Empowerment Program for People With Prediabetes: A Randomized Controlled Trial

糖尿病前期個案之賦權計畫－隨機對照試驗

陳美芳(Mei-Fang Chen) ； 洪淑玲(Shu-Ling Hung) ； 陳淑玲(Shu-Lin Chen)

《The Journal of Nursing Research》 25卷2期 (2017/04) Pp. 99-111

https://doi.org/10.1097/jnr.0000000000000193

摘要

Background: Practicing a health-promoting lifestyle is believed to be effective for delaying or preventing the onset of diabetes. However, although empowerment interventions have proven effective for encouraging the adoption of a health-promoting lifestyle in people with diabetes, these interventions are rarely promoted to people with prediabetes. Purpose: The aims of this study were to develop an empowerment program for people with prediabetes and to examine its efficacy in terms of the adoption of a health-promoting lifestyle and improvements in blood sugar, body mass index, and self-efficacy. Methods: A randomized controlled trial was conducted between May and December 2013. A convenience sample of people with a fasting blood sugar level of 100-125 mg/dl during the previous 3 months was recruited from the health examination center of a hospital in Kaohsiung, Taiwan. Participants were assigned to either the experimental group or the control group using block randomization with a block size of 8. The experimental group (n = 38) participated in a 4-month empowerment program (the ABC empowerment program), which encouraged participants to practice a health-promoting lifestyle in three phases: awareness raising, behavior building, and results checking. The control group (n = 40) received routine clinical care. Statistical analyses included descriptive statistics, independent t test, paired t test, and generalized estimated equations. Results: After controlling for the differences at baseline and considering the interaction between group and time from baseline to 1 week and 3 months after completing the intervention, the generalized estimating equation showed significantly larger improvements in a health-promoting lifestyle, blood sugar, and self-efficacy in the experimental group than in the control group (p ＜ .01). Furthermore, the experimental group achieved a larger reduction in body mass index than the control group at 3months after completing the intervention (p = .001). Conclusions/Implications for Practice: The empowerment program was shown to have short-term, positive effects on behavioral, physical, and psychosocial outcomes in a Taiwan population with prediabetes. The results of this study provide a useful reference not only for healthcare personnel when implementing empowerment interventions in people with prediabetes but also for nursing educators and healthcare policymakers.

關鍵字

empowerment ； prediabetes ； health-promoting lifestyle ； blood sugar ； self-efficacy

並列摘要

背景　賦權介入可提升執行健康促進生活型態之結果，進而延緩或預防糖尿病的發生。然而，少有研究測試賦權介入對於糖尿病前期個案的成效。目的　發展賦權介入方案，並評價對於糖尿病前期個案健康促進生活型態、血糖、身體質量指數與自我效能之效果。方法　2013年5月至12月，進行實驗性研究。在高雄市某醫院健檢門診，以方便取樣，選取糖尿病前期個案，以隨機區塊方式，8人為一區塊，分成實驗組與對照組。38位實驗組接受為期4個月「ABC賦權介入方案」，依覺醒、行動與省思階段，協助個案能執行健康促進生活型態。40位對照組接受原本之醫院照護。統計方法包括描述性統計、獨立樣本t檢定、配對t檢定與廣義估計方程式。結果　從介入前至介入完成後1星期與3個月，實驗組比對照組在健康促進生活型態、血糖與自我效能有更大的改善（p ＜ .01）。從介入前至介入完成後3個月，實驗組比對照組在身體質量指數有顯著的降低（p = .001）。結論　賦權介入方案對台灣的糖尿病前期個案在行為、生理、心理與社會有短期正向結果，此可作為教育、實務及研究的參考。

並列關鍵字

充能 ； 糖尿病前期 ； 健康促進生活型態 ； 血糖 ； 自我效能

參考文獻

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