliable and broad database to enable the outline of strategies and the promotion of efficient health policies.In this sense,the purpose of this editorial is to contribute to the debate surrounding the article that analysed epidemiological data from the Lugu community.Diabetes mellitus,hypertension and cardiovascular pathologies and their comorbidities were the most prevalent conditions in this community.Such data could contribute to develop public policies constructively and assertively,allowing investments in the prevention and treatment of these pathologies.展开更多
Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quas...Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.展开更多
Objective: This study aims to improve the health level of patients with diabetes in the community through health management measures under the concept of health management. Methods: Community residents were selected t...Objective: This study aims to improve the health level of patients with diabetes in the community through health management measures under the concept of health management. Methods: Community residents were selected to detect, collate and analyze the social demographic information, body mass index, fasting blood glucose and blood lipid level of diabetic patients before and after health management. Results: The study showed that after the implementation of health management education in the community, the detection rate of diabetes patients increased, but the population was no longer mainly elderly patients, but mainly people under 60 years old. The levels of body mass index, fasting blood glucose, triglyceride (TG), total cholesterol (TC) and low-density lipoprotein (LDL) were significantly decreased (all P Conclusion: Through the investigation of patients before and after health management in residential communities, this study shows that the correct implementation of health management can effectively improve the physiological indicators of diabetes patients, improve the level of health quality, and provide a reference for the prevention and treatment of diabetes patients in communities.展开更多
Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluat...Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluate the effects of educational programs on diabetes knowledge and self-care. Aim: To evaluate the knowledge about diabetes mellitus and the performance of self-care activities, before and after participation in an educational program. Methods: This is an intervention study, with a quantitative approach, in a single comparison group, for the analysis of “before and after” results related to an educational program focused on self-care and concurrent physical training. The study interventions consisted of 42 exercise sessions, as well as individual educational meetings, according to the needs of each participant and through nursing consultations, using educational material prepared from the literature. The sample was initially composed of 33 adults with diabetes mellitus, but 18 completed the study. For the assessment of knowledge and self-care activities, the revised Brazilian versions of the Diabetes Knowledge Scale and the Diabetes Self-Care Activity Questionnaire were used, respectively, in the two moments of the study, that is, prior to the first educational meeting and immediately before the first physical training session, and after the last educational meeting, which ran parallel to the 42nd physical training session, making a six-month interval between the two assessment moments for each participant. Results: The analysis of knowledge about diabetes showed significant improvement after the educational program and, as for self-care, there was clinical improvement in all dimensions, but only the dimension “general diet” obtained statistically significant improvement. Conclusion: The educational program has been shown to be beneficial for improving knowledge and self-care of the disease, which reiterates the need to maintain interventions of this nature for people with diabetes mellitus.展开更多
The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integra...The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integrality and longitudinality of care with this disease.This article aims to present the self-care and self-control of people with type 2 diabetes mellitus in objective terms,taking into account the current recommen-dations based on scientific evidence and also from the subjective point of view,that is,emphasizing the aspects related to experience and subjectivity of these people.Next,we present the essential skills for self-care and self-control of users and professionals working in primary health care.展开更多
Objectives:To examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabe...Objectives:To examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabetes.Methods:Quasi-experimental,two-group,pretest-posttest design was applied.Using random geographic cluster sampling,older adults who met the inclusion criteria were assigned to two groups,62 in the intervention group and 71 in the control group.The intervention group received the comprehensive health education plus village health volunteer monitoring support program.The control group received only the comprehensive health education program.Study outcomes,including blood glucose level,knee pain and range of motion,body weight,physical ability(Timed Up and Go Test),fatigue,depressive symptoms,quality of sleep,and quality of life,were assessed at baseline,3 months,and 6 months after enrollment and analyzed using descriptive statistics and multivariate analysis of variance.Results:One hundred and ten participants completed the study(55 participants in each group).Most patient outcomes in the two groups showed general improvement with statistical significance(P<0.001):pain decreased,physical ability improved,less depressive symptoms and fatigue,quality of life and sleep improved.The interaction effect(the group and time)demonstrated statistically significant differences between the intervention and control groups on pain,knee range of motion,and fatigue according to each time follow-up(P<0.001).Conclusions:The comprehensive health education plus village health volunteer monitoring support program promotes good patient outcomes in this population.The integrated health education resource and support for older adults with knee osteoarthritis and type 2 diabetes is an effective,non-surgical treatment that highlights professional nursing roles and non-professional rolesdvillage health volunteers.Nurses should consider implementing a health education plus monitoring support program to mitigate the effects of chronic diseases and improve patients’quality of life.展开更多
