Friday, November 8, 2013

Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: A randomized controlled trial

Publication date:

October 2013

SOURCE:Primary Care Diabetes, Volume 7, Issue 3

Author(s): Hashim Mohamed , Badriya Al-Lenjawi , Paul Amuna , Francis Zotor , Hisham Elmahdi

ObjectiveTo assess the effectiveness of a culturally sensitive, structured education programme (CSSEP) on biomedical, knowledge, attitude and practice measures among Arabs with type two diabetes.Research designs and methodsA total of 430 patients with type II diabetes mellitus living in Doha, Qatar were enrolled in the study. They were randomized to either intervention (n=215) or a control group (n=215). A baseline and one-year interval levels of biomedical variables including HbA1C, lipid profile, urine for microalbuminuria; in addition to knowledge, attitude and practice (KAP) scores were prospectively measured. The intervention was based on theory of empowerment, health belief models and was culturally sensitive in relation to language (Arabic), food habits and health beliefs. It consisted of four educational sessions for each group of patients (10-20 patients per session), lasting for 3-4h. The first session discussed diabetes pathophysiology and complications; while the second session discussed healthy life style incorporating the Idaho plate method; and the third session dealt with exercise benefits and goal setting and the fourth session concentrated enhancing attitude and practice using counselling techniques. Outcomes were assessed at base line and 12 months after intervention.ResultsAfter 12 months participation in the intervention was shown to have led to a statistically significant reduction in HbA1C in the (CSSEP) group (-0.55mmol/L, P=0.012), fasting blood sugar (-0.92mmol/L, P=0.022), body mass index (1.70, P=0.001) and albumin/creatinine ratio (-3.09, P 0.0001) but not in the control group. The intervention group also had improvement in Diabetes knowledge (5.9%, P 0.0001), attitude (6.56%, P 0.0001), and practice (6.52%, P=0.0001).ConclusionThis study demonstrates the effectiveness of culturally sensitive, structured, group-based diabetes education in enhancing biomedical and behavioural outcomes in Diabetic patients.
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