{"title":"患者激活定制干预对2型糖尿病自我管理和临床结果的影响:一项来自沙特阿拉伯初级保健机构的研究","authors":"Nasser Almutairi, Vinod Gopaldasani, Hassan Hosseinzadeh","doi":"10.1155/2023/2074560","DOIUrl":null,"url":null,"abstract":"<i>Background</i>. Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual’s knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia. <i>Method</i>. A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants’ patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample <span><svg height=\"8.02022pt\" style=\"vertical-align:-0.2063999pt\" version=\"1.1\" viewbox=\"-0.0498162 -7.81382 4.54925 8.02022\" width=\"4.54925pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g></svg>-</span>test for scale variables, and Wilcoxon’s signed-rank test for categorical variables were used for data analysis. <i>Results</i>. A total of 82 patients, mostly female (61%) with a mean age of <span><svg height=\"8.69875pt\" style=\"vertical-align:-0.3499298pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 32.221 8.69875\" width=\"32.221pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,6.24,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,12.48,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,15.444,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,24.59,0)\"></path></g></svg><span></span><svg height=\"8.69875pt\" style=\"vertical-align:-0.3499298pt\" version=\"1.1\" viewbox=\"35.076183799999995 -8.34882 15.711 8.69875\" width=\"15.711pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,35.126,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,41.368,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.332,0)\"><use xlink:href=\"#g113-58\"></use></g></svg></span> years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>),</span></span> hemoglobin A1c (HbA1c) from 8.38 to 7.55 (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>),</span></span> and body mass index (BMI) from 30.90 to 29.16 (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>).</span></span> Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>)</span></span> and DKT from 6.29 to 7.22 (<span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 21.921 11.7782\" width=\"21.921pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>).</span></span> <i>Conclusion</i>. Our findings suggested that tailoring interventions based on patients’ activation levels is more likely to yield promising T2DM self-management and clinical outcomes.","PeriodicalId":15576,"journal":{"name":"Journal of Diabetes Research","volume":"297 8","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings\",\"authors\":\"Nasser Almutairi, Vinod Gopaldasani, Hassan Hosseinzadeh\",\"doi\":\"10.1155/2023/2074560\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Background</i>. Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual’s knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia. <i>Method</i>. A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants’ patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample <span><svg height=\\\"8.02022pt\\\" style=\\\"vertical-align:-0.2063999pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -7.81382 4.54925 8.02022\\\" width=\\\"4.54925pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g></svg>-</span>test for scale variables, and Wilcoxon’s signed-rank test for categorical variables were used for data analysis. <i>Results</i>. A total of 82 patients, mostly female (61%) with a mean age of <span><svg height=\\\"8.69875pt\\\" style=\\\"vertical-align:-0.3499298pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 32.221 8.69875\\\" width=\\\"32.221pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,6.24,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,12.48,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,15.444,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,24.59,0)\\\"></path></g></svg><span></span><svg height=\\\"8.69875pt\\\" style=\\\"vertical-align:-0.3499298pt\\\" version=\\\"1.1\\\" viewbox=\\\"35.076183799999995 -8.34882 15.711 8.69875\\\" width=\\\"15.711pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,35.126,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,41.368,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.332,0)\\\"><use xlink:href=\\\"#g113-58\\\"></use></g></svg></span> years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"></path></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 28.184 11.7782\\\" width=\\\"28.184pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.289,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>),</span></span> hemoglobin A1c (HbA1c) from 8.38 to 7.55 (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-113\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 28.184 11.7782\\\" width=\\\"28.184pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.289,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>),</span></span> and body mass index (BMI) from 30.90 to 29.16 (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-113\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 28.184 11.7782\\\" width=\\\"28.184pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.289,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>).</span></span> Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-113\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 28.184 11.7782\\\" width=\\\"28.184pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.289,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>)</span></span> and DKT from 6.29 to 7.22 (<span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.34882 18.973 11.7782\\\" width=\\\"18.973pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-113\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.342,0)\\\"></path></g></svg><span></span><span><svg height=\\\"11.7782pt\\\" style=\\\"vertical-align:-3.42938pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.555183800000002 -8.34882 21.921 11.7782\\\" width=\\\"21.921pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.605,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,28.845,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,31.809,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.049,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>).</span></span> <i>Conclusion</i>. Our findings suggested that tailoring interventions based on patients’ activation levels is more likely to yield promising T2DM self-management and clinical outcomes.\",\"PeriodicalId\":15576,\"journal\":{\"name\":\"Journal of Diabetes Research\",\"volume\":\"297 8\",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2023-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/2074560\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/2074560","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings
Background. Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual’s knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia. Method. A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants’ patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample -test for scale variables, and Wilcoxon’s signed-rank test for categorical variables were used for data analysis. Results. A total of 82 patients, mostly female (61%) with a mean age of years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 (), hemoglobin A1c (HbA1c) from 8.38 to 7.55 (), and body mass index (BMI) from 30.90 to 29.16 (). Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) () and DKT from 6.29 to 7.22 ().Conclusion. Our findings suggested that tailoring interventions based on patients’ activation levels is more likely to yield promising T2DM self-management and clinical outcomes.
期刊介绍:
Journal of Diabetes Research is a peer-reviewed, Open Access journal that publishes research articles, review articles, and clinical studies related to type 1 and type 2 diabetes. The journal welcomes submissions focusing on the epidemiology, etiology, pathogenesis, management, and prevention of diabetes, as well as associated complications, such as diabetic retinopathy, neuropathy and nephropathy.