International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational ...International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.展开更多
Objectives:To explore the clinical value of applying diabetes health education to endocrinology care.Methods:A total of 122 patients with diabetes admitted to our department from October 2016 to October 2017 were sele...Objectives:To explore the clinical value of applying diabetes health education to endocrinology care.Methods:A total of 122 patients with diabetes admitted to our department from October 2016 to October 2017 were selected.After consulting patients,they were randomly divided into two groups,with 61 cases in each group.The control group performs routine care,and the experimental group provides patients with diabetes-specific health education.After three months,the compliance of the two groups of patients was compared.The ADL scores of the two groups of patients before and after treatment were compared.Results:Experimental group had significantly higher compliance rate than control group in all aspects.The difference was statistically significant(P<0.05).The ADL scores of both groups were significantly improved.The effects before and after the care were compared.The difference was statistically significant(P<0.05).The score of experimental group increased more significantly than that of the control group.The difference was statistically significant(P<0.05).Conclusions:In the endocrinology care,the implementation of diabetes special health education for patients can improve patient compliance and improve patients'daily living ability,which is an ideal nursing measure.It is worth promoting.展开更多
This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective a...This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective about the interaction between education, service and community as well as advances in approach and the strengthening between the school and Primary Health Care. This is an exploratory study with an experience report approach of the Pró-Saúde and PET-Saúde team from 2012 to 2014. The integration of these programs in experimental scenarios of the Unified Health System and the strengthening of the proposed training of human resources capable of the current healthcare system were observed. Thus, contributions in health in undergraduate courses and practices of health services are important, since the approach to the reality of the population and their social needs contribute to the vocational training quality.展开更多
Objective:To compare outcomes associated with patient education about glycemic control via group chat versus patient education as usual among individuals with diabetes in China.Methods:We searched the following databa...Objective:To compare outcomes associated with patient education about glycemic control via group chat versus patient education as usual among individuals with diabetes in China.Methods:We searched the following databases both in English and in Chinese languages:PubMed,CNKI,Wanfang database,VIP database,and CBM for articles published up to Jan 1,2018.The studies were screened by two independent reviewers.Using criteria from the risk of bias assessment tool developed by Cochrane Collaboration to assess the risk of bias of eligible studies.A meta-analysis of studies was performed using comprehensive meta-analysis version 3.0.Results:Twenty-five unique randomized clinical trials,including 2,838 patients,were identified.The education delivered via group chat had large overall pooled effect sizes in improving glucose control measured by hemoglobin A1c[Hedges'g=-0.81,95%CI:(-0.98,-0.64)],fasting blood glucose[Hedges'g=-1.11,95%CI:(-1.37,-0.85)],and 2 h postprandial blood glucose[Hedges'g=-0.98,95%CI:(-1.20,-0.76)].Additionally,patient education delivered via group chat has shown consistently superior outcomes in glucose control in short-term(0-3 months),mid-term(3-6 months)and longer-term(6-12 months).Conclusions:Educational interventions via group chat had a superior outcome in blood glucose control compared to education as usual in China.Educational interventions via group chat had superior shortterm,mid-term,and longer-term outcomes in blood glucose control compared to education as usual in China.展开更多
