| ObjectiveTo explore the effects of health education based on the integrated theory of health behavior change on self-management behavior,self-efficacy,social support,self-perceived burden,quality of life and clinically relevant biochemical indicators in middle-aged patients with type 2 diabetes mellitus.MethodsThere are 86 middle-aged patients with type 2 diabetes who were hospitalized in the department of endocrinology,grade a tertiary hospital of Tianjin from June 2019 to December2019 and met the admission criteria were selected as subjects.In the control group,The type2 patients at middle age were given routine nursing measures and health education,while in the intervention group,health education based on the integrated theory of health behavior change was implemented in addition to routine nursing measures.This study adopts the special self-management behavior questionnaire for diabetes,self-efficacy questionnaire for diabetes,self-perceived burden scale,social support rating scale and diabetes quality of life questionnaire to measure the corresponding outcomes of two groups at intervention beginning,intervention 4 weeks and intervention.At the same time,demographic and disease-related data of the patients were collected before the intervention.The relevant biochemical indicators blood such BMI,fasting blood glucose were identical collected at above three time points.The glycosylated hemoglobin were measured at beginning and ending.The research data was entered in the form of double check to ensure the accuracy of the entered experimental data.SPSS 25.0 statistical software is used for data processing and analysis.The measurement data that conforms to the normal distribution are described using the mean and standard deviation.The Enumeration data for the skewed distribution are described using frequency and percentage.The main statistical analysis involves chi-square test,two independent samples t-test,one-way analysis of variance,and repeated measurement.The two-sided test P <0.05 indicated that the difference was statistically significant.The paired t test was used to compare the differences within the group.Because three paired ttests were required,thus p<0.017 indicates that the difference is statistically significant.ResultsA total of 86 subjects were included in this study,43 in each group.At the end of the intervention,a total of 81 patients completed the in-hospital intervention and follow-up intervention.Two cases in the intervention group,a total of 41 cases in end,and three cases were lost in the control group,a total of 40 cases.There was no significant difference in general demographic data between the two groups before the intervention.The scores of self-management behavior including all dimension,self-efficacy,self-perceived burden,social support level,quality of life of all dimensions and clinical biochemical indicators were not significantly different.After 4 weeks of intervention,the intervention group’s self-management behavior score was(97.27±5.21),which was higher than that of the control group(82.58±4.42).After 12 weeks of intervention,the intervention group’s self-management behavior score was(103.46±7.52),high.Patients in the control group scored(72.65±5.60),and the difference was statistically significant(P<0.05).Repeated measures analysis of variance showed that the total score of self-management behavior of the two groups of patients was statistically significant in the main effect of intervention,the main effect of time,and the interaction effect(P<0.05).The comparison results within the group showed that the self-management behavior scores of the intervention group patients were statistically significant at different time points(P<0.017).The self-management behavior scores of the control group patients were higher than before the intervention after 4 weeks,but The score after 12 weeks of intervention was lower than that of 4 weeks of intervention,the difference was statistically significant(P<0.017),and the difference between 12 weeks of intervention and before intervention was not statistically significant(P>0.017).After 4 weeks of intervention,the self-efficacy score of the patients in the intervention group was(47.83±3.70),and the score of the patients in the control group was(41.48±4.99).After 12 weeks of intervention,the self-efficacy score of the patients in the intervention group was(52.19±3.94),which was higher than Patients in the control group scored(41.50±5.04),and the difference was statistically significant(P<0.05).Repeated measurement analysis of variance showed that the total self-efficacy scores of the two groupsof patients were statistically significant in the main effect of intervention,the main effect of time,and the interaction effect(P<0.05).The comparison results within the group showed that the self-efficacy scores of the intervention group patients were statistically significant at different time points(P<0.017).The self-efficacy scores of the control group patients were higher after 4 weeks of intervention and 12 weeks after intervention.Before the intervention,the difference was statistically significant(P<0.017),and there was no significant difference between the 12-week intervention and the 4-week intervention(P>0.017).After 4 weeks of intervention,the self-perceived burden score of the intervention group was(26.93±3.60),which was lower than that of the control group(29.08±3.04).After 12 weeks of intervention,the self-perceived burden score of the intervention group was(25.46±3.43),low.Patients in the control group scored(29.80±3.65),and the difference was statistically significant(P<0.05).Analysis of repeated measures of variance showed that the total score of self-perceived burden of the two groups of patients was statistically significant in the main effect of intervention,the main effect of time,and the interaction effect(P<0.05).The comparison results within the group showed that the self-perceived burden score of the intervention group had statistically significant differences between groups at each time point(P<0.017).The self-perceived burden score of the control group was 4 weeks before the intervention,12 weeks before the intervention,and The difference at 4 weeks of intervention was statistically significant(P<0.017),and there was no significant difference in scores at 12 weeks of intervention and before and after intervention(P>0.017).After 4 weeks of intervention,the social support score of the patients in the intervention group was(40.54±3.70),and that of the patients in the control group(37.21±3.17).After 12 weeks of intervention,the social support score of the patients in the intervention group was(41.97±3.60),which was higher than the control Patients in the group scored(35.93±3.39),and the difference was statistically significant(P<0.05).Analysis of repeated measures analysis of variance showed that the total social support scores of the two groups of patients were significantly different in intervention main effect,time main effect and interaction effect(P<0.05).The comparison results within the group showed that the social support scores of the patients in the intervention group were statistically significant at different time points(P<0.017).The social support scores of patients in the control group were significantlydifferent after 4 weeks of intervention,before intervention,12 weeks of intervention,and 4weeks of intervention(P<0.017),and there was no significant difference in scores of 12 weeks of intervention and before and after intervention(P>0.017).After 4 weeks of intervention,the quality of life score of patients in the intervention group was(67.63±5.14),which was lower than that of the control group(73.70±8.09).After12 weeks of intervention,the quality of life score of the intervention group was(64.71±5.43),which was lower than the control Patients in the group(74.50±9.12),and the difference was statistically significant(P<0.05).Analysis of repeated measures analysis of variance showed that the total quality of life scores of the two groups were statistically significant in the main effect of intervention,the main effect of time,and the interaction effect(P<0.05).The comparison results within the group showed that the total quality of life scores of the patients in the intervention group were statistically significant at different time points(P<0.017).The quality of life scores of the patients in the control group were 4 weeks after the intervention,before the intervention,and 12 weeks after the intervention.The difference before intervention was statistically significant(P<0.017),and the difference in scores after 12 weeks of intervention and 4 weeks after intervention was not statistically significant(P>0.017).There was no significant difference in blood pressure and BMI levels between the intervention group and the control group at before intervention,at 4 weeks after intervention,and at 12 weeks after intervention(P>0.05).There was no significant difference between the two groups of patients before and after 4 weeks of fasting blood glucose intervention(P>0.05).After 12 weeks intervention of fasting blood glucose intervention in the intervention group(7.61±1.13)mmol/L was lower than that of the control group(8.50±2.34)mmol/L,the glycated hemoglobin content was(7.00±1.32)lower than the control group glycated hemoglobin level(7.79±1.96),the difference was statistically significant(P<0.05).Conclusion(1)Health education based on the integration theory of health behavior change can improve the self-management behavior level of middle-aged patients with type 2 diabetes,improve their self-efficacy level,reduce their self-perceived burden,and improve their social support and quality of life.(2)Health education based on the integrated theory of health behavior change can improve patients’ fasting blood glucose levels and glycated hemoglobin content. |
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