Research On The Effect Of E-Coach Health Education Management Program On The Self-Management Ability Of Patients With Initial Insulin Injection

Objective:1.To construct the health education management intervention program of E-Coach model in patients with initial insulin injection.2.To investigate and assess the feasibility of this program on insulin perception,knowledge,behavior,and diabetes self-management behavior in patients with initial insulin injection before intervention,1 month after intervention,and 3 months after intervention.Methods:The first stage:the construction of E-Coach health education management program.The opinions of experts were summarized and organized to form a revised draft of the program through literature research,program consultation,and group discussion;patients who met the inclusion criteria were pretested for the intervention program,and the program was further improved based on feedback to form the final program.The second stage:the application of the E-Coach health education management program in patients with initial insulin injection.This study was quasi-experimental study.A total of 86 patients with diabetes diagnosed by doctors in a 3-A hospital in Suzhou from May 2022 to December 2022 were selected.According to the order of admission,43 students in the experimental group and the control group were assigned to use a general information questionnaire,insulin perception questionnaire,insulin knowledge-behavior questionnaire,diabetes self-management behavior scale,clinical biochemical index data(FBG,2hPG,HbA1c)after obtaining informed consent.The self-management ability of insulin knowledge,attitude(perception)behavior,and self-management behavior scores were assessed before the intervention,1 month after the intervention,and 3 months after the intervention.Finally,according to the corresponding statistical methods,the intervention effect on patients’ self-management ability was evaluated.Results:The first stage:the construction of E-Coach health education management program.A total of 9 papers were included in the literature review to form the first draft of the management program based on the 8 steps of COACHING;opinions were solicited from 10 clinical and nursing staff,categorized and organized into 4 areas to form a revised draft of the program;5 patients were pretested to further improve the final program.The second stage:the application of E-Coach health education management program in patients with initial insulin injection.A total of 86 patients were enrolled in this study,43 patients in the experimental group and 43 patients in the control group,and 75 patients were followed up,including 40 patients in the experimental group and 35 patients in the control group.The baseline data of the two groups were comparable(P>0.05).1.Comparison of insulin perception scores:Before the intervention,there was no statistically significant difference in insulin perception scores between the two study groups.Within-group comparison 1 month and 3 months after the intervention:the insulin perception scores of the patients in the experimental group improved accordingly,while the difference in insulin perception scores of the control group was not statistically significant;betweengroup comparison:the total insulin perception scores and the scores of each dimension were higher in the test group than in the control group;repeated-measures ANOVA:the time effect,between-group effect and interaction effect of the time effect of the total insulin perception scores of the patients in the two groups were statistically significant.2.Comparison of insulin knowledge-behavior scores:Before the intervention,the differences in insulin knowledge-behavior scores between the two groups were not statistically significant.Within-group comparison 1 month and 3 months after the intervention:the total insulin knowledge-behavior scores of the experimental group were improved,while only the differences in the total insulin knowledge scores of the control group were statistically significant,and the differences in insulin injection behavior were not statistically significant;between-group comparison:the total insulin knowledge-behavior scores of the experimental group were higher than those of the control group;repeated measures analysis:the inter-group,time and interaction effects of the total insulin knowledge scores of the two groups were statistically significant.The differences in the total insulin knowledge scores of the two groups were statistically significant,and the differences in the between-group and interaction effects of the total insulin behavior scores were statistically significant,but the differences in the time effects were not statistically significant.3.Comparison of self-management behavior scores:Before the intervention,the differences in self-management behavior scores between the two groups were not statistically significant.Within-group comparison at 1 month and 3 months after the intervention:the self-management behavior scores of the experimental group were significantly higher,while the differences in the self-management behavior scores of the control group were not statistically significant;between-group comparison:all dimensions and total scores of the experimental group were higher than those of the control group,except for the rational medication dimension,which was not statistically significant;repeated measures analysis:the time,between-group and interaction effects of the total selfmanagement behavior scores of the two groups were statistically significant.4.Comparison of clinical biochemical index data:Before the intervention,the differences in FBG,2hPG,and HbAlc between the two study groups were not statistically significant.Within-group comparison at 1 month and 3 months after intervention:FBG,2hPG,and HbA1c levels improved in both groups;between-group comparison:FBG,2hPG,and HbA1c improved better in the experimental group than in the control group after intervention;repeated measures analysis:the time and between-group effects of 2hPG and HbAlc were statistically significant in both groups,but the interaction effect of 2hPG were not statistically significant;the FBG situation of patients in the experimental group was better than that of the control group,and the time difference was statistically significant.Conclusions:The E-Coach health education management program is scientific,feasible and practical.It can improve the self-management ability of patients with initial insulin injection,such as insulin perception level,insulin knowledge-behavior level and self-management behavior level.It can improve the clinical biochemical indexes of FBG,2hPG and HbA1c,urge patients to deal with the disease more actively,and then comprehensively improve their quality of life.