Cardiovascular diseases, including atherosclerosis, are important causes of death among diabetics. Features of diabetes mellitus (DM) associated with atherogenic risk factors are discussed by a cross-sectional study. ...Cardiovascular diseases, including atherosclerosis, are important causes of death among diabetics. Features of diabetes mellitus (DM) associated with atherogenic risk factors are discussed by a cross-sectional study. It was evaluated 432 families attended by Basic Family Health Unities (FHU), registered at Family Health Program (HIPERDIA) at borough Alto da Maravilha in Senhor do Bonfim, Bahia, Brazil. Among eligible patients, 50 (8.4% of the total) were included in diabetic group (DB), and 80 (9.4% of the total) in the non-diabetic group (NDB). The majority was women (90/ 130) in the age range 48 - 77. The diabetic group showed a high prevalence among analyzed variables, such as hypertension (74.0%) and obesity (46.0%). Significant differences were not found among lipoprotein cholesterol concentrations comparing the DB and NDB groups. The correlation analysis showed significant differences among LDL-C-DB and CT-DB (p < 0.0001), LDL-NDB and CT-NDB (p < 0.0001), LDL-NDB and TG-NDB (p = 0.0034), and CT-NDB and TG-NDB (p = 0.0001). Diabetic and healthy individuals do not present significant differences in the lipid profiles. By the way, the diabetic and health individuals can not present significant differences in the lipid profile, however, probably there are differences in the quality of the lipoprotein molecules between DB and NDB and a divergent tendency of the disease progression, such as a higher disposition to atherosclerosis development in DB. These patients with potential risk to development atherosclerosis or aggravation of diabetes must have more attention about Family Health Program.展开更多
Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cult...Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.展开更多
Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low...Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. Subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. Survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: Systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.展开更多
Background:Recognition and treatment of emotional distress,which affects 20 to 40%of outpatients with type 1 or type 2 diabetes,are important because of its association with worse diabetes self-care,poor glycemic cont...Background:Recognition and treatment of emotional distress,which affects 20 to 40%of outpatients with type 1 or type 2 diabetes,are important because of its association with worse diabetes self-care,poor glycemic control,increased rates of mortality and diabetes-related complications,and a rise in healthcare expenditure.However,although the symptoms of emotional distress improve in diabetic patients after psychological and pharmacological interventions,evidence of benefits in glycemic control is still uncertain.Objective:The aim of this study was to assess the metabolic control in diabetic patients with emotional distress attending primary mental care clinics(PMCC)in the Eastern Province of Saudi Arabia.Method:This study was a single group pretest-posttest design conducted on adult diabetic patients with emotional distress attending PMCC.Out of 194 attendees,62 patients who fulfilled the selection criteria were studied.Data were collected from the patients’records using a worksheet designed for the study.Metabolic parameters including BMI,BP,FBS,HbA1c and lipid profile were recorded before and after the management of emotional distress.Socio-demographic characteristics,complications related to diabetes and co-morbidities were also recorded.Paired t-test was used appropriately to compare continuous variables.A p-value of less than 0.05 was considered significant in all statistical analysis.Results:The majority of the patients had type 2 DM(98.2%)and the presence of co-morbidities was high(83.9%).A comparison of the metabolic parameters before and after management of emotional distress,showed a significant reduction in HbA1c(p=0.020)and elevation in HDL(p=0.010).No differences in BMI,BP,FBS,TC,TG or LDL were found.Conclusions:Treating emotional distress in diabetic patients is associated with an improvement in HbA1c and HDL.展开更多
文摘Aim: This paper aims to evaluate disparities of type 2 diabetes structured health education programmes that is utilised within the communities. Design: systematic review, (a type of secondary research design) aiming to summarize the results of prior primary research studies on available evidence Community type 2 diabetes structured education (CT2DSHE). Methods: Research question: Type 2 diabetic structured health education within a community how effective is it? Qualitative Systematic review, defined as a way to get reliable and objective picture of current available evidence on the specific topic—(CT2DSHE), (Denscombe, 2021) through reflexivity synthesis of available data as an example. This is valuable in time constraints such as project assignments that must be met within specific time and also to bring together available evidence together [1]. Results: This review has shown that CT2DSHE is effective with seven out of the eleven authors supporting, three authors against and one was neutral, further showed that knowledge and skills acquired can last longer with patient activation improved among T2DM patients ideal for sustaining their self-management of T2DM. Conclusion: This research provides suggestive answers to the research question: “Type 2 diabetic structured health education within a community how effective is it?”, This has demonstrated CT2DSHE effectiveness in knowledge acquisition and improving T2DM awareness among T2DM patients, whilst evidencing long effects beyond the study times of 3 - 9 months period in relation to patient activation. Also Identified diabetes education self-management on newly diagnosed (DESMOND) patient as CT2DSHE program for recommendation. Patient or Public Contribution: This work aspires to contribute to CT2DSHE in these areas;Influencing policy decision-making for community diabetes care within the UK and world at large., Contributing to already vast knowledge on diabetes self-management and reasons why?, Influencing educators on how CT2DSHEP are designed, delivered by putting the patient at the Centre and bringing different perspectives on CT2DSHEP in one place that is serving users time of having to consult several resources especially busy clinicians [2] [3].
