scholarly journals Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis (Preprint)

2017 ◽  
Author(s):  
Charlene Connolly Quinn ◽  
Erin C Butler ◽  
Krystal K Swasey ◽  
Michelle D Shardell ◽  
Michael D Terrin ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Healthy Eating ◽  
Patient Engagement ◽  
Intervention Study ◽  
Glucose Monitoring ◽  
Self Management ◽  
Control Group ◽  
Percentage Points ◽  
Diabetes Intervention ◽  
Management Behaviors

BACKGROUND Successful treatment of diabetes includes patient self-management behaviors to prevent or delay complications and comorbid diseases. On the basis of findings from large clinical trials and professional guidelines, diabetes education programs and health providers prescribe daily regimens of glucose monitoring, healthy eating, stress management, medication adherence, and physical activity. Consistent, long-term commitment to regimens is challenging. Mobile health is increasingly being used to assist patients with lifestyle changes and self-management behaviors between provider visits. The effectiveness of mobile health to improve diabetes outcomes depends on patient engagement with a technology, content, or interactions with providers. OBJECTIVES In the current analysis, we aimed to identify patient engagement themes in diabetes messaging with diabetes providers and determine if differences in engagement in the Mobile Diabetes Intervention Study (MDIS) influenced changes in glycated hemoglobin A1c (HbA1c) over a 1-year treatment period (1.9% absolute decrease in the parent study). METHODS In the primary MDIS study, 163 patients were enrolled into 1 of 3 mobile intervention groups or a usual care control group based on their physician cluster randomization assignment. The control group received care from their physicians as usual. Participants in each intervention group had access to a patient portal where they could record monitoring values for blood glucose, blood pressure, medication changes, or other self-management information while also assigned to varying levels of physician access to patient data. Intervention participants could choose to send and receive messages to assigned certified diabetes educators with questions or updates through the secure Web portal. For this secondary analysis, patient engagement was measured using qualitative methods to identify self-care themes in 4109 patient messages. Mixed methods were used to determine the impact of patient engagement on change in HbA1c over 1 year. RESULTS Self-care behavior themes that received the highest engagement for participants were glucose monitoring (75/107, 70.1%), medication management (71/107, 66.4%), and reducing risks (71/107, 66.4%). The average number of messages sent per patient were highest for glucose monitoring (9.2, SD 14.0) and healthy eating (6.9, SD 13.2). Compared to sending no messages, sending any messages about glucose monitoring (P=.03) or medication (P=.01) led to a decrease in HbA1c of 0.62 and 0.72 percentage points, respectively. Sending any messages about healthy eating, glucose monitoring, or medication combined led to a decrease in HbA1c of 0.54 percentage points compared to not sending messages in these themes (P=.045). CONCLUSIONS The findings from this study help validate the efficacy of the mobile diabetes intervention. The next step is to determine differences between patients who engage in mobile interventions and those who do not engage and identify methods to enhance patient engagement. CLINICALTRIAL ClinicalTrials.gov: NCT01107015; https://clinicaltrials.gov/ct2/show/NCT01107015 (Archived by WebCite at http://www.webcitation.org/6wh4ekP4R)

scholarly journals Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis

2017 ◽  
Author(s):  
Charlene Connolly Quinn ◽  
Erin C Butler ◽  
Krystal K Swasey ◽  
Michelle D Shardell ◽  
Michael D Terrin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Blood Glucose ◽  
Patient Engagement ◽  
Intervention Study ◽  
Diabetes Intervention

scholarly journals Mobile Diabetes Intervention Study of Patient Engagement and Impact on Blood Glucose: Mixed Methods Analysis

2018 ◽  
Vol 6 (2) ◽  
pp. e31 ◽  
Author(s):  
Charlene Connolly Quinn ◽  
Erin C Butler ◽  
Krystal K Swasey ◽  
Michelle D Shardell ◽  
Michael D Terrin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Blood Glucose ◽  
Patient Engagement ◽  
Intervention Study ◽  
Diabetes Intervention

