The Effect of Modified Diabetes Self-management Education and Support on Self-care and Quality of Life among Patients with Diabetic Foot Ulcers in Rural Area of Indonesia

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.

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Comparison of hypertensive outcomes after the implementation of self-management program for older adults with uncontrolled hypertension in Krabi, Thailand: a quasi-experimental study

Journal of Health Research ◽

10.1108/jhr-12-2020-0626 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Saowaluck Sukpattanasrikul ◽

Supreeda Monkong ◽

Sirirat Leelacharas ◽

Orapitchaya Krairit ◽

Chukiat Viwatwongkasem

Keyword(s):

Quality Of Life ◽

Blood Pressure ◽

Older Adults ◽

Self Care ◽

Self Management ◽

Uncontrolled Hypertension ◽

Control Group ◽

Content Type ◽

Care Behavior

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.

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The Effect of Diabetes Self-Management Education (DSME) on Improving Self-Management and Quality of Life in Millitus Type 2 Diabetes

JOURNAL FOR QUALITY IN PUBLIC HEALTH ◽

10.30994/jqph.v4i2.176 ◽

2021 ◽

Vol 4 (2) ◽

pp. 31-37

Author(s):

Reza Diko Utama ◽

Indasah Indasah ◽

Siti Farida Noor Layla

Keyword(s):

Quality Of Life ◽

Type Ii Diabetes ◽

Management Education ◽

Self Regulation ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Type Ii ◽

Not Given

Self-management is a form of self-regulation. The purpose of this study was to determine the effect of Diabetes Self-Management Education (DSME) on the Improvement of Self-Management and Quality of Life in Type II Diabetes Millitus Patients. This research method is True-Experiment Pre-Test and Post-Test design. DSMQ and WHOQOL instruments. Independent Variable (DSME) Dependent variable Self-management and quality of life. The subjects of the control group were 55 people and the intervention group was 55 people. Wilcoxon data analysis, Maan-Whitney and Path Analysis. The results of the comparison of self-management between the intervention group and the control group, a significance value of 0.000 less than 0.05 (p <0.05), indicating that the group given effective intervention significantly improved self-management compared to the group that was not given the intervention. The results of the comparison of the quality of life of the intervention group and the control group, the significance value of 0.000 less than 0.05 (p <0.05) indicates that the group given the intervention was more effective in improving the quality of life significantly than the group that was not given the intervention. There is an effect of Diabetes Self-Management Education (DSME) on the Improvement of Self-Management and Quality of Life for Type II Diabetes Millitus Patients in the Work Area of the Kempo Health Center, Kempo District. DSME is a process to facilitate knowledge, skills and abilities in self-care (Self-Management) and quality of life

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Can a Self-Management Education Program for Patients with Chronic Obstructive Pulmonary Disease Improve Quality of Life ?

Canadian Respiratory Journal ◽

10.1155/2011/263574 ◽

2011 ◽

Vol 18 (5) ◽

pp. e77-e81 ◽

Cited By ~ 15

Author(s):

Manon Labrecque ◽

Khalil Rabhi ◽

Catherine Laurin ◽

Helene Favreau ◽

Gregory Moullec ◽

...

Keyword(s):

Quality Of Life ◽

Emergency Room ◽

Management Education ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Chronic Obstructive ◽

Emergency Room Visits ◽

Obstructive Pulmonary Disease

OBJECTIVE: To assess the effects of a self-management program on health-related quality of life (HRQoL) and morbidity commonly associated with chronic obstructive pulmonary disease (COPD).METHODS: A total of 57 outpatients with stable COPD received four weeks of self-management education, while 45 patients received usual care. Patients were evaluated at baseline, at three months and one year following the educational intervention. The primary outcome variable was HRQoL measured by the St George’s Respiratory Questionnaire (SGRQ). The secondary outcome variables were number of emergency room visits and hospitalizations for exacerbation.RESULTS: The intervention group’s HRQoL improved significantly at three months (total score A=−5.0 [P=0.006]) and 12 months (total score A=−6.7 [P<0.001]), as evidenced by decreased scores on the SGRQ. In contrast, the SGRQ scores increased significantly in the control group at three months (total score A=+3.7 [P= 0.022]) and 12 months (total score A=+3.4 [P=0.032]). Global impact appeared to be responsible for the change in the intervention group. Moreover, in the intervention group, the number of hospitalizations dropped from 0.7/person/year to 0.3/person/year (P=0.017), and emergency room visits dropped from 1.1 person/year to 0.2/person/year (P=0.002), while subjects in the control group did not experience any significant decreases in these parameters.CONCLUSIONS: A planned education program improved HRQoL while decreasing the number of emergency room visits and hospitalizations in patients with stable COPD; this improvement persisted at 12 months.

