Volume 3, Issue 3 (Summer 2017 -- 2017)                   JCCNC 2017, 3(3): 205-214 | Back to browse issues page


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1- Department of Health Education and Health Promotion, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran.
2- Department of Public Health, School of Health, Qom University of Medical Sciences and Health Services, Qom, Iran.
3- Department of Health Education and Health Services, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
4- Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
5- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , imanzad96@gmail.com
Abstract:   (5272 Views)
Background: Although compliance with all self-care behaviors is necessary for successful management of diabetes, patients with diabetes often refuse favorable self-care. This article is aimed to test the effects of a theory-related intervention to conduce self-aid adherence and metabolic curb in patients having type-2 diabetes. 
Methods: In this randomized controlled trial, 80 patients suffering from type-2 diabetes were arbitrarily allotted to intervention and control group. The intervention group attended six sessions in a batch and one-on-one consultation and received an education on self-efficacy and outcome expectations on improving the strategies. Self-efficacy, outcome expectations, self-care behaviors and HbA1c were measured and compared in two groups in the starting, after three and six-months of the interventions. “Intention to treat” analysis was used. Data were analyzed using t test and ANOVA for repeated measures.
Results: Mean score of self-efficacy, outcome expectations and self-care behaviors revealed significant differences between two groups in the results of three and six months after the intervention (P < 0.01). A major fall in HbA1c was noted in the intervention group. The mean scores of the HbA1c showed a significant difference between two groups, six months after the intervention (P < 0.05). After the intervention diet, physical activity and foot care improved significantly in the intervention group (P < 0.001). No significant improvement occurred in self-monitoring of blood glucose and medication adherence between two groups after the intervention
Conclusion: It is concluded that implementing educational interventions based on the self-efficacy model and related strategies can be effective for patients with type-2 diabetes and is recommended to be used for patient education in the field of metabolic control.
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Type of Study: Research | Subject: Special
Received: 2017/02/2 | Accepted: 2017/06/13 | Published: 2017/08/1

References
1. Aljasem, L. I. et al., 2001. The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. The Diabetes Educator, 27(3), pp. 393–404. doi: 10.1177/014572170102700309 [DOI:10.1177/014572170102700309]
2. Anderson, R. M. et al., 1995. Patient empowerment: Results of a randomized controlled trial. Diabetes Care, 18(7), pp. 943–9. doi: 10.2337/diacare.18.7.943 [DOI:10.2337/diacare.18.7.943]
3. Bandura, A., 1986. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, Inc.
4. Bandura, A., 1997. Self-efficacy: The exercise of control. New York: Freeman.
5. Bashirian, S., et al., 2012. [Application of theory of planned behavior in predicting factors of substance abuse in adolescents (Persian)]. Journal of Fasa University of Medical Sciences, 2(3), pp. 156-62.
6. Bijl, J. van der, Poelgeest-Eeltink, A. van & Shortridge-Baggett, L., 1999. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing, 30(2), pp. 352–9. doi: 10.1046/j.1365-2648.1999.01077.x [DOI:10.1046/j.1365-2648.1999.01077.x]
7. Brettenthaler, N. et al., 2004. Effect of the insulin sensitizer pioglitazone on insulin resistance, hyperandrogenism, and ovulatory dysfunction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 89(8), pp. 3835–40. doi: 10.1210/jc.2003-031737 [DOI:10.1210/jc.2003-031737]
8. Didarloo, A. R., et al., 2012. Prediction of self-management behavior among Iranian women with type 2 diabetes: Application of the theory of reasoned action along with self-efficacy (etra). Iranian Red Crescent Medical Journal, 14(2), p. 86. [PMID] [PMCID]
9. Eckman, M. H. et al., 2012. Impact of health literacy on outcomes and effectiveness of an educational intervention in patients with chronic diseases. Patient Education and Counseling, 87(2), pp. 143–51. doi: 10.1016/j.pec.2011.07.020 [DOI:10.1016/j.pec.2011.07.020]
10. Franz, M. J., et al., 2004. Nutrition principles and recommendations in diabetes. Diabetes Care, 27, pp. S36-46. PMID: 14693924 [DOI:10.2337/diacare.27.2007.S36] [PMID]
11. Funnell, M. M., 2006. The diabetes attitudes, wishes, and needs (DAWN) study. Clinical Diabetes, 24(4), pp. 154–5. doi: 10.2337/diaclin.24.4.154 [DOI:10.2337/diaclin.24.4.154]
12. Ha, M. et al., 2014. The effects of an educational self-efficacy intervention on osteoporosis prevention and diabetes self-management among adults with type 2 diabetes mellitus. Biological Research For Nursing, 16(4), pp. 357–67. doi: 10.1177/1099800413512019 [DOI:10.1177/1099800413512019]
13. Haghayegh, A. S., Ghasemi, N., Neshatdoost, H.T., Kajbaf, M. and Khanbani, M., 2010. Psychometric properties of Diabetes Management Self-Efficacy Scale (DMSES). Iranian Journal of Endocrinology and Metabolism, 12(2), pp. 111-95.
