金氏目标达成理论对新诊断 2 型糖尿病患者血糖管理的有效性:随机对照试验。

IF 5.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Man Yan, Yingchun Yu, Shuping Li, Peiling Zhang, Jiaxiang Yu
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引用次数: 0

摘要

背景:糖尿病是中国乃至全球面临的一项重大公共卫生挑战,预计到 2035 年,患者人数将达到 5.92 亿,其中亚洲的情况尤为严重。仅在中国,估计就有 1.4 亿人患有糖尿病,其中很大一部分人不坚持服药,这凸显了有效管理策略的紧迫性。认识到对新确诊的 2 型糖尿病患者进行早期综合管理的必要性,本研究基于金氏目标达成理论,采用在线回授方法和 "互联网+护理 "平台。该方法旨在加强血糖控制,减少对疾病的恐惧和误解,满足患者的教育和情感需求:本研究的主要目的是评估金氏目标实现理论在管理新诊断的 2 型糖尿病患者方面的有效性。这项研究旨在开发一种血糖管理协作模式,整合医生、护士和患者的专业知识和角色。该模式旨在加强医疗服务的协同作用,确保糖尿病管理的全面性:本研究于 2022 年 1 月至 2023 年 2 月在常州市中医院进行,符合条件的患者被随机分为对照组和在线反馈组。对照组接受标准护理,而在线反馈组则参加以金氏目标达成理论为基础、以 "互联网+护理 "策略为辅助的在线回授项目。这包括目标规划互动平台、视频内容共享、理解能力评估、误解纠正以及由患者主导的疾病信息回顾。通过 "互联网+护理 "平台促进了健康监测。研究重点是比较各组之间葡萄糖代谢和情绪障碍症状的变化,以评估干预的效果:经过 24 周的干预,我们观察到在线反馈组和对照组(各由 60 名参与者组成)在关键指标上存在显著差异。在线反馈组的空腹血浆葡萄糖、餐后 2 小时血糖和血红蛋白 A1c(PConclusions.)均明显下降:以金氏目标达成理论为指导的在线教学-反馈法能有效加强血糖控制,降低新诊断的 2 型糖尿病患者的空腹血浆葡萄糖、餐后 2 小时血糖和血红蛋白 A1c 水平。同时,它还能缓解与低血糖相关的焦虑,减轻自闭症。这种方法值得在临床上广泛推广和实施:中国临床试验注册中心 ChiCTR2400079547; https://www.chictr.org.cn/showproj.html?proj=208223。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of King's Theory of Goal Attainment in Blood Glucose Management for Newly Diagnosed Patients With Type 2 Diabetes: Randomized Controlled Trial.

Background: Diabetes poses a significant public health challenge in China and globally, with the number of patients expected to reach 592 million by 2035, notably in Asia. In China alone, an estimated 140 million individuals are living with diabetes, and a significant portion is nonadherent to medications, underscoring the urgency of effective management strategies. Recognizing the necessity of early and comprehensive management for newly diagnosed patients with type 2 diabetes, this study leverages an online teach-back method and "Internet + Nursing" platform based on King's Theory of Goal Attainment. The approach aims to enhance glycemic control and reduce fear and misconceptions about the disease, addressing both the educational and emotional needs of the patients.

Objective: The primary aim of this study was to assess the effectiveness of King's Goal Attainment Theory in the management of newly diagnosed patients with type 2 diabetes. This research sought to develop a collaborative model for blood glucose management, integrating the expertise and roles of physicians, nurses, and patients. The model is designed to enhance the synergy in health care provision, ensuring a comprehensive approach to diabetes management.

Methods: In this study conducted at Changzhou Traditional Chinese Medicine Hospital between January 2022 and February 2023, eligible patients were randomized into a control group or an online feedback group. The control group received standard care, while the online feedback group participated in a King's Theory of Goal Attainment-based online teach-back program, enhanced by "Internet + Nursing" strategies. This included an interactive platform for goal planning, video content sharing, comprehension assessment, misconception correction, and patient-driven recaps of disease information. Health monitoring was facilitated through the "Internet + Nursing" platform. The study focused on comparing changes in glucose metabolism and emotional disorder symptoms between the groups to evaluate the intervention's effectiveness.

Results: Following a 24-week intervention, we observed significant differences in key metrics between the online feedback group and the control group, each comprising 60 participants. The online feedback group demonstrated significant reductions in fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c (P<.05). Additionally, there was a notable decrease in hypoglycemia-related anxiety and alexithymia within this group. Conversely, the control group maintained relatively higher values for these metrics at the same time point (P<.05). These findings underscore the efficacy of online feedback in managing glycemic control and reducing psychological distress associated with hypoglycemia.

Conclusions: The online teaching-back method, guided by King's Theory of Goal Attainment, effectively enhances glycemic control, reducing fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c levels in newly diagnosed patients with type 2 diabetes. Simultaneously, it alleviates hypoglycemia-related anxiety and mitigates alexithymia. This approach merits widespread promotion and implementation in clinical settings.

Trial registration: Chinese Clinical Trial Registry ChiCTR2400079547; https://www.chictr.org.cn/showproj.html?proj=208223.

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来源期刊
CiteScore
14.40
自引率
5.40%
发文量
654
审稿时长
1 months
期刊介绍: The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades. As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor. Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.
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