The Effects Of Teach-back Health Education On Self-management Of Patients With Type 2 Diabetes

ObjectiveTo explore the current situation of self-management performance diabetes knowledge and diabetes health beliefs of type 2 diabetes patients;and to analyze factors affecting self-management behavior of type 2diabetes patients and their relationship with diabetes knowledge and diabetes health beliefs.To provide the basic references for improving clinical health education,teach-back method was used to intervene the patients with type 2 diabetes,and evaluate the intervention effects.Methods(1)From March to May 2018,200 patients with type 2 diabetes who were admitted to three tertiary hospitals in Hengyang City were investigated.The survey tools include General Information Questionnaire,The Audit of Diabetes Knowledge,Diabetes Health Belief Questionnaire and Diabetes Self-care Scale.To understand the diabete related knowledge,health beliefs and self-management behavior of patients with type 2 diabetes,and to analyze the influencing factors of self-management behavior in patients with type 2 diabetes and their relationship with diabetes knowledge and diabetes health beliefs.(2)From July to September 2018,80 patients with type 2 diabetes mellitus admitted to the endocrinology department of a tertiary hospital in Hengyang City were randomly selected and divided into intervention group and control group.General information,knowledge,health beliefs,self-management behavior,and control indicators of the group of patients.The control group received the routine health education and the intervention group received teach-back health education.Both groups were followed up by telephone(or network)+outpatient follow-up for 3months.The self-management behavior,knowledge,health beliefs and control indicators of the two groups were compared before and 3 months after intervention.(3)Statistical analysis was performed using SPSS18.0 statistical soft-ware.Mean,standard deviation,composition ratio,t test,?~?test,rank sum test,analysis of variance,Pearson correlation analysis and multiple linear stepwise regression analysis were performed.Results(1)The self-management behavior score of patients with type 2diabetes was(83.73±17.83).The standard score for each dimension were diet control(64.60±17.90),regular exercise(58.23±18.21),compliance medication(71.17±17.22),blood glucose monitoring(60.95±18.19),foot care(65.14±18.04),prevention and treatment of high and low blood sugar(67.78±19.10).Age,education level,cardiovascular complications were the main influencing factors of self-management behavior.(2)The total score of diabetes knowledge in patients with type 2diabetes was(52.85±20.89),62.5%of patients stayed in low level in diabetes related knowledge.(3)The overall score of health belief was(68.38±11.00),the standard scores of each dimension from high to low were the therapeutic benefits(76.38±17.48),maintaining health motivation(73.96±18.41),diabetes risk(70.40±16.29),treatment necessity(67.10±21.13),treatment of harm(64.80±19.77),69.5%of patients have a healthy belief at a medium level.(4)There was a positive correlation between diabetes knowledge and self-management behavior(r=0.387 P<0.05),and there was a positive correlation between health belief and self-management behavior(r=0.455P<0.05).(5)Before intervention,there were no significant differences in the general data,self-management behavior,diabetes knowledge,diabetes health beliefs and diabetes control indicators between the two groups(P>0.05).(6)3 months after discharge,the intervention group members'self-management behavior scores was(109.70±11.66),diet control dimension scores(26.50±3.86),regular exercise dimension scores(14.20±2.91),according to the drug dimension score(13.80±1.90),blood glucose monitoring dimension score(12.19±3.64),foot care dimension score(16.29±4.51),prevention and treatment of high and low blood sugar The dimension scores(13.56±3.82)were higher than those before the intervention,and the difference was statistically significant(P<0.05).While,the self-aDMinistration behavior scores and the scores of each dimension in the intervention group were higher than the control group's,the difference was statistically significant(P<0.05).(7)Scores of diabetes knowledge,scores of each dimension,scores of diabetes health beliefs and scores of each dimension in the intervention group were higher than those in the control group,and the difference was statistically significant(P<0.05).(8)The diabetes control index of the intervention group:glycosylated hemoglobin and body mass index were significantly better than the control group,the difference was statistically significant(P<0.05).Conclusions(1)The knowledge level of patients with type 2 diabetes stayed in a low level,and their health beliefs was remained in a medium level.Diabetes related knowledge,belief and self-management behavior were positively correlated.(2)The self-management behavior of patients with type 2 diabetes was in a medium level,and age,education level,cardiovascular complications were the influencing factors.(3)The teach-back health education may improve the knowledge level of patients with type 2 diabetes,enhance health beliefs,improve self-management ability,and improve diabetes control indicators.