The Effects Of Peer Applied Insulin Interview Tool To Patients With Diabetes Mellitus

Objectives:To describe the situation of glycemic control of the diabetes patients and explore the effects of the peer applied insulin interview tool to diabetes patients accepted insulin therapy in the community.Methods:A randomized controlled trail was used in this community study. There were76patients with DM were selected from communities in Changsha City and were assigned to experimental group and control group,38cases of each group. Both these two groups received the health education related to diabetes care for5months, while the experimental group received peer education based on insulin interview tool at the same time. A series of data were collected and compared of the two groups at the pre-and post intervention, which included the number of DKA, coma and hypoglycemia, FBG,2hPBG, HbA1C, perception of insulin therapy, knowledge and practice behaviors related to insulin therapy, quality of life, self-efficacy and so on. SPSS13.0was applied to analysis the data, and repeated measures ANOVA was used to analysis the effects of intervention.Results:(1) The average of FBG,2hPBG, HbA1C of76diabetes patients were7.8mmol/L,11.19mmol/L and8.58%respectively, they were all higher than the criterion. Among these76diabetes patients,65.79%accepted health education related to insulin therapy, the contents included insulin injection(63.16%), insulin preserve(51.32%), adjusting the dosage of insulin(28.95%), rotating the injection sites(43.42%), as well as dealing with needles (25%) and side effects(17.11%). Only13.16%diabetes patients mastered the knowledge related to insulin therapy completely, there were still34.21%diabetes patients not mastered the knowledge at all.(2) Repeated measures ANOVA revealed that the number of hypoglycemia, FBG,2hPBG, perceptions of insulin, practice behaviors related to insulin therapy, empowerment ability, quality of life had time effects and interaction effects(P<0.05), the effects of experimental group improved better than the control group. The number of hypoglycemia, FBG,2hPBG of experimental group decreased1.77times,0.64mmol/L and1.71mmol/L respectively after5months intervention, while the control group decreased0.63times,1.03and0.35.mmol/L respectively. The score of perceptions of insulin and quality of life of experimental group decreased28.54and14.14points, while the control group decreased17.28and5.03points. The score of practice behaviors related to insulin therapy and empowerment ability of experimental group improved9.15and1.22points, while the control group improved2.00and0.40points. The self-efficacy had time effect and intervention effect (P<0.05), the score of experimental group decreased7.08points than the control group if ignored the time factor.Conclusions:(1) The blood glucose of diabetes patients accepted insulin therapy in community controlled poorly, especially the HbA1C. The health education related to insulin therapy was not comprehensive and the patients not mastered it very well.(2) Health education combined with peer applied insulin interview tool can decrease the number of hypoglycemia, FBG and2hPBG of patients more effectively than health education only.(3) Health education combined with peer applied insulin interview tool can improve the perceptions of insulin therapy, sets up good attitude towards insulin therapy, change the bed practice behaviors related to insulin therapy, improve the empowerment ability and quality of life as well as self-efficacy of patients more effectively than health education only.