The Application Of Diabetes Conversation Map Tool Which Based On Empowerment Theory In Health Education Of Insulin Initiation Patients

Objective1To describe the demographic distribution characteristic and the relevant clinical manifestation of insulin initiation patients, to offer the data for education of them.2To evaluate the effect of diabetes conversation map tool in the health education of insulin initiation patients, which on empowerment capabilities, self-care behaviors, hypoglycemia, subcutaneous induration, effect of treatment.MethodsThe research designed in this study is a randomized controlled trial. We chose136type2diabetic inpatients who were the first time to received insulin therapy, coming from Metabolic diseases hospital of Tianjin Medical University from2012October to2013June. After the inclusion and exclusion criteria,124cases of patients were selected, who all use of insulin pen injector4to inject insulin from the same company. Then were randomly divided into two groups:intervention group and control group.In1week,4weeks,24weeks after discharge, by trained investigators’following up. A total of102patients of insulin initiation were randomly divided into two groups. The patients in the control group received routine health education, while intervention group received diabetes conversation map education which based on empowerment theory. All patients received insulin injection as the guidance, ensure that patients can control self injection of insulin when the discharge. We adopt the visit by telephone interview and outpatient visits combined in order to understand the patient’s disease control and guide the patients. The fasting blood glucose,2hour postprandial blood glucose, HbA1c, incidence of adverse effect, empowerment ability and self-care behaviors were measured and compared between the two groups after the intervention. All data were analyzed by SPSS16.0statistical software.Results1General patients information:enrolled124patients, of which10cases were lost,12patients stopped in the middle of the treatment during the therapy visits period. Among the enrolled102cases there are52male patients and50female ones, aged from22to67years old, with a disease duration from0to23years. Their education level:22with junior middle school diploma and38from high school and technical secondary school,27college ones and25cases up to universities and higher education. The102patients were randomly divided into a control group of56patients and a intervention group of46cases. By comparison, the differences between the two sets of general information including gender, age, disease duration, education level, total insulin dose, frequency of injections was not statistically significant (P>0.05), which indicates the experimental statistics are comparable.2The assessment of the patient empowerment ability:The mean scores of empowerment ability is3.92±0.98.The empowerment ability of receiving the two former groups of insulin injections education had no significant difference.24weeks after the education, the scores of the follow-up intervention group is higher than the control group. The difference was statistically significant (P<0.05).3The assessment of the patient self-care behaviors:The mean scores of self-care behaviors is78.67±14.65. The self-care ability scores of the two groups before accepted insulin injections education had no significant differences,24weeks after the education the follow-up intervention group scored higher than the previous in self-care education, and the difference was statistically significant (P<0.05); the sores of blood glucose monitoring test and sport management showed great difference before education and after education.4The assessment of biochemical parameters:24weeks after the education, two groups of FBG, P2BG, HbAlc all decreased compared with former, among which the intervention group decreased more significantly.5The frequency of adverse events after insulin injections:the frequency of hypoglycemia, and the frequency of subcutaneous induration in the intervention group were lower than the control group, and the rest was not statistically significant.Conclusion1In the study, insulin initiation patients which with an averge50.12years of age, averge education level was senior middle school, and averge course of diabetes is 11.5years. The premixed insulin were prescribed for them frequently, infection times usually were2-3times, therapeutic program often chose infection2times premixed insulin per day.2In the study, insulin initiation patients have a poor situation of blood glucose control, the scores of empowerment ability is above medium level, while the scores of self-care ability is the medium level.3The diabetes conversation map tool which based on empowerment thoery can improve the abilities of empowermet and self-care for insulin initiation patients, and improve the effect of treament, reduce the frequency of adverse events after insulin injections.