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Pengaruh Diabetes Self-Management Education and Support (DSME/S) Terhadap Kualitas Hidup pada Pasien Diabetes Melitus Tipe 2

Pustaka Kesehatan ◽

10.19184/pk.v6i3.11688 ◽

2018 ◽

Vol 6 (3) ◽

pp. 453

Author(s):

Anis Fitri Nurul Anggraeni ◽

Rondhianto Rondhianto ◽

Peni Perdani Juliningrum

Keyword(s):

Quality Of Life ◽

Treatment Group ◽

Management Education ◽

Self Care ◽

Self Management ◽

Control Group ◽

Type 2 Dm ◽

Post Test

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

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Effect of Counseling on Quality of Life and Self-Care Agency for Patients Who are Scheduled for Total Knee Replacement

Clinical Nursing Research ◽

10.1177/10547738211058985 ◽

2021 ◽

pp. 105477382110589

Author(s):

Çiğdem Kaya ◽

Özlem Bilik

Keyword(s):

Quality Of Life ◽

Total Knee Replacement ◽

Knee Replacement ◽

Intervention Group ◽

Self Care ◽

Control Group ◽

Face To Face ◽

Total Knee ◽

Care Agency

This study aims to determine the effect of counseling on quality of life and self-care agency for patients who are scheduled for total knee replacement (TKR). The study has a quantitative and quasi-experimental design with a control group. The patients in the control group ( n = 40) received routine care. Face-to-face and telephone counseling was offered to individuals in the intervention group ( n = 39). The data was collected at face-to-face interviews by using a patient characteristics form, Quality of Life Scale, and Self-Care Agency Scale. The scores for quality of life and self-care agency in the 6th to 8th and 14th to 16th weeks after surgery were very significantly higher in the intervention group than in the control group ( p < .001). This study shows that counseling given by the nurse increases the quality of life and self-care agency of patients undergoing TKR.

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Pengaruh Diabetes Self Management Education and Support (DSME/S) terhadap Diabetes Distress pada Pasien Diabetes Melitus Tipe 2 di RSD dr. Soebandi Jember (The Effect of Diabetes Self Management Education and Support [DSME/S] on Diabetes Distress in Patie

Pustaka Kesehatan ◽

10.19184/pk.v6i1.6868 ◽

2018 ◽

Vol 6 (1) ◽

pp. 133

Author(s):

Novita Nurkamilah ◽

Rondhianto Rondhianto ◽

Nur Widayati

Keyword(s):

Diabetes Mellitus ◽

Management Education ◽

Intervention Group ◽

Self Care ◽

T Test ◽

Self Management ◽

Diabetes Distress ◽

Control Group ◽

Significant Difference

Diabetes Mellitus (DM) is a chronic disease that requires a continous self-care. A low level ofknowledge about self-care can worsen health condition and cause diabetes distress. The continuingstress can cause hyperglycemia that lead to complications of DM. DSME/S is a structured healtheducation that facilitates DM patients in implementing and maintaining their behavior for sustainableself-care. This research aimed to analyze the effect of DSME/S on diabetes distress in patients withtype 2 DM. This research was quasi experimental with non randomized control group pretestposttest design. Thirty respondents in this study were divided into 15 respondents as theintervention group and 15 respondents as the control group by consequtive sampling technique.DSME/S was conducted in 6 sessions: 4 sessions in the hospital and 2 sessions at respondent'shouse. The data were analyzed by using dependent t test and independent t test with significancelevel of 0.05. The result of dependent t test revealed a significant difference of diabetes distressbetween pretest and posttest both in the intervention group (p=0.001) and in the control group(p=0.046). Furthermore, independent t test showed a significant difference between interventiongroup and control group (p=0.001). The decrease of diabetes distress was higher in the interventiongroup than control group. This result indicates that there was a significant effect of DSME/S ondiabetes distress in patients with type 2 DM. Nurses are expected to apply DSME/S as a dischargeplanning to reduce diabetes distress in patients with type 2 DM.Keywords: diabetes distress, DSME/S, Diabetes Mellitus

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The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial (Preprint)

10.2196/preprints.15323 ◽

2019 ◽

Author(s):

Thomas Timmers ◽

Loes Janssen ◽

Walter van der Weegen ◽

Dirk Das ◽

Willem-Jan Marijnissen ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Physical Functioning ◽