Perilaku Self-Management Pasien Diabetes Melitus (DM)

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Dwi Siwi Handayani ◽  
Kurniawan Yudianto ◽  
Titis Kurniawan
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Foot Care ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Almost All ◽  
Management Behaviors ◽  
Diabetes Melitus

Diabetes Melitus (DM) merupakan penyakit kronik, oleh karena itu peran self-managementsangat penting dalam perawatan maupun pencegahan komplikasi akibat DM. Penelitian ini bertujuan untuk mengetahui gambaran perilaku self- management.pasien DM dari aspek diet, medikasi, olahraga, pemantauan kadar gula darah dan perawatan kaki. Sebanyak 94 responsden diambil secara acak. Perilaku self-managementdiukur menggunakan kuesioner yang dikembangkan oleh penulis, dengan skor Alpha Chronbach 0,930 dan korelasi inter-item 0,385–0,797 dimana nilai tersebut valid dan reliabel untuk uji instrumen. Hasil penelitian menunjukkan lebih dari setengah responsden (64,9%) melakukan lima aspek self-managementdengan baik. Hampir semua responsden (94,7%) melakukan medikasi dengan baik, lebih dari setengah responsden melakukan diet (69,1%), olahraga (61,7%) dan perawatan kaki (77,7%) dengan baik. Namun hanya 25,5% responsden yang melakukan pemantauan gula darah dengan baik. Hasil penelitian ini dapat menjadi acuan bagi perawat untuk memberikan penyuluhan mengenai pentingnya pemantauan pada gula darah.Kata kunci: Diabetes Melitus, perilaku, self-management AbstractDiabetes Mellitus (DM) is one of the serious health problems in Indonesia. Since DM is a chronic disease, patients’ role (self-management) is very important either for treatment or DM-related complications prevention. This study was purposed to determine the level of patients’ diabetes self-management behavior, including diet, medication, exercise, blood glucose monitoring and foot care. Ninety-four responsdents were recruited randomly by gave the informed consent to diabetes patients. The questionnaire was developed by the researcher, with Chronbach Alpha 0,930 and inter-item correlation 0,385 to 0,797, which mean the instrument was valid and reliable. The results showed that in five aspects, more than half of responsdents (64,9%) reported that they performed good self-management. Almost all responsdents (94,7%) reported good medication, more than half of responsdents did well in diet, exercise (61.7%) and foot care (77.7%). However, only 25.5% responsdents who performed monitoring blood glucose levels properly. It called be good level when it fill the score criteria of the answer.Therefore, it was recommended for nurses and the hospital to develop any program to improve patients’ diabetes self-management behaviors, especially in the monitoring blood glucose.Key words: Behavior, diabetes mellitus, self-management

scholarly journals The effectiveness of nurse-led self-management support program for people with chronic kidney disease stage 3-4 (CKD-NLSM): Study protocol for a randomized controlled trial

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Al Sawad Ayat Ali ◽  
Soo Kun Lim ◽  
Li Yoong Tang ◽  
Aneesa Abdul Rashid ◽  
Boon-How Chew
Keyword(s):  
Kidney Disease ◽  
Controlled Trial ◽  
Self Management ◽  
Control Group ◽  
Management Support ◽  
Disease Knowledge ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Ckd Stage ◽  
Management Behaviors

The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3–4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3–4 will be randomly assigned to either the intervention ( n = 77) or control group ( n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes. Clinical Trials Registration: www.ClinicalTrials.gov , identifier: NCT03974646.

scholarly journals Prevalence of Poor Diabetes Self-Management Behaviors among Ethiopian Diabetes Mellitus Patients: A Systematic Review and Meta- Analysis