文摘Ageing has a close relationship with chronic non-communicable diseases,such as diabetes mellitus and high blood pressure.These pathologies are often associated with changes in eating habits and promote crucial physiological changes which act silently in the long term in the elderly population.Due to the speed of urban development and technological advances,there has been an increase in the population's life expectancy.However,it is essential to know the socio-demographic profile and prevalent comorbidities of the elderly population,which can provide a reliable and broad database to enable the outline of strategies and the promotion of efficient health policies.In this sense,the purpose of this editorial is to contribute to the debate surrounding the article that analysed epidemiological data from the Lugu community.Diabetes mellitus,hypertension and cardiovascular pathologies and their comorbidities were the most prevalent conditions in this community.Such data could contribute to develop public policies constructively and assertively,allowing investments in the prevention and treatment of these pathologies.
文摘Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.
文摘Objective: This study aims to improve the health level of patients with diabetes in the community through health management measures under the concept of health management. Methods: Community residents were selected to detect, collate and analyze the social demographic information, body mass index, fasting blood glucose and blood lipid level of diabetic patients before and after health management. Results: The study showed that after the implementation of health management education in the community, the detection rate of diabetes patients increased, but the population was no longer mainly elderly patients, but mainly people under 60 years old. The levels of body mass index, fasting blood glucose, triglyceride (TG), total cholesterol (TC) and low-density lipoprotein (LDL) were significantly decreased (all P Conclusion: Through the investigation of patients before and after health management in residential communities, this study shows that the correct implementation of health management can effectively improve the physiological indicators of diabetes patients, improve the level of health quality, and provide a reference for the prevention and treatment of diabetes patients in communities.
文摘Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluate the effects of educational programs on diabetes knowledge and self-care. Aim: To evaluate the knowledge about diabetes mellitus and the performance of self-care activities, before and after participation in an educational program. Methods: This is an intervention study, with a quantitative approach, in a single comparison group, for the analysis of “before and after” results related to an educational program focused on self-care and concurrent physical training. The study interventions consisted of 42 exercise sessions, as well as individual educational meetings, according to the needs of each participant and through nursing consultations, using educational material prepared from the literature. The sample was initially composed of 33 adults with diabetes mellitus, but 18 completed the study. For the assessment of knowledge and self-care activities, the revised Brazilian versions of the Diabetes Knowledge Scale and the Diabetes Self-Care Activity Questionnaire were used, respectively, in the two moments of the study, that is, prior to the first educational meeting and immediately before the first physical training session, and after the last educational meeting, which ran parallel to the 42nd physical training session, making a six-month interval between the two assessment moments for each participant. Results: The analysis of knowledge about diabetes showed significant improvement after the educational program and, as for self-care, there was clinical improvement in all dimensions, but only the dimension “general diet” obtained statistically significant improvement. Conclusion: The educational program has been shown to be beneficial for improving knowledge and self-care of the disease, which reiterates the need to maintain interventions of this nature for people with diabetes mellitus.