Postoperative Care ◽

Intervention Group ◽

Self Care ◽

Self Management ◽

Health Care Consumption ◽

Perceived Involvement

BACKGROUND Patients who undergo primary Total Knee Replacement surgery (TKR) are often discharged within 1-3 days after surgery. With this relatively short length of hospital stay, a patient’s self-management is a crucial factor in optimizing the outcome of their treatment. In the case of TKR, self-management primarily involves adequate pain management, followed by physiotherapy exercises and daily self-care activities. Patients are educated on all these topics by hospital staff upon discharge from the hospital but often struggle to comprehend this information due to its quantity, complexity, and the passive mode of communication used to convey it. OBJECTIVE This study primarily aims to determine whether actively educating TKR patients with timely, day-to-day postoperative care information through an app could lead to a decrease in their level of pain compared to those who only receive standard information about their recovery through the app. In addition, physical functioning, quality of life, ability to perform physiotherapy exercises and daily self-care activities, satisfaction with information, perceived involvement by the hospital, and health care consumption were also assessed. METHODS A multicenter randomized controlled trial was performed in five Dutch hospitals. In total, 213 patients who had undergone elective, primary, unilateral TKR participated. All patients had access to an app for their smartphone and tablet to guide them after discharge. The intervention group could unlock day-to-day information by entering a personal code. The control group only received weekly, basic information. Primary (level of pain) and secondary outcomes (physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption) were measured using self-reported online questionnaires. All outcomes were measured weekly in the four weeks after discharge, except for physical functioning and quality of life, which were measured at baseline and at four weeks after discharge. Data was analyzed using Student <italic>t</italic> tests, chi-square tests, and linear mixed models for repeated measures. RESULTS In total, 114 patients were enrolled in the intervention group (IG) and 99 in the control group (CG). Four weeks after discharge, patients in the IG performed significantly better than patients in the CG on all dimensions of pain: pain at rest (mean 3.45 vs mean 4.59; <italic>P</italic>=.001), pain during activity (mean 3.99 vs mean 5.08; <italic>P</italic><.001) and pain at night (mean 4.18 vs mean 5.21; <italic>P</italic>=.003). Additionally, significant differences were demonstrated in favor of the intervention group for all secondary outcomes. CONCLUSIONS In the four weeks following TKR, the active and day-to-day education of patients via the app significantly decreased their level of pain and improved their physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption compared to standard patient education. Given the rising number of TKR patients and the increased emphasis on self-management, we suggest using an app with timely postoperative care education as a standard part of care. CLINICALTRIAL Netherlands Trial Register NTR7182; https://www.trialregister.nl/trial/6992

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The Effect of Self-Care Education on the Quality of Life in Patients with Pulmonary Tuberculosis

Medical - Surgical Nursing Journal ◽

10.5812/msnj.108877 ◽

2020 ◽

Vol 9 (2) ◽

Author(s):

Maryam Abiz ◽

Hasan Robabi ◽

Alireza Salar ◽

Farshid Saeedinezhad

Keyword(s):

Quality Of Life ◽

Statistical Tests ◽

Intervention Group ◽

Self Care ◽

T Test ◽

Control Group ◽

Care Education ◽

Significant Difference ◽

Quasi Experimental

Background: Tuberculosis (TB) affects various aspects of quality of life (QoL), and self-care is the most important form of primary care and one of the main factors involved in the process of treating chronic diseases and improving the patients’ QoL. Objectives: This study aimed to investigate the effect of self-care education on the QoL of TB patients. Methods: In this quasi-experimental study, 110 TB patients referred to the TB coordinating Center in Zahedan, Southeastern Iran, in 2018, are studied. Participants were selected using convenience sampling and were randomly assigned to the intervention (n = 55) and control (n = 55) groups. Data were collected using the tuberculosis quality of life-version 2 (TBQol-v2). For the intervention group, first, patients and their caregivers were divided into groups compromising of 4 to 6 members, and then three sessions of self-care education, including lectures and questions and answers meetings, each lasted for 30 minutes (in total 90 minutes) were provided to each group. Data were analyzed in SPSS version 21 using descriptive statistical tests, independent t-test, paired t-test, and chi-squared test. Results: Mean of the total QoL score of the two groups before the intervention was 67.56 ± 5.99 and 67.09 ± 5.03, respectively, indicating no significant difference (P = 0.65). But after providing the intervention, the mean score of patients QoL in the intervention group (74.84 ± 4.90) was significantly higher than the control group (67.98 ± 0.68) (P = 0.001). Conclusions: Since self-care education can effectively enhance the QoL of TB patients, it is recommended to provide such educations for both treatment and follow-up of these patients along with directly observed treatment, short-course (DOTS).

