Effect of a participatory patient education programme (NExt EDucation) in group-based patient education among Danes with type 2 diabetes

Abstract

Objective To assess the effect of a participatory group-based education programme for individuals with type 2 diabetes, Next Education. Method In a quasi-experimental study, individuals with type 2 diabetes were recruited from 14 Danish municipalities with a patient education programme. Eight municipalities using Next Education were intervention sites; six control sites used usual group-based education programmes. Data were collected through questionnaires at baseline and at 3 and 12 months after programmes ended. Changes in quality of life (EQ-5D-5L), diabetes-related emotional distress (PAID-5), physical activity, diet, foot care and sense of coherence (SOC-13) were assessed in generalised linear mixed models. Results At baseline, 310 participants (52.6% females, mean age 62.5 years [SD = 10.7] and a mean duration of type 2 diabetes of 6.9 years [SD = 8.4]) participated in Next Education ( n = 234) or group-based education ( n = 76) at control sites. Compared with participants at control sites, participants at intervention sites had significantly larger sense of coherence scores at 3 (9.4%, p = 0.03) and 12 (9.8%, p = 0.02) months of follow-up. Other measures did not differ significantly between groups. Discussion It is likely that person-centeredness and high degrees of user participation at the intervention sites improved sense of coherence among Danes with type 2 diabetes.

Impact of patient‐centred diabetes self‐management education targeting people with type 2 diabetes: an integrative review

“…Patient‐reported outcome measures reported in quantitative studies included diabetes distress ( n =3), the Summary of Diabetes Self‐Care Activities measure (SDSCA; n =3), the Diabetes Empowerment Scale (DES; n =3) and quality of life ( n =4), assessed using four different scales: the visual analogue scale , Diabetes Quality of Life (DQOL) , the six‐dimension health state short form (SF‐6D) and the five‐level EuroQol five‐dimensional questionnaire (EQ‐5D‐5L) (Table 2). There was some consistency in the use of patient‐reported outcomes across the included studies, with a focus on self‐efficacy and quality of life; however, there was limited consistency in terms of specific patient‐reported outcome measures used in the studies; for example, four studies measuring quality of life used four different scales .…”

“…One report included several theoretical frameworks, such as Leventhal’s common sense theory, the dual process theory and social learning theory , and another described the study’s theoretical foundation as Hernandez’s theory of integration of the personal understanding of type 2 diabetes, illness integration and turning points in type 2 diabetes (Table 4). Finally, one report described the theoretical model ‘The Balancing Person’ as the foundational framework of the intervention . The Balancing Person is a comprehensive health educational model developed for group‐based patient education to address perceived challenges and needs in living with chronic illness .…”

“…Thirteen of the included interventions were group‐based programmes and might have benefited from the unmeasured impact of group dynamics and peer support on outcomes, although the associated reports did not describe group dynamics . Six interventions were framed as individual programmes .…”

“…Another intervention also used a workbook containing information and goal‐setting exercises, a relaxation CD, and a programme overview CD . Another study used 24 dialogue tools in four categories: 1) reflection and experience; 2) motivation and goals; 3) knowledge and learning; and 4) body and senses . Finally, one study used three‐dimensional cubes with visual illustrations of specific diabetes‐related themes to stimulate group discussions, increase understanding of the biological and psychological concepts in diabetes and promote emotional responses to type 2 diabetes .…”

Playing with peers: Exploring peer support mechanisms of a type 2 diabetes-specific board game

“…Peer support is associated with improved diabetes management and psychosocial and physical outcomes, including reduced stress, depression and hospitalisation (Chan et al, 2014; Heisler, 2010). Moreover, people attending diabetes-specific peer support interventions highly value exchanging experiences with their peers (Christoffersen et al, 2018; Jensen et al, 2019) and may benefit as much from providing social support as from receiving it (Heisler, 2010). In general, participants appreciate peer interactions in educational group programs (Stenov et al, 2016).…”