■糖尿病视网膜病变(DR)是糖尿病最常见的微血管并发症,导致视力障碍和最终失明。促进自我护理行为对于控制DR进展和预防失明至关重要。
■本研究旨在调查自我护理促进计划(SCPP)对参与自我护理行为的影响,HbA1c水平,视敏度(VA),DR的严重程度,2型糖尿病和DR患者的视觉相关生活质量(VRQoL)。
■本研究采用单盲随机对照试验设计,将SCPP与常规糖尿病护理干预措施(标准护理)进行比较。SCPP基于慢性病自我护理理论,自我效能理论,以及纳入健康教育的糖尿病护理和教育专家协会(ADCES)指南,自我护理维护,监测,和管理技能培训超过12周。98名参与者被随机分配到实验组或对照组(每组49名)。虽然实验组在标准护理的同时接受了SCPP,对照组仅接受标准治疗.数据收集发生在2022年5月至2023年3月之间,包括人口统计信息,糖尿病自我护理指数问卷(SCODI),糖尿病眼部护理自我护理问卷(SCFDE),视力障碍问卷的影响(IVI-泰国版),和DR严重程度分级的视网膜图像。数据分析利用描述性统计,卡方检验,t检验,还有MANOVA.
■经过8周和16周的SCPP,与对照组相比,实验组在参与自我护理和眼睛护理行为方面的平均得分显著较高(p<0.001).得分最高的是自我保健和眼睛保健信心行为,其次是维护,监测,和管理。此外,在第16周,HbA1c水平和VRQoL显着降低,并低于对照组(分别为p<0.001和p<0.05)。然而,VA没有显着差异,到第16周,两组的DR严重程度均增加。
■SCPP使患有DR的个人受益,增强他们的信心和执行能力,监视器,管理自我照顾行为。这些策略有助于改善糖尿病管理,提高生活质量,减少DR相关的失明。建议将SCPP集成到常规DR管理中,护士在监督和推动这种整合方面发挥着关键作用,强调护士在管理这一全球性疾病中的关键作用。
■泰国临床试验注册(TCTR20230302002)。
UNASSIGNED: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, leading to visual impairment and eventual blindness. Promoting self-care behaviors is crucial in controlling DR progression and preventing blindness.
UNASSIGNED: This
study aimed to investigate the effects of a Self-Care Promoting Program (SCPP) on engagement in self-care behaviors, HbA1c levels, visual acuity (VA), severity of DR, and vision-related quality of life (VRQoL) among individuals with type 2 diabetes and DR.
UNASSIGNED: This
study employed a single-blind randomized controlled
trial design to compare SCPP with conventional diabetic care interventions (standard care). The SCPP was based on the Self-Care of Chronic Illness Theory, Self-efficacy theory, and the Association of Diabetic Care and Education Specialist (ADCES) guidelines incorporating health education, self-care maintenance, monitoring, and management skills training over 12 weeks. Ninety-eight participants were randomly allocated to the experimental or control group (n = 49 per group). While the experimental group received SCPP alongside standard care, the control group received standard care alone. Data collection occurred between May 2022 and March 2023 and included demographic information, the Self-Care of Diabetes Index questionnaire (SCODI), the self-care for diabetes eye care questionnaire (SCFDE), the impact of visual impairment questionnaire (IVI-Thai version), and retinal images for DR severity grading. Data analysis utilized descriptive statistics, Chi-Square tests, t-tests, and MANOVA.
UNASSIGNED: Following 8 and 16 weeks of SCPP, the experimental group had significantly higher mean scores in engagement with self-care and eye-care behaviors compared to the control group (p <0.001). The highest scores were observed in self-care and eye-care confidence behaviors, followed by maintenance, monitoring, and management. Furthermore, HbA1c levels and VRQoL significantly decreased and were lower than those of the control group at week 16 (p <0.001 and p <0.05, respectively). However, there were no significant differences in VA, and DR severity increased in both groups by week 16.
UNASSIGNED: SCPP benefits individuals with DR, enhancing their confidence and ability to perform, monitor, and manage self-care behaviors. These strategies contribute to improved diabetes management, enhanced quality of life, and reduced DR-related blindness. Integrating SCPP into routine DR management is recommended, with nurses playing a pivotal role in overseeing and driving this integration, highlighting the critical role of nurses in managing this widespread global disease.
UNASSIGNED: Thai Clinical Trials Registration (TCTR20230302002).