نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد علوم بهداشتی در تغذیه، دانشکده بهداشت، دانشگاه علوم پزشکی قزوین، قزوین، ایران

2 استاد علوم تغذیه، گروه علوم بهداشتی در تغذیه، دانشکده بهداشت، مرکز تحقیقات رشد کودکان، پژوهشکده پیشگیری از بیماریهای غیرواگیر، دانشگاه علوم پزشکی قزوین، قزوین، ایران

3 فوق تخصص روماتولوژی، مرکز تحقیقات بیماری های متابولیک، پژوهشکده پیشگیری از بیماری های غیرواگیر، دانشگاه علوم پزشکی قزوین، قزوین، ایران.

4 دانشیار گروه بهداشت عمومی و آموزش سلامت، مرکز تحقیقات ایمنی محصولات بهداشتی، دانشگاه علوم پزشکی قزوین، قزوین، ایران

چکیده

مقدمه و هدف: این مطالعه با هدف تعیین تاثیر آموزش بر کنترل قندخون در سالمندان مبتلا به دیابت نوع دو اجرا گردید.‬‬‬‬‬‬‬‬‬‬‬‬‬

روش کار: پژوهش حاضر یک مطالعه مداخله ای شاهددار تصادفی شده با روش نمونه گیری چند مرحله ای تصادفی بر روی 110 سالمند مبتلا به دیابت نوع دو در شهرستان ملارد انجام گردید (55 نفر در گروه مداخله و 55 نفر در گروه کنترل). افراد گروه مداخله تحت 2 جلسه آموزشی فشرده و سپس پیگیری آموزشی از طریق ارسال روزانه پیام کوتاه به تلفن همراه در طول مدت مدت سه ماه قرار گرفتند. داده های مربوطه به وضعیت دموگرافیک، شاخص های آنتروپومتریک، میزان خودمراقبتی و شاخص های پروفایل قندی بیماران قبل و بعد از مداخله جمع آوری و با نرم افزار SPSS ویرایش 22 و آزمون های تی مستقل، واریانس یک طرفه و ANOVA تحلیل شدند.

نتایج: مقایسه پروفایل قندی بیماران گروه کنترل و مداخله قبل و پس از سه ماه مداخله آموزشی، نشان دهنده کاهش معنی دار میانگین FBS و HbA1c بود(001/0 ˂p). هم چنین یافته ها نشان داد میانگین تمام حیطه های خودمراقبتی به جز حیطه مرتبط به عدم مصرف سیگار در بیماران گروه مداخله افزایش معنی دار داشته است( 05/0˂p) و میانگین نمره کل خودمراقبتی آنان نیز از سطح نامطلوب و نیمه مطلوب به سطح مطلوب ارتقاء پیدا کرده است(001/0˂p).

نتیجه گیری: رفتارهای خودمراقبتی و کنترل قندخون سالمندان دیابتی نوع 2 با برنامه آموزشی فشرده مبتنی بر تئوری مراحل تغییر به طور معناداری بهبود یافت، بنابراین توجه به متغیرهای مذکور در طراحی مداخلات آموزشی این گروه سنی ضروری به نظر می رسد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of intensive educational intervention based on the trans theoretical model on improving self-care and blood sugar control behaviors in the elderly with type 2 diabetes

نویسندگان [English]

  • Azadeh Hajipour 1
  • Maryam Javadi 2
  • Mahnaz Abbasi 3
  • Isa Mohammadi Zeidi 4

1 M.Sc. Student of Health Sciences in Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran

2 Professor, Department of Health Sciences in Nutrition, School of Health, Children Growth Research Center, Research Institute for Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran

3 Associate Professor of Rheumatology, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

4 Associate Professor, Health Promotion and Education Department, Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran

چکیده [English]

Introduction: The present study was conducted to determine the effect of education on glycemic control in the elderly with type 2 diabetes.