文摘The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integrality and longitudinality of care with this disease.This article aims to present the self-care and self-control of people with type 2 diabetes mellitus in objective terms,taking into account the current recommen-dations based on scientific evidence and also from the subjective point of view,that is,emphasizing the aspects related to experience and subjectivity of these people.Next,we present the essential skills for self-care and self-control of users and professionals working in primary health care.
基金This study was funded by the National Research Council of Thailand(NRCT/2019).
文摘Objectives:To examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabetes.Methods:Quasi-experimental,two-group,pretest-posttest design was applied.Using random geographic cluster sampling,older adults who met the inclusion criteria were assigned to two groups,62 in the intervention group and 71 in the control group.The intervention group received the comprehensive health education plus village health volunteer monitoring support program.The control group received only the comprehensive health education program.Study outcomes,including blood glucose level,knee pain and range of motion,body weight,physical ability(Timed Up and Go Test),fatigue,depressive symptoms,quality of sleep,and quality of life,were assessed at baseline,3 months,and 6 months after enrollment and analyzed using descriptive statistics and multivariate analysis of variance.Results:One hundred and ten participants completed the study(55 participants in each group).Most patient outcomes in the two groups showed general improvement with statistical significance(P<0.001):pain decreased,physical ability improved,less depressive symptoms and fatigue,quality of life and sleep improved.The interaction effect(the group and time)demonstrated statistically significant differences between the intervention and control groups on pain,knee range of motion,and fatigue according to each time follow-up(P<0.001).Conclusions:The comprehensive health education plus village health volunteer monitoring support program promotes good patient outcomes in this population.The integrated health education resource and support for older adults with knee osteoarthritis and type 2 diabetes is an effective,non-surgical treatment that highlights professional nursing roles and non-professional rolesdvillage health volunteers.Nurses should consider implementing a health education plus monitoring support program to mitigate the effects of chronic diseases and improve patients’quality of life.
文摘International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.
文摘Objectives:To explore the clinical value of applying diabetes health education to endocrinology care.Methods:A total of 122 patients with diabetes admitted to our department from October 2016 to October 2017 were selected.After consulting patients,they were randomly divided into two groups,with 61 cases in each group.The control group performs routine care,and the experimental group provides patients with diabetes-specific health education.After three months,the compliance of the two groups of patients was compared.The ADL scores of the two groups of patients before and after treatment were compared.Results:Experimental group had significantly higher compliance rate than control group in all aspects.The difference was statistically significant(P<0.05).The ADL scores of both groups were significantly improved.The effects before and after the care were compared.The difference was statistically significant(P<0.05).The score of experimental group increased more significantly than that of the control group.The difference was statistically significant(P<0.05).Conclusions:In the endocrinology care,the implementation of diabetes special health education for patients can improve patient compliance and improve patients'daily living ability,which is an ideal nursing measure.It is worth promoting.
文摘This study proposes to discuss the experience lived by Pró-Saúde and PET-Saúde team of FACISA/ UFRN together with the Municipal Health Department of Santa Cruz/RN from a critical-reflexive perspective about the interaction between education, service and community as well as advances in approach and the strengthening between the school and Primary Health Care. This is an exploratory study with an experience report approach of the Pró-Saúde and PET-Saúde team from 2012 to 2014. The integration of these programs in experimental scenarios of the Unified Health System and the strengthening of the proposed training of human resources capable of the current healthcare system were observed. Thus, contributions in health in undergraduate courses and practices of health services are important, since the approach to the reality of the population and their social needs contribute to the vocational training quality.