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Quality of Life of Diabetic Foot Ulcer Patients with Hyperbaric Oxygen Therapy

Folia Medica Indonesiana ◽

10.20473/fmi.v55i2.14344 ◽

2019 ◽

Vol 55 (2) ◽

pp. 127

Author(s):

Kusnanto Kusnanto ◽

Dismalyansa Dismalyansa ◽

Retnayu Pradanie ◽

Hidayat Arifin

Keyword(s):

Quality Of Life ◽

Hyperbaric Oxygen ◽

Diabetic Foot ◽

Intervention Group ◽

Foot Ulcer ◽

Foot Ulcers ◽

Rank Test ◽

Control Group ◽

Signed Rank Test

DM with ulcer can result in a decrease in the quality of life of patients and need to reduce the intensity of pain and odor on the ulcer, preventing amputation and Hyperbaric Oxygen as an adjuvant therapy in accelerating wound healing. This study aims to explain the effect of HBO on the quality of life of patients with diabetic foot ulcers at RSAL Dr. Ramelan Surabaya. Methods: The research used quasi-experimental design with a non-equivalent control group design approach. The samples were 70 patients from population of all diabetes patients who suffered from diabetic foot ulcers at RSAL Dr. Ramelan. Data were collected by WHOQOL-BREF questionnaire. Analyzed byWilcoxon signed rank test and Mann Whitney U test. Result: Mann Whitney in the post test, the physical p-value domain (0.000), psychological domain (0.012), social domain (0.003), and environmental domain (0,001), where the intervention group has a better value than the control group. Wilcoxon signed rank test results on the physical domain (0,000), psychological (0,012), social (0,003), and environmental (0,001), meaning there were significant differences between pre post test in intervention group. Discussion: Diabetes mellitus patients with foot ulcers given hyperbaric oxygen showed improvement on wound condition, thus reducing pain and medical needs. This makes patients motivated, reduce anxiety, and improve interpersonal support and confidence. Therefore, it is necessary to socialize the effect of HBO on DM patients with foot ulcer, as a treatment option in improving the quality of life of DM patients with foot ulcers.

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Mobile Health App With Social Media to Support Self-Management for Patients With Chronic Kidney Disease: Prospective Randomized Controlled Study (Preprint)

10.2196/preprints.19452 ◽

2020 ◽

Author(s):

Wen-Yi Li ◽

Fu-Chun Chiu ◽

Jyun-Kai Zeng ◽

Yao-Wei Li ◽

Su-Hua Huang ◽

...

Keyword(s):

Quality Of Life ◽

Social Media ◽

Kidney Disease ◽

Health Management ◽

Intervention Group ◽

Wearable Devices ◽

Self Management ◽

Control Group ◽

Management Platform

BACKGROUND Chronic kidney disease (CKD) is a global health burden. Self-management plays a key role in improving modifiable risk factors. OBJECTIVE The aim of this study was to evaluate the effectiveness of wearable devices, a health management platform, and social media at improving the self-management of CKD, with the goal of establishing a new self-management intervention model. METHODS In a 90-day prospective experimental study, a total of 60 people with CKD at stages 1-4 were enrolled in the intervention group (n=30) and control group (n=30). All participants were provided with wearable devices that collected exercise-related data. All participants maintained dietary diaries using a smartphone app. All dietary and exercise information was then uploaded to a health management platform. Suggestions about diet and exercise were provided to the intervention group only, and a social media group was created to inspire the participants in the intervention group. Participants’ self-efficacy and self-management questionnaire scores, Kidney Disease Quality of Life scores, body composition, and laboratory examinations before and after the intervention were compared between the intervention and control groups. RESULTS A total of 49 participants completed the study (25 in the intervention group and 24 in the control group); 74% of the participants were men and the mean age was 51.22 years. There were no differences in measured baseline characteristics between the groups except for educational background. After the intervention, the intervention group showed significantly higher scores for self-efficacy (mean 171.28, SD 22.92 vs mean 142.21, SD 26.36; P<.001) and self-management (mean 54.16, SD 6.71 vs mean 47.58, SD 6.42; P=.001). Kidney Disease Quality of Life scores were also higher in the intervention group (mean 293.16, SD 34.21 vs mean 276.37, SD 32.21; P=.02). The number of steps per day increased in the intervention group (9768.56 in week 1 and 11,389.12 in week 12). The estimated glomerular filtration rate (eGFR) of the intervention group was higher than that of the control group (mean 72.47, SD 24.28 vs mean 59.69, SD 22.25 mL/min/1.73m2; P=.03) and the decline in eGFR was significantly slower in the intervention group (–0.56 vs –4.58 mL/min/1.73m2). There were no differences in body composition between groups postintervention. CONCLUSIONS The use of wearable devices, a health management platform, and social media support not only strengthened self-efficacy and self-management but also improved quality of life and a slower eGFR decline in people with CKD at stages 1-4. These results outline a new self-management model to promote healthy lifestyle behaviors for patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04617431; https://www.clinicaltrials.gov/ct2/show/NCT04617431

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