Methods: The present study was a randomized controlled intervention that was performed on 110 elderly people with type 2 diabetes by multi-stage random sampling method in Mallard city (55 in the intervention group and 55 in the control group). The cases received 2 intensive training sessions and then the training follow-up by sending daily SMS to the mobile phone for a period of three months. Data related to demographic status, anthropometric indices, self-care rate and glucose profile indices of patients were collected before and after the intervention. Data were analyzed using SPSS software version 22 and independent t-test, one-way ANOVA and ANOVA.

Results: Comparison of glucose profiles of control and intervention patients before and after three months of educational intervention showed a significant decrease in mean FBS and HbA1c (p

کلیدواژه‌ها [English]

  • Diabetes Mellitus
  • Education
  • Diet
  • Self-care
  • Trans theoretical Model
  1. Badran M, Laher I. Type II Diabetes Mellitus in Arabic-Speaking Countries. International journal of endocrinology. 2012;2012:902873.
  2. Association AD. Classification and diagnosis of diabetes: standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Supplement 1):S13-S27.
  3. Mahan L, Raymond J. Krause's food & nutrition care process-e-book: Elsevier Health Sciences; 2016
  4. Patnaik L, Joshi A, Sahu T. Mobile phone-based education and counseling to reduce stress among patients with diabetes mellitus attending a tertiary care hospital of India. International journal of preventive medicine. 2015;6:37.
  5. Hazavehei M M FSP, Moeini B, Soltanian A R. Evaluation of the Educational Nutrition Intervention's Effects on Healthy Nutritional Behaviors Promotion in Elderly of Sanandaj: Application BASNEF Model. Neyshabur Univ Med Sci. 2017;5 (1) :39-51.
  6. Mohammadi-zeidi I, Pakpour hajiagha, A., Mohammadi-zeidi, B. Effectiveness of educational intervention based on transtheoretical model in promoting oral health self-care behaviors. Journal of Isfahan Dental Schoo. 2013.
  7. Mohamadi Zeidi E, Pakpor Pakpour Haji Agha A, Karbord A, Mohamadi Zeidi B. Effectiveness of an educational intervention based on the trans theoretical model in order to smoking cessation in patients referred to dental clinics. Journal of Dental Medicine. 2015;28(2):146-58.
  8. Mohammadi Zeidi A, Pakpour A. Effect of using the transtheoretical model for breakfast and healthy snacks on education for elementary students in Qazvin. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(2):201-10
  9. Ebrahimi Fakhar MA, Zand S. Nutritional status and associated factors in elderly residents in nursing homes. Health Monitor Journal of the Iranian Institute for Health Sciences Research. 2013;12(2):143-9.
  10. Hazavehei MM, Faghih Solaimani P, Moeini B, Soltanian AR. Evaluation of the Educational Nutrition Intervention's Effects on Healthy Nutritional Behaviors Promotion in Elderly of Sanandaj: Application BASNEF Model. Journal Of Neyshabur University Of Medical Sciences. 2017;5(1):39-51
  11. Khoshbin S, Radpouyan L, Azizabadi farahani A, Alizadeh M, editors. Integrated and comprehensive care service booklet of the Ministry of Health and Medical Education [Internet].Iran;2015.Available:http://health.sbmu.ac.ir/uploads/22_5907_1559547710426_3.pdf
  12. Ashfaque AR, Khanam N, Khan F, Waghmare RN, Joshi SK. Assessment of Self-Care Practices among Type 2 Diabetes Patients at a Tertiary Care Hospital--A Cross-Sectional Study. Journal of Evolution of Medical and Dental Sciences. 2020;9(36):2630-6.
  13. Parizad N, Hemmati Maslakpak M, Khalkhali HR. Promoting Self-Care in Patients with Type 2 Diabetes: Tele-Education. Hakim Health Systems Research Journal. 2013;16(3):220-7.
  14. Shojaeezadeh D, Tol A, Sharifirad G, Alhani F. Effect of education program based on empowerment model in promoting self-care among type 2 diabetic patients in Isfahan. RJMS. 2013; 20 (107) :18-31