14. International Diabetes Federation. Diabetes Atlas 2013. Brussels: International Diabetes Federation.
15. Karter, A. J. et al., 2000. Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diabetes Care, 23(4), pp. 477–83. doi: 10.2337/diacare.23.4.477 [DOI:10.2337/diacare.23.4.477]
16. King, D. K. et al., 2010. Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors. Diabetes Care, 33(4), pp. 751–3. doi: 10.2337/dc09-1746 [DOI:10.2337/dc09-1746]
17. Lendemeijer, B. & Shortridge-Baggett, L., 1997. The use of seclusion in psychiatry: A literature review. Scholarly Inquiry for Nursing Practice, 11(4), pp. 299-315. PMID: 9564234 [PMID]
18. Miller, C. K. & Gutschall, M., 2008. A randomized trial about glycemic index and glycemic load improves outcomes among adults with type 2 diabetes. Health Education & Behavior, 36(3), pp. 615–26. doi: 10.1177/1090198108317598 [DOI:10.1177/1090198108317598]
19. Miller, C. K. et al., 2002. Evaluation of a theory-based nutrition intervention for older adults with diabetes mellitus. Journal of the American Dietetic Association, 102(8), pp. 1069–81. doi: 10.1016/s0002-8223(02)90242-7 [DOI:10.1016/S0002-8223(02)90242-7]
20. Moattari, M. et al., 2012. Impact of self management on metabolic control indicators of diabetes patients. Journal of Diabetes & Metabolic Disorders, 11(1), p. 6. doi: 10.1186/2251-6581-11-6 [DOI:10.1186/2251-6581-11-6]
21. Morrish, N. J. et al., 2001. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia, 44(S2), pp. S14–S21. doi: 10.1007/pl00002934 [DOI:10.1007/PL00002934]
22. Nath, C., 2007. Literacy and diabetes self-management. American Journal of Nursing, 107(Supplement), pp. 43–9. doi: 10.1097/01.naj.0000277829.28043.93 [DOI:10.1097/01.NAJ.0000277829.28043.93]
23. Pe-a-Purcell, N. C., Boggess, M. M. & Jimenez, N., 2011. An empowerment-based diabetes self-management education program for Hispanic/Latinos. The Diabetes Educator, 37(6), pp. 770–9. doi: 10.1177/0145721711423319 [DOI:10.1177/0145721711423319]
24. Piccinino, L. et al., 2015. Recent trends in diabetes knowledge, perceptions, and behaviors. Health Education & Behavior, 42(5), pp. 687–96. doi: 10.1177/1090198115577373 [DOI:10.1177/1090198115577373]
25. Reisi, M. et al., 2016. Impact of health literacy, self-efficacy, and outcome expectations on adherence to self-care behaviors in Iranians with type 2 diabetes. Oman Medical Journal, 31(1), pp. 52–9. doi: 10.5001/omj.2016.10 [DOI:10.5001/omj.2016.10]
26. Reisi, M. et al., 2015. Assessment of some predicting factors of self-efficacy in patients with type 2 diabetes. Iranian Journal of Endocrinology and Metabolism, 17(1), pp. 44-52.