2020 ◽  
Vol 30 (4) ◽  
Author(s):  
Teshome Tesfaye Habebo ◽  
Ebrahim Jaafari Pooyan ◽  
Ali Mohammad Mosadeghrad ◽  
Getachew Ossabo Babore ◽  
Blen Kassahun Dessu
Keyword(s):  
Quality Assessment ◽  
Addis Ababa ◽  
Meta Analysis ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Self Management ◽  
Diabetic Patients ◽  
Pooled Prevalence ◽  
Meta Analyses ◽  
Management Behaviors

BACKGROUND: Diabetes has no cure so far, but appropriate self-management contributes to delay or control its progression. However, poor self-management by diabetic patients adds to disease burden. The pooled prevalence of overall, and its main components of poor self-management among Ethiopian diabetic patients remain elusive. Hence, this study aimed to determine the prevalence of poor diabetes self-management behaviors among diabetic patients in Ethiopia.METHOD: by using different combinations of search terms, we accessed articles done until February 15, 2020 through Pubmed, Scopus, Web of Science and Embase databases. Newcastle-Ottawa quality assessment scale was used for quality assessment, and STATA version 14 software along with the random-effects model was employed for statistical analyses. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA.) guideline was followed to report the results.RESULT: Twenty-one studies with 7,168 participants were included in this meta-analysis. The overall pooled prevalence of poor self-management behavior among diabetic patients in Ethiopia was 49.79% (95% CI: 43.58%, 56.01%). Based on subgroup analysis, the estimated magnitudes of poor selfmanagement by regions were 68.58% in Tigray, 55.46% in Harari, 54.74%, in Amhara, 40.90%, in SNNPRS and 37.06% in Addis Ababa. The worst (80.91%) and relatively better (24.65%) self-management components were observed on self-blood glucose monitoring and medication adherence, respectively.CONCLUSION: One in two diabetic patients in Ethiopia had poor self-management. Thus, we strongly recommend to the ministry of health and universities to train diabetes health educators, and the health facilities to deliver tailored diabetes health education.

scholarly journals Effects of an Outpatient Diabetes Self-Management Education on Patients with Type 2 Diabetes in China: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fan Zheng ◽  
Suixin Liu ◽  
Yuan Liu ◽  
Lihua Deng
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Education ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Self Care ◽  
Education Programme ◽  
Self Management ◽  
Control Group

Objective. This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme. Methods. In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n=30) and intervention group (n=30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme. Results. The total mean score of the summary of diabetes self-care activities measure was 17.60±6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82±15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P<0.01). Conclusion. This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.

scholarly journals The Effects of Group Discussion Based Education on the Promotion of Self-Management Behaviors in Hemodialysis Patients

2018 ◽  
Vol 7 (4) ◽  
pp. 225-232 ◽  
Author(s):  
Azam Mahjubian ◽  
Nasrin Bahraminejad ◽  
Koorosh Kamali
Keyword(s):  
Group Discussion ◽  
Hemodialysis Patients ◽  
Wilcoxon Test ◽  
Self Management ◽  
Control Group ◽  
Control Groups ◽  
Educational Method ◽  
Management Interventions ◽  
And Control ◽  
Management Behaviors

Introduction: Improving self-management of the patients undergoing hemodialysis is an effective way to reduce complications and to improve the quality of life of them. The current study aims to assess the effects of group discussion on the promotion of self-management behaviors in hemodialysis patients. Methods: In this quasi -experimental clinical trial study (with experimental and control groups) 60 patients were arranged in two experimental and control groups through using convenience sampling with random allocation. Self-management interventions were conducted on the experimental group during 3 to 4 sessions of group discussion. The control group received routine interventions. The data were collected through Li and colleagues' self-management standard questionnaire before and 3 months after the intervention. The data were analyzed via SPSS software version 13 and chi-square, t-test, Mann-Whitney, and Wilcoxon test. Results: The results showed that the mean scores of four dimension of self-management including participation with the medical team, problem solving, self-care and emotional management after the implementation of group were significantly different between the experimental and control groups. Conclusion: Based on the findings, group discussion was an effective educational method to promote self-management of chronic hemodialysis patients. Therefore, holding group discussion to reinforce the self- management behaviors in patients undergoing hemodialysis is recommended.