  15. Karimzadeh A, Farvid M, Farvid Z, Shakibazadeh E. Association between Transtheoretical Model constructs and dietary fat intake in type 2 diabetic patients. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(1):187-96.
  16. Peterson KA, Hughes M. Readiness to change and clinical success in a diabetes educational program. J Am Board Fam Pract. 2002;15(4):266-71. PMID: 12150458.
  17. Mahdi H, Maddah SMB, Mahammadi F. The Effectiveness of Self-Care Training on Quality of Life Among Elderlies With Diabetes. Iranian Journal of Rehabilitation Research in Nursing. 2016;2(4):32-9.
  18. Nouhi e, Khandan m, Mirzadeh A. Effective of electronic education on knowledge attitude and self-care in patient’s diabetic type 2 refer to diabetic center of Kerman University of medical science. Iranian Journal of Nursing Research. 2011;6(22):73-80
  19. Merakou K, Knithaki A, Karageorgos G, Theodoridis D, Barbouni A. Group patient education: effectiveness of a brief intervention in people with type 2 diabetes mellitus in primary health care in Greece: a clinically controlled trial. Health Educ Res. 2015;30(2):223-32. 
  20. Partapsingh V, Maharaj R, Rawlins J. Applying the Stages of Change model to Type 2 diabetes care in Trinidad: A randomised trial. Journal of negative results in biomedicine. 2011;10(1):13
  21. Zalak K, Kazemi Haki B, Matlabi H. Obstacles to Self-Care From The Viewpoint of TypeII Diabetic Patients and Guidelines to Remove Them. Jorjani Biomedicine Journal. 2012;0(1):30-7.
  22. Abbas B, Fares A, Jabbari M, Eldali A, Orifi F. Effect of Mobile Phone Short Text Messages on Glycemic Control in Type 2 Diabetes. International journal of endocrinology and metabolism. 2015;13:e18791.
  23. Ghotbi T, Maddah SMB, Dalvandi A, Arsallani N, Farzi M. The effect of self-care education behaviors based on family-centered empowerment modeling type 2 diabetes. Journal of Advances in Nursing and Midwifery. 2013;23.(83)
  24. White KM, Terry DJ, Troup C, Rempel LA, Norman P, Mummery K, et al. An extended theory of planned behavior intervention for older adults with type 2 diabetes and cardiovascular disease. Journal of aging and physical activity. 2012;20(3):281-99.
  25. Muller AM, Khoo S, Morris T. Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial. Journal of medical Internet research. 2016;18(1):e5.
  26. Dashtian M, Eftekhar Ardebili H, Karimzadeh Shirazi K, Shahmoradi M, Azam K. Predicting factors affecting medication adherence and physical activity in patients with type-2 diabetes mellitus based on the theory of planned behavior. Journal of School of Public Health and Institute of Public Health Research. 2017;15(2):133-46.
  27. Azizi M, Arsalani N, Mohammadi Shahboulaghi F, Hosseinzadeh S, Rajab A. The effect of self-care education on the control of diabetes complications, medications and HbA1C in adolescents with type 1 diabetes. Journal of Hayat. 2017; 22 (4) :350-361
  28. Naghibi SA, Asghari M, Rostami F. Investigation the effect of education on self-care promotion in type 2 diabetic patients in Noor health centers in 2015. Journal of health research in community. 2015;1(2):22-8.
  29. Murray CM, Shah BR. Diabetes self-management education improves medication utilization and retinopathy screening in the elderly. Primary care diabetes. 2016;10(3):179-85.
  30. Zhang S, Hamburger E, Kahanda S, Lyttle M, Williams R, Jaser SS. Engagement with a Text-Messaging Intervention Improves Adherence in Adolescents with Type 1 Diabetes: Brief Report. Diabetes technology & therapeutics. 2018;20(5):386-9
  31. Jalilian F, Zinat Motlagh F, Solhi M. Effectiveness of Education Program on Increasing Self Management Among Patients with Type II Diabetes. journal of ilam university of medical sciences. 2012;20(1):26-34.