A self-management intervention to improve quality of life and psychosocial impact for people with type 2 diabetes

Abstract

Aim: To evaluate the effectiveness of self-management intervention for people with diabetes mellitus.

Background: Enhancing self-efficacy and improving health quality of life for persons with diabetes are ongoing challenges for health care providers. There currently is a need to develop and test the effects of a self-management programme.

Design: A quasi-experimental design.

Method: The study was carried out in the outpatient clinic of a municipal hospital in Taipei. Patients aged 30 and over with type 2 diabetes and an oral medication regimen were recruited. One hundred and forty-five participants completed the six-month post-treatment assessments (72 in the intervention group and 73 in the control group). Both control and intervention groups received a standard diabetic educational programme. The self-management intervention is to improve psychosocial skills or addressing attitudes and beliefs specific to diabetes or the regimen behaviours. The intervention group received the following additional interventions: (1) a diabetic booklet (2) DVD viewing (3) four counselling sessions (4) and a telephone follow-up. The main outcome measures were Short Form 12 for health-related quality of life, the Medical Outcomes Study Social Support scale and the Center for Epidemiology Studies Short Depression Scale.

Results: The scores for social support were significantly increased in the intervention group at Time 2 and Time 3 (three and six months from commencement of the intervention) compared with those of the control group (p < 0·01), whereas health-related quality of life and depression were not significantly different. Conclusions. The diabetic self-management intervention programme improved social support for participants, but future studies are needed. Replication of this study in various settings, with other populations, or with additional outcome measures may result in different findings.

Relevance to clinical practice: Self-management programmes should be held regularly and evaluated in clinical practices, especially in developing countries. Providing practical screening tools and conducting psychological research on diabetes drive policy and health care system change.