Cardiac-diabetes self-management program for Australians and Taiwanese: A randomized blocked design study

Nurs Health Sci. 2017 Sep;19(3):307-315. doi: 10.1111/nhs.12346. Epub 2017 May 25.

Abstract

Cardiac disease and type 2 diabetes are prevalent diseases globally. Cardiac rehabilitation and diabetes self-management programs empower patients' self-management to improve their health outcomes. However, inappropriate delivery modes and continuing low participation rates indicate some programs are less than optimal. A previous study demonstrated the feasibility of incorporating telephone and text messages into a cardiac-diabetes self-management program in Australia; however, the program did not specifically address patients' cultural backgrounds. This current study used a randomized blocked design to evaluate short-term efficacy of the cardiac-diabetes self-management program incorporating telephone and text-messaging across different cultural contexts in Australia and Taiwan in comparison to usual care. No significant differences between groups were observed for outcomes of self-care behavior, self efficacy, knowledge and health-related quality of life, with patients in both groups demonstrating improvements. Patient-reported outcomes indicated some evidence of an interaction effect between country of origin and group allocation. Findings indicated an improved tendency of outcome measures between the baseline and follow-up assessments within usual care and intervention groups. Further research is required to clarify components of the program work for each cultural group.

Keywords: Randomized blocked design; cardiovascular; diabetes; international; self-management; telehealth.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Australia
  • Cardiac Rehabilitation / methods
  • Cross-Cultural Comparison
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Heart Diseases / complications
  • Heart Diseases / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Reminder Systems
  • Self Care / instrumentation
  • Self Care / methods*
  • Self Efficacy
  • Statistics, Nonparametric
  • Taiwan
  • Telephone*
  • Text Messaging*