scholarly journals Implications of diabetes self-management education in metabolic control

2020 ◽  
Vol 8 (16) ◽  
pp. 72-80
Author(s):  
Ana Laura López González

Diabetes is a chronic, progressive and disabling disease that affects millions of people around the world, with a high mortality rate derived from poor control. The paradigm of the treatment of diabetes has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education, or DSME, is a process where people with diabetes gain the knowledge and skills needed to make informed decisions, modify their behaviour and to self-manage, in collaboration with health personnel, successfully the disease and its related conditions. To achieve these goals a structured educational program is used, in 4 stages which include assessment, planning, implementation and evaluation; to carry on this program, the model of the seven self-care behaviours known as AADE7®, developed by the American Association of Diabetes Educators, is used as a frame of reference. The objective of this paper is to analyse the components of the education program for diabetes self-care as well as its reference framework, the AADE7® model, and its importance in the metabolic control of diabetes.

2018 ◽  
Vol 6 (3) ◽  
pp. 453
Author(s):  
Anis Fitri Nurul Anggraeni ◽  
Rondhianto Rondhianto ◽  
Peni Perdani Juliningrum

Type 2 DM is a chronic disease requiring long-term care, so it needs self-management education toprevent the complication. The patient's inability to perform self-care can reduce the quality of life. DSME/Sis one of education which facilitates knowledge, skills, patient abilities, and family support in self-care.DSME/S is given in the form of discharge planning to improve knowledge and skills in self-care. Thisresearch aimed to analyze the effect of Diabetes Self-Management Education and Support (DSME/S) onquality of life of patients with type 2 diabetes mellitus in RSD dr. Soebandi. The research design wasquasi experimental with pre-test post-test with control group design. A number of samples were 30 peopledivided into two groups: 15 people in the treatment group and 15 people in the control group. DSME/Swas conducted in 6 sessions. Sessions 1-4 were performed in the hospital and sessions 5-6 wereperformed at the patient’s home. The data were analyzed by using dependent t test and independent ttest which significance level of 0.05. The result of t-dependent test indicated that there was significantdifferent quality of life between pre-test and post-test in the treatment group (p = 0.001) and control group(p = 0.002). The result of Independent t test showed a significant difference between treatment group andcontrol group (p = 0.001). The enhancement of quality of life on the treatment group was greater than thecontrol group. The conclusion showed that there was significant effect of DSME/S on the quality of life oftype 2 DM patients. DSME/S could improve patient self-care knowledge and abilities in controlling bloodsugar and prevent complications may effect of quality of life. Nurses can apply DSME/S in healthpromotion programs to type 2 DM patients in hospital. Keywords: Type 2 diabetes mellitus, quality of life, DSME/S


2021 ◽  
Vol 9 (G) ◽  
pp. 81-87
Author(s):  
Dedi Damhudi ◽  
Nyoman Kertia ◽  
Christantie Effendy

BACKGROUND: Diabetes self-management education and support (DSMES) programs are patient-centered, holistic solution that enables it one of the best approaches for improving medication adherence enhanced coping, empowerment and self-efficacy, quality of life (QoL), and lower rates of depression, in people with type 2 diabetes mellitus (T2DM). In isolation, DSME strategies have not shown significant improvements to self-care and/or reduction of diabetic foot ulcer (DFU). AIM: This study sought to determine the effect of modified DSMES on self-care, DFU severity, and QoL in rural Indonesian patients with DFUs. METHODS: A quasi-experimental design with pre-test and post-test control group design, in Singkawang, West Kalimantan, Indonesia, with a total sample of 60 patients consisting of 30 patients in the intervention group and 30 patients in the control group. The DSMES has been adapted to cover 2 h of content for a period of 8 weeks and the eight-core components of DSMES. The curriculum was culturally adapted revised to incorporate culturally appropriate nature similarities, such as a prominent change to represent changes in glucose counts; to incorporate photos; to incorporate culturally relevant eating habits, such as fish and fruit; to communicate in detail the significance of medication adherence, with an emphasis on metformin’s organic, plant-based characteristics; and to emphasize engagement. Intention-to-treat analyses were conducted to determine the effect of modified DSMES on self-care, DFU severity, and QoL. RESULTS: The DSMES program improved outcomes in three of the three outcome indicators when compared to the control group at T1: In this study, (1) the DFU degree increased by 3.3% points (95% confidence interval [CI]: 0.018–0.194), (2) the diabetes foot self-care behavior score increased by a modest 8.8% points (95% CI: 0.021–0.203), and (3) the QoL increased by 32.7% points (95% CI: 00.075–0.689). The degree of DFU (difference-in-difference [DID] coef. 0.350, 95% CI 0.084–0.572), diabetes foot self-care behavior (DID coef. 0.085, 95% CI 0.065–0.405), and QoL (DID coef. 0.343, 95% CI 0.078–0.436) are all still significantly improved compared to the control at T2. CONCLUSION: The primary outcome analyses indicate that the adapted DSMES was more effective than standard care at improving self-care and QoL and decreasing DFU degree in this sample of Indonesians with DFU, both immediately after and 3 months after the intervention. As nurse educators, it is our responsibility to ensure that we evaluate all of the support options accessible to the patients in our care.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.


