[Effects of a Steno Diabetes Dialogue Card-Based Intervention on Self-Perceived Health, Health Literacy, and Glycemic Control in Older Adults With Type 2 Diabetes Mellitus Living in the Community].

Abstract

Background: The process of aging is associated with the deterioration of normal body functions as well as lower health awareness due to a reduced ability to acquire and understand health-related information. The subjects of this study were older adults with diabetes mellitus living in community settings. Visual-learning-based Steno diabetes dialogue cards were used to strengthen the learning and knowledge absorption capabilities of the subjects to improve diabetes health knowledge and increase compliance with blood sugar control protocols to achieve blood sugar control goals and delay / reduce the severity of complications.

Purpose: This study was designed to assess the comparative effects of Steno diabetes dialogue cards and conventional health interventions on self-perceived health, health literacy, glycated hemoglobin (HbA1c) level, and fasting blood glucose level in older adults with diabetes.

Methods: An experimental study was conducted in an outpatient clinic of the department of metabolism in a hospital in northern Taiwan. The subjects were randomized into the experimental group (receiving the Steno diabetes dialogue cards intervention) and control group (receiving conventional health education). Individual health education interventions of 15-20 min each were conducted once a month for 3 consecutive months in both groups.

Results: There were 51 subjects in the experimental group and 47 in the control group, with an attrition rate of 10.91%. The changes in the experimental group and the control group before the intervention and three months after the intervention were analyzed, with significant between-group differences found in health literacy and self-perceived health (p < .001). The experimental group's three-month post-test scores were both greater than the pre-test. Significantly, there were significant, positive differences between pre- and post-test values for self-perceived health (p = .005), health literacy (p < .001), glycated hemoglobin (p < .001) and fasting blood glucose (p = .002). Moreover, the improvements were greater in the experimental than the control group.

Conclusions / implications for practice: The individual health education interventions improved glycemic control efficacy in all of the subjects. However, the experimental group showed more significant improvements in all measures. Therefore, Steno diabetes dialogue cards offer a clear benefit in enhancing older adults' knowledge regarding self-glycemic control and improving compliance with disease behaviors.