scholarly journals Daily School Physical Activity Improves Academic Performance

Sports ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 83
Author(s):  
Jesper Fritz ◽  
Marcus E. Cöster ◽  
Björn E. Rosengren ◽  
Caroline Karlsson ◽  
Magnus K. Karlsson
Keyword(s):  
Physical Activity ◽  
Academic Performance ◽  
Intervention Study ◽  
Control Group ◽  
Compulsory School ◽  
Final Grade ◽  
School Based ◽  
Percentage Points ◽  
Upper Secondary ◽  
The Mean

Physical activity (PA) may improve brain development, cognition, concentration and academic performance. In this prospective controlled intervention study, we increased the level of PA in 338 children aged 6–8 years at study start, from the Swedish standard of 60 min per week to 200 min per week (40 min daily). The intervention continued in all nine compulsory school years until the students graduated between 2007–2012. All other 689,881 Swedish children who graduated the same years were included as a control group. We registered at graduation eligibility rate for upper secondary school and the final grade score (from 0 to 320 grade points). We also registered the same end points in the 295 students in the index school and in all other 471,926 Swedish students who graduated in 2003–2006, that is, those who graduated before the intervention study started. Before the intervention, academic performance was similar among children in the index school as for all other Swedish boys and girls. With the intervention, the eligibility rate increased for boys in the index school by 7.3 percentage points and the mean grade scores by 13.3 points. This should be compared with a decrease of 0.8 percentage points in eligibility rate and an increase by 2.7 points in grade score in other Swedish boys. No changes were seen for intervention girls, neither in eligibility rates or grade scores. By introducing daily school-based PA in compulsory school, more boys would probably reach the eligibility rate for higher education.

scholarly journals Theater Performing Arts (TPA): Community Empowerment to Improve Blood Glucose Control Behavior in Yogyakarta

2020 ◽  
Vol 18 (4) ◽  
Author(s):  
Mahendro Prasetyo Kusumo ◽  
Julita Hendrartini ◽  
Zaenal Muttaqien Sufro ◽  
Fatwa Sari Tetra Dewi Dewi
Keyword(s):  
Blood Glucose ◽  
Glucose Control ◽  
Quantitative Methods ◽  
Blood Glucose Control ◽  
Community Empowerment ◽  
Self Management ◽  
Average Score ◽  
Control Group ◽  
Management Behavior ◽  
Number Of Patients

Background: Poor self-management behavior is one of the causes of the high number of patients with type 2 diabetes mellitus (T2DM) in Indonesia. Objectives: The aim of this study was to measure the effectiveness of TPA-based community empowerment as a form of education in improving the blood glucose control practices of patients with T2DM in Yogyakarta. Methods: This study used quantitative methods with a quasi-experimental non-equivalent pre-posttest control group design. The subjects of this study were “Prolanis member” patients with T2DM in the four primary health care centers in Sleman, Yogyakarta, Indonesia. Purposive sampling was done at four primary care in Sleman, Yogyakarta, Indonesia. From 138 T2DM patients, only 102 were eligible to become respondents. The questionnaires were adapted to the recommendations of endocrine experts’ associations to measure the level of T2DM patients’ knowledge, attitude and practices. Intervention was done for three months, from October to December 2019. Measurements were made before and after the TPA. Results: Attitude and behavior scores showed a significant increase (P < 0.05) after TPA intervention. Meanwhile, the average score of knowledge after the TPA intervention showed no significant increase (P > 0.05). Good self-management behavior in patients with T2DM was observed in Sleman Regency. Education through TPA based community empowerment should be considered as an appropriate intervention to improve DM management practice. Patients can receive material that is delivered easily because of the relaxed and pleasant environment during TPA. Conclusions: TPA-based community empowerment can create a relaxed and pleasant environment to improve blood glucose control practices in patients with T2DM.

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