Effect Of Peer Education On Activation And Self-management Behavior For The Patients With Type 2 Diabetes

Objectives:To investigate the current situation, influencing factors of activation and self-management behavior for the patients with type 2 diabetes in community, and to discuss the effect of peer education on their activation, self-management behavior and blood glucose control.Methods:This research belongs to quasi-experiment study. Forty patients with type 2 diabetes who were selected from two communities in changsha of Hunan province, were randomly divided into two groups such as the experiment group or control group. After the baseline evaluations for the patients in March 2010, the traditional health education and peer education were used for the patients of the experimental group, but not peer education for those of the control group. The traditional health education involved six times blockveranstaltung and diabetes health education manual learning.During the peer education, the experiment group was divided into five small groups, five peer educators trained by researcher were dispatched to instructed the small groups and organize activities respectively, taking the introductions and discussions of the self-management experiences and diabetes related knowledge of peer educators as the major form, with added forms like homemade diet, group exercises and self testing blood glucose. The patients of the experimental or control group were instructed for 12 weeks. In the end or 3 months later of the education, the activation, self-management behavior and blood glucose control of the two groups were evaluated. The statistical software SPSSl5.0 was used to analyze the collected data, the statistical methods included statistical description, t-test, Single factor analysis of variance, Chi-square test, rank sum test, multivariate linear regression analysis, profile analysis, repetitive measure anova and so on.Results:1. There were 79 patients with type 2 diabetes (40 in the experimental group and 39 in the control group) who accomplished the whole research process. Activation average score was 50.65±9.30 before the patients were instructed education, thereinto, the first level occupy 30.4%, second level occupy 35.4%, third level occupy 27.8%, fourth level occupy 6.3%. It was positive correlation between patient's activation and patient's salary, health education, but it was negative correlation between patient's activation and mode of living.2. The total score of self-management behavior was 87.65±10.80, and the standard score was 67.42, the highest score among the six dimensionalities was the patients taking medicine following the doctor's advice, and the lowest was monitoring blood sugar. There was positive correlation between patient's self-management behavior and standard of culture, job.3. In the end or 3 months later of the research, the total score of activation was significantly higher than that before the research either in the experimental group or in the control group(P < 0.01). Meanwhile, it was significantly higher in the experimental group than that in the control group (P<0.05). There was not significantly difference about activation level distribution between 2 groups in the end of the education(P>0.05), but it was obviously different 3 months later(P<0.05).4. After health education and 3 months later, every patient's aggregate score of self-management behavior was higher than that before the education(P<0.01). Meanwhile, it was significantly higher for aggregate score of self-management behavior and score of diet control, regular exercise in the experimental group than that in the control group after health education, and it was higher for aggregate score of self-management behavior and score of diet control, take medicine following the doctor's advice, foot care, high-low blood glucose treating in the experimental group 3 months after health education(P<0.05 or P<0.01).5. There was not significantly difference about fasting blood glucose between 2 groups by repetitive measure anova(P>0.05), but it was obviously different about post-meal blood glucose(P<0.05). After health education and 3 months later, the standard-reaching rate of fasting blood glucose was not significantly different between 2 groups(P>0.05), but that of post-meal blood glucose was obviously different(P<0.01), and it was higher in the experiment group than in the control group.Conclusion:1. The activation of patients with type 2 diabetes in community is unsatisfactory and needs being further improved, and its influencing factors cover patient's salary, health education and mode of living.2. The self-management behavior of patients with type 2 diabetes needs further improvement, and its influencing factors cover standard of culture, job and so on.3. Peer education is conducive to improve the activation of patients with type 2 diabetes.4. Peer education is conducive to positive implementing self-management behavior for the patients with type 2 diabetes.5. Peer education is conducive to the blood glucose control for the patients with type 2 diabetes, especially to the post-meal blood glucose.