Overall , family support had a positive impact on healthy diet , increased perceived support , higher self-efficacy , improved psychological well-being and better glycemic control .
This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients .
The rate of type-2 diabetes mellitus ( T2D ) is dramatically increasing worldwide .
Continuing diabetes mellitus ( DM ) care needs effective self-management education and support for both patients and family members .
This study aim ed to review and describe the impacts of diabetes mellitus self-management education ( DSME ) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence , blood glucose monitoring , diet and exercise changes , health outcomes including psychological well-being and self-efficacy , and physiological markers including body mass index , level of blood pressure , cholesterol level and glycemic control .
The effect of the Talking Diabetes consulting skills intervention on glycaemic control and quality of life in children with type 1 diabetes: cluster randomised controlled trial (DEPICTED study)
Objective To evaluate the effectiveness on glycaemic control of a training programme in consultation skills for paediatric diabetes teams . Design Pragmatic cluster r and omised controlled trial . Setting 26 UK secondary and tertiary care paediatric diabetes services . Participants 79 healthcare practitioners ( 13 teams ) trained in the intervention ( 359 young people with type 1 diabetes aged 4 - 15 years and their main carers ) and 13 teams allocated to the control group ( 334 children and their main carers ) . Intervention Talking Diabetes programme , which promotes shared agenda setting and guiding communication style , through flexible menu of consultation strategies to support patient led behaviour change . Main outcome measures The primary outcome was glycated haemoglobin ( HbA1c ) level one year after training . Secondary outcomes were clinical measures ( hypoglycaemic episodes , body mass index , insulin regimen ) , general and diabetes specific quality of life , self reported and proxy reported self care and enablement , perceptions of the diabetes team , self reported and carer reported importance of , and confidence in , undertaking diabetes self management measured over one year . Analysis was by intention to treat . An integrated process evaluation included audio recording a sample of 86 routine consultations to assess skills shortly after training ( intervention group ) and at one year follow-up ( intervention and control group ) . Two key domains of skill assessment were use of the guiding communication style and shared agenda setting . Results 660/693 patients ( 95.2 % ) provided blood sample s at follow-up . Training diabetes care teams had no effect on HbA1c levels ( intervention effect 0.01 , 95 % confidence interval −0.02 to 0.04 , P=0.5 ) , even after adjusting for age and sex of the participants . At follow-up , trained staff ( n=29 ) were more capable than controls ( n=29 ) in guiding ( difference in means 1.14 , P<0.001 ) and agenda setting ( difference in proportions 0.45 , 95 % confidence interval 0.22 to 0.62 ) . Although skills waned over time for the trained practitioners , the reduction was not significant for either guiding ( difference in means −0.33 , P=0.128 ) or use of agenda setting ( difference in proportions −0.20 , −0.42 to 0.05 ) . 390 patients ( 56 % ) and 441 carers ( 64 % ) completed follow-up question naires . Some aspects of diabetes specific quality of life improved in controls : reduced problems with treatment barriers ( mean difference −4.6 , 95 % confidence interval −8.5 to −0.6 , P=0.03 ) and with treatment adherence ( −3.1 , −6.3 to −0.01 , P=0.05 ) . Short term ability to cope with diabetes increased in patients in intervention clinics ( 10.4 , 0.5 to 20.4 , P=0.04 ) . Carers in the intervention arm reported greater excitement about clinic visits ( 1.9 , 1.05 to 3.43 , P=0.03 ) and improved continuity of care ( 0.2 , 0.1 to 0.3 , P=0.01 ) . Conclusions Improving glycaemic control in children attending specialist diabetes clinics may not be possible through brief , team-wide training in consultation skills . Trial registration Current Controlled Trials IS RCT N61568050
Overall , family support had a positive impact on healthy diet , increased perceived support , higher self-efficacy , improved psychological well-being and better glycemic control .
This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients .
The rate of type-2 diabetes mellitus ( T2D ) is dramatically increasing worldwide .
Continuing diabetes mellitus ( DM ) care needs effective self-management education and support for both patients and family members .
This study aim ed to review and describe the impacts of diabetes mellitus self-management education ( DSME ) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence , blood glucose monitoring , diet and exercise changes , health outcomes including psychological well-being and self-efficacy , and physiological markers including body mass index , level of blood pressure , cholesterol level and glycemic control .