Lasting impact of an implemented self-management programme for people with type 2 diabetes referred from primary care: a one-group, before–after design
Engelsk titel: Lasting impact of an implemented self-management programme for people with type 2 diabetes referred from primary care: a one-group, before–after design
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Författare:
Flöde, Mari
;
Iversen, Marjlein M
;
Aarflot, Morten
;
Haltbakk, Johannes
Email: Johannes.Haltbakk@hib.no
Språk: Eng
Antal referenser: 23
Dokumenttyp:
Artikel
UI-nummer: 18030163
Sammanfattning
Background: Research interventions in uniform clinical settings and in patients fulfilling well-defined inclusion criteria might show a more pronounced effect than implementing the same intervention in existing practice. Diabetes Self-Management Education (DSME) is complex, and should be assessed in existing practice as it is an intervention widely implemented.
Objectives: To examine the impact of an established group-based DSME in unselected people with type 2 diabetes referred from primary care.
Method: A one-group, before–after design was used for assessments before, immediately after, and 3 months after participation in a group-based DSME programme conducted at two Learning and Mastering Centres in Norway between November 2013 and June 2014. Participants completed a questionnaire before (n = 115), immediately after (n = 95) and 3 months after (n = 42) the DSME programme. Primary outcome measure was diabetes knowledge (Michigan Diabetes Knowledge Test). Also patient activation (Patient Activation Measure [PAM]) and self-efficacy (General Self-Efficacy scale [GSE]) were measured. Changes in outcome measures were analysed using paired t-tests for normally distributed data and Wilcoxon signed-rank test for skewed data.
Results: Mean knowledge improved significantly from baseline (p < 0.001). Changes persisted at the 3-month assessment. Mean PAM scores improved significantly from baseline (p < 0.001), and changes persisted for 3 months. Mean GSE scores improved from baseline (p = 0.022) and persisted for 3 months. However, when results were stratified for participants who responded at all three time points, GSE showed no change during the study period.
Conclusion: The complexity self-management in the individual is challenging to reflect in DSME. This implemented DSME programme for people with type 2 diabetes improved levels of diabetes knowledge and patient activation, persisting for at least 3 months. Hence, the DSME programme appears to be robust beyond standardised research settings, in educating unselected diabetes patients referred from primary care. Published by arrangement with John Wiley & Sons.