بیمار خبره: رویکردی جدید در خود - مدیریتی دیابت نوع 2 بر مبنای آموزش دانش دیابت و شناخت جسم‌آگین

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشگاه خوارزمی

2 دانشگاه جانزهاپکینز

3 انجمن دیابت ایران

4 دانشگاه علوم پزشکی تهران

چکیده

مقدمه: این مطالعه به منظور طراحی برنامه‌های مداخله‌ای برای بیماران دیابت نوع 2 بر اساس رویکرد توانمندسازی و نقش فعال بیمار در راستای اتخاذ رفتارهای خود - مدیریتی و روان‌شناختی انجام شد.
روش: مطالعه از نوع آزمایشی - مقطعی بود که به صورت کارآزمایی بالینی تصادفی با 21 بیمار مبتلا به دیابت نوع 2 زن و مردکه به طور تصادفی به سه گروه آزمایشی و کنترل تخصیص یافتند، انجام شد. بیماران مراجعه کننده به انجمن دیابت از مهر ماه  تا بهمن 1395، سنجش‌های خط پایه شامل پرسشنامه‌های دموگرافیک و بالینی، پرسشنامه‌های ادراک بیماری - تجدید نظرشده، رفتارهای خود - مراقبتی، کیفیت زندگی، خود - کارآمدی، پریشانی و افسردگی را تکمیل کردند و میزان قند خون و هموگلوبین گلیکوزیله اندازه‌گیری شد. سپس مداخلات به صورت دوگروه آزمایشی ویک گروه کنترل (در دومرحله به صورت آموزش دانش دیابت و غیر دیابت و مرحله دوم آموزش ژست‌های قدرت و خنثی) در جلسات گروهی و فردی انجام شد و سنجش‌های پایانی انجام شد. تجزیه و تحلیل داده‌ها با نرم‌افزار رایانه‌ای اس. پی. اس. اس. نسخه 21 انجام شد.
نتایج: نمرات گروه آزمایشی و کنترل، قبل و بعد از مداخله اول از نظر کنترل قند خون، ادارک علائم بیماری (خرده‌مقیاس‌های پیامد، کنترل و درمان‌پذیری، پیوستگی و بازنمایی هیجانی)، خود - مراقبتی و کیفیت زندگی به لحاظ آماری تفاوت معنی‌داری داشتند (0.01>p تا p <0.05). نمرات قبل و بعد از مداخله دوم نیز در خود - کارآمدی، احساس قدرت، رفتارهای خود - مراقبتی، K-10، قند خون و هموگلوبین گلیکوزیله به لحاظ آماری تفاوت معنی‌داری داشتند (0.01>p تا p <0.05).
بحث و نتیجه‌گیری: نتایج نشان داد که اجرای برنامه‌های توانمندسازی می‌تواند کارایی بیماران را در رفتارهای خود - مراقبتی، تغییر نگرش و ادراک علائم بیماری، شناخت جسم‌آگین و در نهایت کنترل قند خون و هموگلوبین گلیکوزیله افزایش دهد. یافته‌های پژوهش حاضر در راستای توجه به عوامل روان‌شناختی و خود - مدیریتی موثر در پیشگیری از عوارض دیابت و کنترل موثرتر دیابت نوع دو است.

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