Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Continuous ambulatory peritoneal dialysis telemonitoring and education:A scoping review

The risk of peritonitis complications in continuous ambulatory peritoneal dialysis(CAPD)can be prevented or reduced by providing proper education and continuous monitoring.Telemedicine and telemonitoring are methods that enable remote monitoring and patient care.This study aimed to determine the success and factors affecting telemonitoring in CAPD patient care.This study is a scoping review(ScR)using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR method.Article searches were carried out on ProQuest,PubMed,and ScienceDirect with a time range of 2018-2023.Data extraction was performed regarding knowledge level,quality of life,clinical outcomes(peritonitis),and risk of hospitalization.Of the 12 articles and studies included,6 articles were related to the effect of telemonitoring on CAPD patient outcomes,and 6 articles were associated with the effect of education on CAPD patient outcomes.Education provided to patients can improve patient understanding of therapeutic modalities for renal disorders,reduce the potential for peritonitis and dialysis complications,and improve the quality of life of patients with CAPD.CAPD patients who received telemonitoring had a better quality of life,good clinical outcomes,and a lower risk of hospitalization than those who did not receive telemonitoring and had fewer health-care visits.In summary,the implementation of telemonitoring and education in chronic kidney disease patients with CAPD modality therapy has been proven effective in improving quality of life and reducing dialysis-related risks.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Exploration of the Path of Intelligent Development of Continuing Education in the Digital Age

With the rapid development of big data and intelligent technology,opportunities and challenges coexist in continuing education work,and the integration of continuing education and intelligent education is imperative.Therefore,China’s continuing education should strengthen the construction of the education system,make long-term plans,strengthen overall management in system construction,promote the transformation of continuing education models,and accelerate the modernization process of education.Based on this,this article analyzes and studies the path of intelligent development of continuing education in the digital era,explores its inevitability,analyzes the main characteristics of intelligent continuing education,explores the problems of intelligent development of continuing education,and proposes strategies for the intelligent development of continuing education.

Migration of Healthcare Professionals: Exploring Self-Perception about Midwifery Professional Life and Continued Education

Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .

Exploring the Influences of Continuous Self-Management Education on the Self-Care Skills and Health Behavior of Patients with PICC Intubation

Objective:To analyze the effects of continuous self-management education on the selfcare ability and health behavior of patients with tumor through peripherally inserted central venous catheters(PICC).Methods:The period from August 2018 to August 2020 was used as the research time range,and the random number table method was used as the basis for grouping.80 patients with malignant tumors who regularly performed fixed catheter maintenance care in the PICC clinic of our hospital were admitted in the experimental group(given PICC specialist nursing,and implemented continuous self-management education),and 80 patients with PICC tube malignant tumors discharged from the superior hospital during this time range served as the control group(return to the original catheterization hospital from time to time or perform catheter maintenance care in the nursing clinic of our hospital).The self-care ability scores,health behavior scores,and complications during intubation between both groups were analyzed.Results:(1)There was no significant difference in self-care ability score and healthy behavior score between groups before the intervention,P>0.05;the self-care ability score and health behavior score of the research group were better than the control group after intervention,P<0.05;(2)After investigation,the incidence of complications in the research group(2.50%)was lower than that of the control group(10.00%),but there was no difference between the groups,P>0.05.Conclusion:Continuous self-management education has good effects on improving the self-care ability of tumor patients with PICC intubation.It can urge patients to maintain good health behaviors and reduce complications.It is worthy of promotion.

Impact of stage-specific limb function exercises guided by a selfmanagement education model on arteriovenous fistula maturation status

BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.

Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

The effect of goal setting in asthma self-management education:A systematic review

Background: Asthma self-management education combining with behavior therapy is considered to be more effective.Goal setting is a common behavior change technique used to help patients self-manage their symptoms.However,empirical evidence around its effectiveness on asthma management lacks clarity.Aims: To systematically integrate and appraise the evidence for effectiveness of goal setting interventions on asthma outcomes.Methods: Databases included CENTRAL,PubMed,EMBASE,CINAHL and Proquest Psychology Database were systematically searched for relevant intervention studies employing goal setting technique as a method in asthma education program for self-management.Characteristic of studies and outcomes in clinical,psychosocial and healthcare utilization outcome were extracted.Results: From a total of 2641 citations,45 full-text articles were assessed for eligibility and 9 studies met the inclusion criteria.Eight studies were randomized controlled trial and one was before-after study.None studies have a high methodological quality.Goal-setting based intervention appeared to improve symptom control,quality of life and self-efficacy in adult patients with asthma.Conclusion: This systematic review highlighted the potential of a goal setting technique in the asthma self-management education.However,due to the limitations of the quality and quantity of the included literature,more rigorous studies are needed.In the future,better effective study protocol combining with goal setting approach and other behavior technique is needed to further investigate.

Preferences of Persons with Type 2 Diabetes for Diabetes Self-Management Education Interventions: An Exploration

Objectives: Treatment preferences affect treatment engagement, adherence and outcomes. There is limited knowledge of patients’ preferences for Diabetes Self-Management Education (DSME). This study explored the preferences of Canadians with diabetes for components, mode and dose for implementing DSME interventions. Methods: A cross-sectional design was used. Adults with diabetes completed a questionnaire to assess participants’ preferences for components (i.e. content), mode (i.e. teaching strategies, delivering formats) and dose (i.e. number and length of sessions) of DSME. Descriptive statistics were used to analyze the data. Results: Participants (n = 100) were middle-aged men and women, who had diabetes for 6.1 years and previously received (95.0%) DSME. They indicated preference for DSME to include a combination of educational, behavioral and psychological components;to be delivered in individual, face-to-face sessions (4 sessions, 60 minutes each, given monthly) that allowed discussion with one diabetes educator to develop and carry out a care plan. Conclusions: Diabetes educators may consider eliciting patient’s preferences and tailoring DSME to fit patients’ preferences. Delivering interventions that are consistent with patients’ preferences increases their motivation to engage in intervention, satisfaction and adherence to treatment and achievement of desired outcomes.

Efficacy of empowerment education in self-management with Type 2 Diabetes Mellitus:A systematic review and meta-analysis

Objective:To evaluate the impact of empowerment education in self-management with Type 2 Diabetes Mellitus.Methods:A literature search was performed in PubMed,Web of Science,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),WanFang Data,CQVIP and China Biology Medicine disc(CBMdisc)and for randomized controlled trials published before November 2018.RevMan5.3 software was used for metaanalysis.Results:A total of 11 articles were included,involving 1139 patients.The group of empowerment education included 574 participants,and the regular education groups 565 participants.Meta-analysis showed that the group of empowerment education has an advantage over the control group in the levels of self-efficacy[MD=17.55,95%CI(14.14,20.96),P<0.00001],self-management[SMD=0.85,95%CI(0.60,1.11),P<0.00001],as well as the effectiveness of short-term empowerment education(within 6 months)on reducing HbA1c(P<0.05);however failed to long-term empowerment education(beyond 12 months)(P=0.05).Conclusion:This meta-analysis indicates that empowerment education can be an acceptable and appropriated nursing intervention for type 2 diabetes mellitus patients.

Effect of a new health education model on continuous nursing in elderly patients with diabetes mellitus

Objective: We aimed to explore the effect of a new health education model on continuous nursing care in elderly patients with diabetes mellitus who had undergone an operation for fracture.Methods: Convenience sampling was used to select 59 elderly patients with diabetes mellitus and fracture. New health education methods were used, and patient parameters were evaluated before and after the intervention.Results: Evaluation of medication, reasonable diet, regular exercise, blood glucose monitoring, and regular follow-up compliance were significantly improved in the experimental group compared to the control group(P<0.05). There were also significant differences between groups in fasting blood glucose, 2-hour postprandial blood glucose, triglyceride, high-density lipoprotein, and low-density lipoprotein levels(P < 0.05); however, the differences between groups in terms of glycosylated hemoglobin and total cholesterol levels were not statistically significant(P > 0.05). Finally, the functional recovery and mental health of the experimental group were significantly better than those of the control group(P < 0.05).Conclusions: The implementation of a menu of voluntary services in community-based continuous nursing provided standardized nursing care for elderly patients with fracture and diabetes mellitus and improved their quality of life.

