Effectiveness of a patient-centred, empowerment-based intervention programme among patients with poorly controlled type 2 diabetes: A randomised controlled trial

Cheng, Li; Sit, Janet W H; Choi, Kai Chow; Li, Xiaomei; Wu, Yuning; Jiang, Long; Tao, Mei‐Hua

doi:10.1016/j.ijnurstu.2017.10.021

Cited by 44 publications

(70 citation statements)

References 44 publications

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“…Some researchers have noted improved dietary and physical activity (Ekong & Kavookjian, 2016;Swoboda, Miller, & Wills, 2016), and decreased blood glucose levels (Ekong & Kavookjian, 2016), but others found that the effects of motivational interviewing on glycaemic control were not significant (Concert, Burke, Eusebio, Slavin, & Shortridge‐Baggett, 2012). Empowerment‐focused interventions, that is education aligned with an individual's needs and experiences living with type 2 diabetes mellitus, have been found to be effective in improving adherence to diet recommendations and blood glucose self‐monitoring with subsequently lower HbA1C levels for up to 80% of study participants; however, such improvements decrease over time (Cheng et al., 2018;Ebrahimi, Sadeghi, Amanpour, & Vahedi, 2016). Interventions supporting autonomy, such as patient‐centred consultation and personalised physical activity programmes, increase engagement in physical activity and healthy eating behaviours but are inconsistently successful in significantly decreasing HgA1C levels (Vanroy et al., 2017;Varming et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Despins

Wakefield

2020

Journal of Clinical Nursing

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Aims and objectives To describe individuals' with type 2 diabetes mellitus sense‐making of blood glucose data and other influences impacting self‐management behaviour. Background Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self‐management regimens is an ongoing healthcare challenge. Examining individuals’ sense‐making processes can advance staff knowledge of and improve diabetes self‐management behaviour. Design A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self‐management decisions. Methods Sixteen one‐on‐one interviews with adults diagnosed with type 2 diabetes mellitus using a semi‐structured interview guide were conducted from March–May 2018. An inductive–deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self‐Management was used. The consolidated criteria for reporting qualitative research (COREQ) checklist were used in completing this paper. Results Three main themes described participants’ type 2 diabetes mellitus sense‐making and influences on self‐management decisions: classifying blood glucose data, building mental models and making self‐management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. Conclusion Individuals use self‐monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyse the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycaemic data and influences on diabetes self‐management behaviour with periodic reassessment of this understanding can guide the healthcare team in optimising collaborative individualised care plans. Relevance to clinical practice Nurses must assess sense‐making processes in self‐management decisions. Periodic “refresher” diabetes education may be needed for individuals with type 2 diabetes mellitus.

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Section: Introductionmentioning

confidence: 99%

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Despins

Wakefield

2020

Journal of Clinical Nursing

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“…Esse achado foi contrário ao observado na maioria dos estudos, que descrevem prejuízo da memória nesta população (17,69,70) . Entretanto, a maioria dos estudos é desenvolvida em ambiente hospitalar (20) , que atende casos mais graves e com possivelmente maior impacto da DM na cognição. Um aspecto diferencial do nosso estudo foi ter sido desenvolvido em atenção primária, de forma que é possível inferir que os portadores de DM apresentavam uma menor gravidade de doença, e apesar de prejuízos globais e de aspectos específicos de função executiva, esses sujeitos possam estar utilizando de mecanismos compensatórios de reserva cognitiva através de recursos de memória (20,67,71) .…”

Section: Resultados ____________________________________unclassified

“…Na avaliação direta a capacidade funcional do Nos aspectos emocionais, observamos a presença de sintomas depressivos e ansiosos significativamente diferentes quando comparamos diabéticos e controle. Nosso achado vai ao encontro da literatura (20,74) , na qual descreve a presença de quadros depressivos e ansiosos em pacientes com DM (74) . Noriega e cols.…”

Section: Resultados ____________________________________unclassified

“…(2017) reforçaram a importância de pesquisar depressão em DM e ressaltaram a importância da rede social no manejo e controle do quadro de DM. Na mesma direção, Braga e cols (2017) (19) reforçam a necessidade de estratégias para identificação precoce de quadros depressivos, bem como políticas publicas visando estratégias de prevenção de quadros de humor em diabéticos, que levam a piora do prognóstico (18,20) . A presença de depressão associada a DM podem vulnerabilizar a maiores dificuldades no manejo do seu autocuidado, dificuldades de mudança de hábito de vida diária (dieta e atividade física) e pior aderência ao tratamento medicamentoso (19,67,74) .…”

Section: Resultados ____________________________________unclassified

“…Algumas pesquisas apontam para a dificuldade para a valorização, controle e manejo da DM pelos profissionais de saúde, estas muitas vezes, restritas na identificação através de uma simples inspeção, como pé diabético, associadas a feridas com neuropatias, estas identificadas pelas queixas dos pacientes, no entanto, complicações renais, cardiovasculares e psicológicas são subsequentes aos manejos nesses casos (19,20) .…”

Section: Diabetes E Atenção Primáriaunclassified

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Alterações cognitivas, funcionalidade e qualidade de vida de pacientes portadores de Diabetes Mellitus em uma unidade básica de saúde

Oliveira¹

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Effectiveness of a patient-centred, empowerment-based intervention programme among patients with poorly controlled type 2 diabetes: A randomised controlled trial

Cited by 44 publications

References 44 publications

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

Alterações cognitivas, funcionalidade e qualidade de vida de pacientes portadores de Diabetes Mellitus em uma unidade básica de saúde

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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