基金Dr.Mijung Park received support from the National Institute of Nursing Research (7K01NR015101)
文摘Objective:To compare outcomes associated with patient education about glycemic control via group chat versus patient education as usual among individuals with diabetes in China.Methods:We searched the following databases both in English and in Chinese languages:PubMed,CNKI,Wanfang database,VIP database,and CBM for articles published up to Jan 1,2018.The studies were screened by two independent reviewers.Using criteria from the risk of bias assessment tool developed by Cochrane Collaboration to assess the risk of bias of eligible studies.A meta-analysis of studies was performed using comprehensive meta-analysis version 3.0.Results:Twenty-five unique randomized clinical trials,including 2,838 patients,were identified.The education delivered via group chat had large overall pooled effect sizes in improving glucose control measured by hemoglobin A1c[Hedges'g=-0.81,95%CI:(-0.98,-0.64)],fasting blood glucose[Hedges'g=-1.11,95%CI:(-1.37,-0.85)],and 2 h postprandial blood glucose[Hedges'g=-0.98,95%CI:(-1.20,-0.76)].Additionally,patient education delivered via group chat has shown consistently superior outcomes in glucose control in short-term(0-3 months),mid-term(3-6 months)and longer-term(6-12 months).Conclusions:Educational interventions via group chat had a superior outcome in blood glucose control compared to education as usual in China.Educational interventions via group chat had superior shortterm,mid-term,and longer-term outcomes in blood glucose control compared to education as usual in China.
文摘Cardiovascular diseases, including atherosclerosis, are important causes of death among diabetics. Features of diabetes mellitus (DM) associated with atherogenic risk factors are discussed by a cross-sectional study. It was evaluated 432 families attended by Basic Family Health Unities (FHU), registered at Family Health Program (HIPERDIA) at borough Alto da Maravilha in Senhor do Bonfim, Bahia, Brazil. Among eligible patients, 50 (8.4% of the total) were included in diabetic group (DB), and 80 (9.4% of the total) in the non-diabetic group (NDB). The majority was women (90/ 130) in the age range 48 - 77. The diabetic group showed a high prevalence among analyzed variables, such as hypertension (74.0%) and obesity (46.0%). Significant differences were not found among lipoprotein cholesterol concentrations comparing the DB and NDB groups. The correlation analysis showed significant differences among LDL-C-DB and CT-DB (p < 0.0001), LDL-NDB and CT-NDB (p < 0.0001), LDL-NDB and TG-NDB (p = 0.0034), and CT-NDB and TG-NDB (p = 0.0001). Diabetic and healthy individuals do not present significant differences in the lipid profiles. By the way, the diabetic and health individuals can not present significant differences in the lipid profile, however, probably there are differences in the quality of the lipoprotein molecules between DB and NDB and a divergent tendency of the disease progression, such as a higher disposition to atherosclerosis development in DB. These patients with potential risk to development atherosclerosis or aggravation of diabetes must have more attention about Family Health Program.
文摘Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.
文摘Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. Subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. Survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: Systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.
文摘Background:Recognition and treatment of emotional distress,which affects 20 to 40%of outpatients with type 1 or type 2 diabetes,are important because of its association with worse diabetes self-care,poor glycemic control,increased rates of mortality and diabetes-related complications,and a rise in healthcare expenditure.However,although the symptoms of emotional distress improve in diabetic patients after psychological and pharmacological interventions,evidence of benefits in glycemic control is still uncertain.Objective:The aim of this study was to assess the metabolic control in diabetic patients with emotional distress attending primary mental care clinics(PMCC)in the Eastern Province of Saudi Arabia.Method:This study was a single group pretest-posttest design conducted on adult diabetic patients with emotional distress attending PMCC.Out of 194 attendees,62 patients who fulfilled the selection criteria were studied.Data were collected from the patients’records using a worksheet designed for the study.Metabolic parameters including BMI,BP,FBS,HbA1c and lipid profile were recorded before and after the management of emotional distress.Socio-demographic characteristics,complications related to diabetes and co-morbidities were also recorded.Paired t-test was used appropriately to compare continuous variables.A p-value of less than 0.05 was considered significant in all statistical analysis.Results:The majority of the patients had type 2 DM(98.2%)and the presence of co-morbidities was high(83.9%).A comparison of the metabolic parameters before and after management of emotional distress,showed a significant reduction in HbA1c(p=0.020)and elevation in HDL(p=0.010).No differences in BMI,BP,FBS,TC,TG or LDL were found.Conclusions:Treating emotional distress in diabetic patients is associated with an improvement in HbA1c and HDL.