Diabetes Self-Management Education in the Home

Abstract

PurposeDiabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients' homes.MethodsBaseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided.ResultsThe biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address. ConclusionsThis project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting.

Diabetes self‐management education exposure and glycated haemoglobin levels among Marshallese participants in a randomized controlled study

“…The lack of variation in attendance within arms suggests that the Adapted‐Family DSME may have improved attendance and, therefore, exposure to the intervention. The increased exposure and effectiveness of the Adapted‐Family DSME are consistent with prior literature showing that culturally adapted models of DSME are often more effective with minority and immigrant populations , and that DSME delivered in the home is effective in improving glycaemic control . Interestingly, retention rates in the study's data collection events were not significantly different, suggesting that retention efforts across arms were consistent and differences in exposure were due to the characteristics of the interventions.…”

Avaliação da visita domiciliar para o empoderamento do autocuidado em diabetes

“…A similar result was found in a study in which the assessed outcome was improvement of self-care practices in patients followed for six months (intervention), compared to the conventional follow-up of health services (control), confirming the beneficial effect of this educational strategy. (7) These results are important for glycemic control and consequently, for the prevention of complications of type 2 diabetes, because self-care practices such as healthy eating and regular practice of physical exercise help in the metabolic control of this chronic health condition. (4) Complementarily, the home environment enabled the assistance to users regarding appropriate decision making for meeting goals in face of their specific needs and social context, which positively influenced self-care practices.…”

“…(4) Complementarily, the home environment enabled the assistance to users regarding appropriate decision making for meeting goals in face of their specific needs and social context, which positively influenced self-care practices. (7,24) Corroborating evidence from the literature, home visits facilitate users' understanding on self-care with diet, physical exercise and weight control by improving their diabetes management continuously. (6,7,24) It is noteworthy that home visits as an educational strategy for adherence to diabetes selfcare practices allows monitoring the performance of the care executed by users and predicting the factors interfering in the development of care for diabetes control.…”

“…(7,24) Corroborating evidence from the literature, home visits facilitate users' understanding on self-care with diet, physical exercise and weight control by improving their diabetes management continuously. (6,7,24) It is noteworthy that home visits as an educational strategy for adherence to diabetes selfcare practices allows monitoring the performance of the care executed by users and predicting the factors interfering in the development of care for diabetes control. (17) Regarding empowerment for self-care practices, the results revealed an increase in the median score The users who participated in home visits increased confidence hence, improved their ability of making informed decisions and developing skills to improve self-care behaviors.…”

“…(2)(3)(4)(5) Home visits provide space for dialogue and qualified listening, since this educational strategy, as a way to empower users for diabetes self-care, allows an approximation to their life reality, and helps them making informed decisions. (5)(6)(7) In this study, was used the empowerment approach in home visits. It is based on behavioral and psychosocial aspects inherent to users' autonomy and abilities to effectively take responsibility for their own care.…”