Interactive Development of Community Education and Migrant Workers' Continuing Education

Community education is an essential carrier of continuing education and plays a positive role in promoting continuing education of migrant workers. On the one hand,it can raise employment quality and labor skills of migrant workers; on the other hand,it manifests function of serving society of community education. Besides,it is also an important measure for building learning society and lifelong learning system.From the perspective of interactive development,it discusses interactive relationship between community education and migrant workers' continuing education,analyzes their interactive mechanism,and comes up with recommendations for developing community education and migrant workers' continuing education.

Continuing Education for Teacher Intellectual Development

This paper starts with exploring how the philosophy of lifelong education may be applied to teacher continuing education programmes, which is followed by an analysis of some negative factors which have resulted in some teacher development programmes devalued. It then proposes a theoretical framework aiming at teacher intellectual development allied to lifelong education philosophy.

Evaluation and analysis of the effect of continuing education on nurses’physical restraint knowledge,attitude,and behavior

Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge,attitudes,and behaviors of nurses before and after training.Results:The nurses were satisfied with the overall curriculum;the total scores of PR’knowledge,attitude and behavior of nurses after training were higher than before,and the difference was statistically significant(P<0.05);the total scores of nurses who received evidence‑related training before this training were higher than those of nurses who did not receive relevant training,and the difference was statistically significant(P<0.05).Conclusion:Continuing education can effectively improve nurses’knowledge,attitude,and behavior level of PR,ensure patient safety,and promote physical and psychological rehabilitation of patients.

Continuing professional development:progress beyond continuing medical education

Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.

Education Fair： Discussion on Implementing the Continuing Education to Achieve ＂No Child Left Behind＂ Equitable Education

Confucius＇s ＂No Child Left Behind＂ education ideology which was put forward two thousand years ago reflected the importance of education for educators and the simple pursuit of educational equity at that time. Education Fair is the current composition content of China＇s basic education dream. Practicing ＂No Child Left Behind＂ education is the cornerstone to achieve China＇s fair education dream. Making implementing continuing education in order to achieve ＂No Child Left Behind＂ equitable education as a research issue, based on analyzing the status and problems of educational equity issues under the perspective of NCLB, the author explored the realistic way through multi-channel and diverse continuing education to achieve ＂No Child Left Behind ＂equitable education.

Interpretation of proposed measures for continuing nursing education

1 Introduction With the development of modern medicine,the growth of the social demand for nursing,and the gradual improvement of the concept and connotation of lifelong nursing education,continuing nursing education(CNE),as a key form of lifelong nursing education,has received wide attention and played an important role worldwide.CNE is a kind of lifelong education of nursing science on the basis of continuing

A Survey on the Continuing Education Status and Demand of Nurses in Chongqing Grass-Root Medical Institutions

Background: With the increased aging of population, the continuous increase in the morbidity of chronic diseases, and the issuance of universal two-child policy, the grass-root medical teams become more and more important. Objective: To investigate the continuing education status and demand of nurses in the grass-root medical institutions and thus provide a reference for optimizing the continuing education plan. Methods: From October 2018 to May 2019, a survey of 270 nurses from 28 grass-root medical institutions in Tongliang District of Chongqing was performed using a self-designed questionnaire. Results: In the grass-root medical institutions, the major continuing education pattern of nurses was hospital training and distance education;the continuing education focused on new basic theoretical knowledge and new nursing techniques, and its satisfaction was 67.8%. About 20.6% questionnaire answerers never had received continuing nursing education. As shown by one-way analysis of variance (ANOVA) and binary logistic regression analysis, the following factors were associated with the continuing education participation in the past three years: work unit, organizational affiliation, age, professional title and hospital policies. There were 93.0% questionnaire answerers reflecting that it was necessary to participate in the continuing education and wishing the conformance between the pattern and contents of continuing nursing education and the actual implementation status. Conclusion: The continuing education demand of nurses in the grass-root medical institutions is basic but diverse, and the organizations shall provide effective policy support for continuing education and make the diversified training plan by combining Internet technology, so as to realize the maximization of continuing education participation and keep improving the overall service quality of gross-root nurses.