2018 ◽  
Vol 6 (9) ◽  
pp. 1762-1767 ◽  
Author(s):  
Rina Amelia

BACKGROUND: Diabetes is a type of chronic disease with exceptional medical care for a patient's lifetime, which ultimately requires lifestyle and behavioural adjustments to prevent complications to death. Patients with good self-care behaviour will cause diabetes to be controlled to avoid complications to death and make patients have a better quality of life. AIM: This study aims (1) to determine the model of self-care behaviour in Type 2 diabetes patients in Binjai City (2) to analyse the effect of self-care behaviour on quality of life, metabolic control and lipid control of Type 2 diabetes patients in Binjai City. METHODS: This type of research is survey-based and explanatory using a cross-sectional approach. The study population was Type 2 Diabetes Mellitus (T2DM) patients who remained patients in 8 primary health centres in Binjai City. The consecutive sampling yielded a sample size of 115 people. Data analysis method uses descriptive statistics and Structural Equation Modeling (SEM) using SPSS and Amos 16.0. RESULTS: The results showed that all factors that build T2DM patient self-care behaviour were able to be predictors that shape the patient's self-care behaviour. The self-care behaviour model consists of knowledge, attitudes, communication, financing, family support, motivation, and self-efficacy. Motivation is the most significant predictor of its contribution to the self-care behaviour of Type 2 diabetes patients. Self-care behaviour was also known to be significantly related to the quality of life, metabolic control and lipid control of T2DM patients (p < 0.05). CONCLUSION: Self-care behaviour in T2DM patients can have a substantial and significant impact on quality of life, metabolic control and lipid control possessed by Type 2 Diabetes patients.


2020 ◽  
Vol 73 (10) ◽  
pp. 2170-2174
Author(s):  
Oleksii M. Korzh

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach’s reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided “inadequate quality” of diabetes self-management in all areas. Doctors had the highest average score in the domain of “drug intake” (4.46 ± 0.61). Average scores in the “problem-solving domain” (3.52 ± 0.63) and “ being active domain” (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors’ communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Saowaluck Sukpattanasrikul ◽  
Supreeda Monkong ◽  
Sirirat Leelacharas ◽  
Orapitchaya Krairit ◽  
Chukiat Viwatwongkasem

PurposeThis study aims to examine the effects of a self-management program (SMP) on self-care behavior, blood pressure and quality of life among older adults with uncontrolled hypertension.Design/methodology/approachA quasi-experimental design with repeated measures was conducted in two primary care units in Krabi, Thailand. One hundred and fifty-six older adults with uncontrolled hypertension were selected based on the inclusion criteria and divided into experimental and control groups with 78 participants in each. The experimental group received the SMP, including the intervention related to the self-management process (from the 1st to 4th weeks) and a follow-up phase (from the 5th to 16th weeks). The control group received standard care. The outcomes were measured over time, including self-care behavior (baseline, 4th and 16th weeks), blood pressure (baseline, 4th, 8th, 12th and 16th weeks) and quality of life (baseline and 16th week).FindingsThe generalized estimating equations showed that the SMP, compared with the control group, statistically significantly improved self-care behavior (p < 0.001), decreased blood pressure (p < 0.001) and improved quality of life (p < 0.001) at the 16th week.Originality/valueThe SMP improved the self-care behavior, decreased blood pressure and improved the quality of life among older adults with uncontrolled hypertension. Registered nurses could administer this program for long-term benefits and help reduce the burden on primary care services.


2012 ◽  
Vol 2 (3) ◽  
pp. 77-81
Author(s):  
Vijairam Selvaraj

Many individuals in India are nowadays either being diagnosed early with type 2 diabetes or lack optimal control of their diabetes. Reducing the burden and impact of diabetes mellitus in India is a major priority among the healthcare system. Diabetes educators, through DPP models, have shown to reduce the risk of developing diabetes among pre-diabetics through lifestyle changes. Among diabetics, DSME is seen as an essential intervention and as a cornerstone of diabetes care. Short-lived benefits and presence of barriers & challenges limit the inclusion of sufficient numbers of health educators or trained individuals in resource limited Indian settings to educate high risk individuals and improve self-management behaviors.


Sign in / Sign up

Export Citation Format

Share Document