27. Roglic, G. et al., 2005. The burden of mortality attributable to diabetes: Realistic estimates for the year 2000. Diabetes Care, 28(9), pp. 2130–5. doi: 10.2337/diacare.28.9.2130 [DOI:10.2337/diacare.28.9.2130]
28. Sherer, M. et al., 1982. The self-efficacy scale: Construction and validation. Psychological Reports, 51(2), pp. 663–71. doi: 10.2466/pr0.1982.51.2.663 [DOI:10.2466/pr0.1982.51.2.663]
29. Shi, Q., Ostwald, S. K. & Wang, S., 2010. Improving glycaemic control self-efficacy and glycaemic control behaviour in Chinese patients with Type 2 diabetes mellitus: randomised controlled trial. Journal of Clinical Nursing, 19(3-4), pp. 398–404. doi: 10.1111/j.1365-2702.2009.03040.x [DOI:10.1111/j.1365-2702.2009.03040.x]
30. Sicree, R., Shaw, J., & Zimmet, P., 2010. The global burden of diabetes: Diabetes and impaired glucose tolerance. Prevalence and Projections. IDF Atlas, pp. 10-104.
31. Sigurðardóttir, Á. K., 2005. Self-care in diabetes: model of factors affecting self-care. Journal of Clinical Nursing, 14(3), pp. 301–14. doi: 10.1111/j.1365-2702.2004.01043.x [DOI:10.1111/j.1365-2702.2004.01043.x]
32. Skelly, A. H. et al., 1995. Self-efficacy and confidence in outcomes as determinants of self-care practices in inner-city, African-American women with non-insulin-dependent diabetes. The Diabetes Educator, 21(1), pp. 38–46. doi: 10.1177/014572179502100107 [DOI:10.1177/014572179502100107]
33. Sorani, M. et al., 2012. Predictors of self-care behaviors of patients with type 2 diabetes. Health System Research, 8, pp. 814-24.
34. Shortridge-Baggett, L. M. & van der Bijl, J. 1996. International collaborative research on management self-efficacy in diabetes mellitus. The Journal of the New York State Nurses Association, 27, 9-14. [PMID]
35. Tan, M. Y. & Magarey, J., 2008. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Patient Education and Counseling, 72(2), pp. 252–67. doi: 10.1016/j.pec.2008.03.017 [DOI:10.1016/j.pec.2008.03.017]
36. Toobert, D. J., Hampson, S. E. & Glasgow, R. E., 2000. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), pp. 943–50. doi: 10.2337/diacare.23.7.943 [DOI:10.2337/diacare.23.7.943]
37. Tuomilehto, J. et al., 2001. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18), pp. 1343–50. doi: 10.1056/nejm200105033441801 [DOI:10.1056/NEJM200105033441801]
38. Van Der Bijl, J. J., & Shortridge-Baggett, L. M., 2001. The theory and measurement of the self-efficacy construct. Scholarly Inquiry for Nursing Practice, 15, pp. 189-207. [PMID]
39. Wild, S. et al., 2004. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care, 27(5), pp. 1047–53. doi: 10.2337/diacare.27.5.1047 [DOI:10.2337/diacare.27.5.1047]
40. World Medical Association., 2001. World medical association declaration of Helsinki, ethical principles for medical research involving human subjects. Bulletin of the World Health Organization, 79(4). PMC: 2566407
41. Wu, S. F., 2007. Effectiveness of self-management for persons with type 2 diabetes following the implementation of a self-efficacy enhancing intervention program in Taiwan (PhD dissertation). Brisbane, Queensland: Queensland University of Technology.
42. Yang, W. et al., 2010. Prevalence of diabetes among men and women in China. New England Journal of Medicine, 362(12), pp. 1090–101. doi: 10.1056/nejmoa0908292 [DOI:10.1056/NEJMoa0908292]
43. Zareban, I. et al., 2013. The effect of education program based on health belief model on decreasing blood sugar levels in diabetic type 2 patients in Zahedan. Health Scope, 2(2), pp. 73–8. doi: 10.17795/jhealthscope-8690 [DOI:10.17795/jhealthscope-8690]
44. Zhou, Y. et al., 2013. Self-care practices of Chinese individuals with diabetes. Experimental and Therapeutic Medicine, 5(4), pp. 1137–42. doi: 10.3892/etm.2013.945 [DOI:10.3892/etm.2013.945]

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