scholarly journals Development of a salutogenic intervention for healthy eating among Dutch type 2 diabetes mellitus patients

Author(s):  
Kristel C M M Polhuis ◽  
Lenneke Vaandrager ◽  
Sabita S Soedamah-Muthu ◽  
Maria A Koelen

Summary Healthy eating can be challenging for type 2 diabetes mellitus (T2DM) patients. The theory of salutogenesis, which focuses on the resources required to organize behavioural changes in everyday life, was used to develop an intervention for healthy eating. The aim was to describe the development, structure and content of this salutogenic intervention. The development consisted of two phases that were based on the operationalization of important key principles of salutogenesis. In Phase 1 (Exploration and synthesis), a systematic review and three qualitative studies were performed to explore important characteristics to enable healthy eating in everyday life. The results were used to develop the draft intervention. In Phase 2 (Validation and adjustment), interviews and workshops were conducted with T2DM patients, healthcare providers and scientists. Based on this, the draft intervention was modified into its final form. The developmental process resulted in a 12-week, group-based intervention that aimed to enable important resources for healthy eating via self-examination, reflection, setting goals and sharing experiences. Attention was also paid to disease information, disease acceptance, food literacy, stress management, self-identity and social support. The group sessions began following an individual intake session, with a booster session held 3 months after the intervention. The researcher’s translation of the stakeholders’ priorities into an intervention was corrected for and approved by the stakeholders concerned. This comprehensive salutogenic intervention was developed based on practical and scientific evidence. Providing transparency in developmental processes and content is important because it determines the scientific integrity and credibility of an intervention.

2018 ◽  
Vol 17 (2) ◽  
pp. 153-184
Author(s):  
Rosana Cristina Franco ◽  
Tânia Alves Canata Becker ◽  
Paula Parisi Hodniki ◽  
Maria Lúcia Zanetti ◽  
Paula B. de Oliveira Sígoli ◽  
...  

Objetivo: Investigar los efectos de la asistencia telefónica en la adhesión a la práctica de una dieta saludable de los pacientes con diabetes mellitus tipo 2.Métodos: Se realizó un ensayo clínico que involucró a 63 pacientes con diabetes mellitus tipo 2, 36 pacientes asignados al grupo de intervención (G1) y 27 en el grupo control (G2). Para el G1 se llevó a cabo una intervención de asistencia telefónica que correspondía a cuatro llamadas telefónicas que abordan: la planificación de comidas, tipos y porciones de comida y la comida sana. Para G2, se llevó a cabo la atención habitual en sus unidades. Los efectos de la asistencia telefónica en la dieta sana se midieron al inicio del estudio (T1) y después de la intervención (T2) en cuatro meses.Resultados: En  G1, 16 (44,44%) pacientes se unieron en T1, disminuyendo para 14 (38.88%) en T2. En el  G2, 08 (29,62%) pacientes se unieron en T1 y aumentó a 09 (33,33%) en T2. Hubo un aumento del consumo de frutas y verduras, reducción el consumo de alimentos ricos en grasas y alta en la tasa de azúcar, así como un aumento en el fraccionamiento de las comidas después de la intervención en G1. Hubo una diferencia significativa en la reducción de los niveles de glucosa en ayuno en los pacientes no adherentes y em la reducción de Hb1Ac entre los pacientes adherente G1.Conclusión: Los efectos de la asistencia telefónica después de la intervención de cuatro meses resultó insuficiente para aumentar la adherencia a una alimentación sana, pero observó un aumento del consumo de frutas y verduras y la disminución del consumo de alimentos ricos en grasas y alto contenido de azúcar y refrescos. Objective: To verify the effects of telephone support on adherence to healthy eating practices among patients with type 2 diabetes mellitus. Methods: This was a clinical trial with 63 patients with type 2 diabetes mellitus; 36 patients were allocated to the intervention group (G1) and 27 patients to the control group (G2). For G1, telephone support was provided, consisting of four telephone calls addressing food planning, types and portions of food, and healthy foods. For G2, normal care was given in their health facility. The effects of telephone support on healthy eating were measured at baseline (T1) and at four months after the intervention (T2).Results: In G1, 16 (44.44%) patients joined at T1, which dropped to 14 (38.88%) by T2. In G2, 8 (29.62%) patients started at T1 and the number rose to 9 (33.33%) by T2. After the G1 intervention, there was an increase in the consumption of fruits and vegetables, a reduction in the consumption of fatty foods and foods high in sugar, and an increase in meal frequency. A significant difference was noted in reduced fasting blood glucose among non-adherent patients and reduced Hb1Ac among adherent patients from G1. Conclusion: The four-month intervention using telephone support proved insufficient to increase adherence to healthy eating. However, there was an increase in consumption of fruits and vegetables and a decrease in the consumption of fatty foods, foods high in sugar, and soft drinks. Objetivo: Verificar os efeitos do suporte telefônico na adesão á prática de uma alimentação saudável de pacientes com diabetes mellitus tipo 2. Métodos: Tratou-se de um ensaio clínico do qual participaram 63 pacientes com diabetes mellitus tipo 2, sendo 36 pacientes alocados para o grupo intervenção (G1) e 27 para o grupo controle (G2). Para o G1, foi conduzida uma intervenção de suporte telefônico que correspondeu a quatro ligações telefônicas abordando: planejamento alimentar, tipos e porções de alimentos e alimentos saudáveis. Para o G2, foi conduzido o cuidado usual em sua unidade de saúde. Os efeitos do suporte telefônico na alimentação saudável foram medidos no início (T1) e após a intervenção (T2) em quatro meses.Resultados: No G1, 16 (44,44%) pacientes aderiram no T1, diminuindo para 14 (38,88%) no T2. No G2, 08 (29,62%) pacientes aderiram no T1 e aumentou para 09 (33,33%) no T2. Houve aumento do consumo de frutas, verduras e legumes, redução do consumo de alimentos gordurosos e ricos em açúcar além de aumento no fracionamento das refeições após a intervenção no G1. Observou-se diferença significativa na redução da glicemia de jejum entre os pacientes não aderentes e na redução da Hb1Ac entre os pacientes aderentes do G1. Conclusão: Os efeitos do suporte telefônico após a intervenção de quatro meses mostrou-se insuficiente para aumentar a adesão à alimentação saudável, porém observamos o aumento de consumo de frutas, verduras e legumes e diminuição do consumo de alimentos gordurosos e ricos em açúcar e refrigerantes.


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