Effect of a self-care promoting program on engagement in self-care behaviors and health-related outcomes among persons with type 2 diabetes and diabetic retinopathy: A single-blind randomized controlled trial.

IF 1.1 Q3 NURSING Belitung Nursing Journal Pub Date : 2024-06-28 eCollection Date: 2024-01-01 DOI:10.33546/bnj.3360
Wimol Madit, Teeranut Harnirattisai, Debra Hain, Paul Anton Gaudio
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Abstract

Background: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, leading to visual impairment and eventual blindness. Promoting self-care behaviors is crucial in controlling DR progression and preventing blindness.

Objective: This study aimed to investigate the effects of a Self-Care Promoting Program (SCPP) on engagement in self-care behaviors, HbA1c levels, visual acuity (VA), severity of DR, and vision-related quality of life (VRQoL) among individuals with type 2 diabetes and DR.

Methods: This study employed a single-blind randomized controlled trial design to compare SCPP with conventional diabetic care interventions (standard care). The SCPP was based on the Self-Care of Chronic Illness Theory, Self-efficacy theory, and the Association of Diabetic Care and Education Specialist (ADCES) guidelines incorporating health education, self-care maintenance, monitoring, and management skills training over 12 weeks. Ninety-eight participants were randomly allocated to the experimental or control group (n = 49 per group). While the experimental group received SCPP alongside standard care, the control group received standard care alone. Data collection occurred between May 2022 and March 2023 and included demographic information, the Self-Care of Diabetes Index questionnaire (SCODI), the self-care for diabetes eye care questionnaire (SCFDE), the impact of visual impairment questionnaire (IVI-Thai version), and retinal images for DR severity grading. Data analysis utilized descriptive statistics, Chi-Square tests, t-tests, and MANOVA.

Results: Following 8 and 16 weeks of SCPP, the experimental group had significantly higher mean scores in engagement with self-care and eye-care behaviors compared to the control group (p <0.001). The highest scores were observed in self-care and eye-care confidence behaviors, followed by maintenance, monitoring, and management. Furthermore, HbA1c levels and VRQoL significantly decreased and were lower than those of the control group at week 16 (p <0.001 and p <0.05, respectively). However, there were no significant differences in VA, and DR severity increased in both groups by week 16.

Conclusion: SCPP benefits individuals with DR, enhancing their confidence and ability to perform, monitor, and manage self-care behaviors. These strategies contribute to improved diabetes management, enhanced quality of life, and reduced DR-related blindness. Integrating SCPP into routine DR management is recommended, with nurses playing a pivotal role in overseeing and driving this integration, highlighting the critical role of nurses in managing this widespread global disease.

Trial registry number: Thai Clinical Trials Registration (TCTR20230302002).

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自我护理促进计划对 2 型糖尿病和糖尿病视网膜病变患者参与自我护理行为和健康相关结果的影响:单盲随机对照试验。
背景:糖尿病视网膜病变(DR)是糖尿病最常见的微血管并发症,可导致视力损害和最终失明。促进自我保健行为对控制糖尿病视网膜病变的发展和预防失明至关重要:本研究旨在探讨自我护理促进计划(SCPP)对 2 型糖尿病和 DR 患者的自我护理行为参与、HbA1c 水平、视力(VA)、DR 严重程度和视力相关生活质量(VRQoL)的影响:本研究采用单盲随机对照试验设计,比较 SCPP 与传统糖尿病护理干预(标准护理)。SCPP以慢性病自我护理理论、自我效能理论和糖尿病护理与教育专家协会(ADCES)指南为基础,结合健康教育、自我护理维护、监测和管理技能培训,为期12周。98 名参与者被随机分配到实验组或对照组(每组 49 人)。实验组在接受标准护理的同时接受 SCPP,而对照组则只接受标准护理。数据收集时间为 2022 年 5 月至 2023 年 3 月,内容包括人口统计学信息、糖尿病自我护理指数问卷(SCODI)、糖尿病眼部自我护理问卷(SCFDE)、视力损伤影响问卷(IVI-泰国版)以及用于 DR 严重程度分级的视网膜图像。数据分析采用了描述性统计、Chi-Square 检验、t 检验和 MANOVA:结果:在接受 8 周和 16 周的 SCPP 治疗后,与对照组相比,实验组在自我护理和护眼行为参与度方面的平均得分明显更高(P P P 结论:SCPP 对 DR 患者有益,并能改善他们的视力:SCPP 能增强 DR 患者的信心,提高他们执行、监控和管理自我护理行为的能力,从而使他们受益。这些策略有助于改善糖尿病管理,提高生活质量,减少与 DR 相关的失明。建议将 SCPP 纳入常规 DR 管理中,护士在监督和推动这一整合中发挥关键作用,这凸显了护士在管理这一广泛存在的全球性疾病中的关键作用:泰国临床试验注册(TCTR20230302002)。
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CiteScore
1.90
自引率
42.90%
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0
审稿时长
12 weeks
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