Effect of Family-Based Education on the Quality of Life of Persons With Type 2 Diabetes: A Randomized Clinical Trial

10.1097/jnr.0000000000000212

Hossein Ebrahimi；Zahra Ashrafi；Daryadokht Masroor Rudsari；Zohreh Parsayekta；Hamid Haghani

family ； quality of life ； type 2 diabetes ； education ； family members

The Journal of Nursing Research

26卷2期（2018 / 04 / 01）

97 - 103

英文

Background: Diabetes, a disease with increasing prevalence, requires comprehensive support from family members to ensure that sufferers are able to perform daily activities. The chronic nature of diabetes and its potential side effects impose high financial costs on patients and families, reduce their quality of life (QOL), and change the lifestyle of both patients and their families. Purpose: The aim of this study was to investigate the effects of a family-based training program on QOL in persons with Type 2 diabetes. Methods: A randomized clinical trial was used to assess the effects of an educational program on QOL both before and after 12 weeks of training for the experimental group (40 patients and families) and of standard care for the control group (40 patients) at an endocrinology clinic in a hospital in Iran. A demographic and social questionnaire and the QOL questionnaire for patients with Type 2 diabetes were used for data collection. The study groups were selected using block randomization sampling, and results were analyzed using descriptive and inferential statistics. Results: Both the experimental and control groups were homogeneous in terms of demographic characteristics and QOL before the intervention. The results of the mean score of patient QOL after the 12-week training program showed a significant difference between the scores for the two groups of patients in the physical, mental, social, economic, disease, and treatment dimensions. Moreover, the total score and QOL of the experimental group improved significantly after the patients' families had attended the training program. Conclusions/Implications for Practice: Educating the families of patients was shown in this study to improve the QOL of the patient. The design of educational programs for nursing students must emphasize the role of the family in the care of chronic patients.

1. Albano, M. G.,Crozet, C.,d'Ivernois, J. F.(2008).Analysis of the 2004Y2007 literature on therapeutic patient education in diabetes: Results and trends.Acta Diabetologica,45(4),211-219.
2. American Diabetes Association(2013).Standards of medical care in diabetes-2013.Diabetes Care,36(1, Suppl.),S11-S66.
3. Barrera, M., Jr.,Toobert, D. J.,Angell, K. L.,Glasgow, R. E.,MacKinnon, D. P.(2006).Social support and socialecological resources as mediators of lifestyle intervention effects for type 2 diabetes.Journal of Health Psychology,11(3),483-495.
4. Bédard, M.,Gibbons, C.,Lambert-Belanger, A.,Riendeau, J.(2014).Development of a tool to investigate caregiving issues from the perspective of family physicians and discussion of preliminary results.Primary Health Care Research & Development,15(2),220-226.
5. Bernstein, M. A.,Nelson, M. E.,Tucker, K. L.,Layne, J.,Johnson, E.,Nuernberger, A.,Singh, M. F.(2002).A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders.Journal of the Academy of Nutrition and Dietetic,102(10),1421-1427.
6. Chen, L.,Magliano, D. J.,Balkau, B.,Colagiuri, S.,Zimmet, P. Z.,Tonkin, A.M.,Shaw, J. E.(2010).AUSDRISK: An Australian Type 2 Diabetes Risk Assessment Tool based on demographic, lifestyle and simple anthropometric measures.The Medical Journal of Australia,192(4),197-202.
7. Darvishpoor Kakhaki, A.,Abed Saeedi, Z.,Yaghmaie, F.,Alavi Majd, H.(2005).Instrument development to measure diabetic clients quality of life (DCQOL).Iranian Journal of Endocrinology and Metabolism,7(2),149-155.
8. Dunbar, S. B.,Clark, P. C.,Deaton, C.,Smith, A. L.,De, A. K.,O'Brien, M. C.(2005).Family education and support interventions in heart failure: A pilot study.Nursing Research,54(3),158-166.
9. Harris, M. A.,Freeman, K. A.,Beers, M.(2009).Family therapy for adolescents with poorly controlled diabetes: Initial test of clinical significance.Journal of Pediatric Psychology,34(10),1097-1107.
10. Kahn, E. B.,Ramsey, L. T.,Brownson, R. C.,Heath, G. W.,Howze, E. H.,Powell, K. E.,Corso, P.(2002).The effectiveness of interventions to increase physical activity: A systematic review.American Journal of Preventive Medicine,22(4, Suppl.),73-107.
11. Kim, I.(2007).Social support for older person: The role of family, community and state in selected Asian countries.Paper presented at the expert group meeting on the regional preparations for the global review of Madrid plan of action on aging,Bangkok, Thailand:
12. Mayberry, L. S.,Osborn, C. Y.(2012).Family support, medication adherence, and glycemic control among adults with type 2 diabetes.Diabetes Care,35(6),1239-1245.
13. Mollaoğ lu, M.,Beyazit, E.(2009).Influence of diabetic education on patient metabolic control.Applied Nursing Research,22(3),183-190.
14. Nagelkerk, J.,Reick, K.,Meengs, L.(2006).Perceived barriers and effective strategies to diabetes self-management.Journal of Advanced Nursing,54(2),151-158.
15. Norris, S. L.,Nichols, P. J.,Caspersen, C. J.,Glasgow, R. E.,Engelgau, M. M.,Jack, L.,McCulloch, D.(2002).Increasing diabetes self-management education in community settings: A systematic review.American Journal of Preventive Medicine,22(4, Suppl.),39-66.
16. Pollard, S. L.,Zachary, D. A.,Wingert, K.,Booker, S. S.,Surkan, P. J.(2014).Family and community influences on diabetes-related dietary change in a low-income urban neighborhood.The Diabetes Educator,40(4),462-469.
17. Rosenbek Minet, L. K.,Wagner, L.,Lønvig, E. M.,Hjelmborg, J.,Henriksen, J. E.(2011).The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: A randomised controlled trial.Diabetologia,54(7),1620-1629.
18. Smith, C. E.,Piamjariyakul, U.,Yadrich, D. M.,Ross, V. M.,Gajewski, B.,Williams, A. R.(2010).Complex home care: Part IIIVEconomic impact on family caregiver quality of life and patients' clinical outcomes.Nursing Economic$,28(6),393-414.
19. Snel, M.,Sleddering, M. A.,Vd Peijl, I. D.,Romijn, J. A.,Pijl, H.,Meinders, A. E.,Jazet, I. M.(2012).Quality of life in type 2 diabetes mellitus after a very low calorie diet and exercise.European Journal of Internal Medicine,23(2),143-149.
20. Solli, O.,Stavem, K.,Kristiansen, I. S.(2010).Health-related quality of life in diabetes: The associations of complications with EQ-5D scores.Health and Quality of Life Outcomes,8,18.
21. Tan, H.(2006).St. Catharines, Ontario.,Faculty of Education, Brock University.
22. Tankova, T.,Dakovska, G.,Koev, D.(2001).Education of diabetic patients-A one year experience.Patient Education and Counseling,43(2),139-145.
23. Trief, P. M.,Sandberg, J.,Greenberg, R. P.,Graff, K.,Castronova, N.,Yoon, M.,Weinstock, R. S.(2003).Describing support: A qualitative study of couples living with diabetes.Families, Systems, & Health,21(1),57-67.
24. van't Riet, E.,Dekker, J. M.,Sun, Q.,Nijpels, G.,Hu, F. B.,van Dam, R. M.(2010).Role of adiposity and lifestyle in the relationship between family history of diabetes and 20-year incidence of type 2 diabetes in US women.Diabetes Care,33(4),763-767.
25. Woods, S. L.,Froelicher, E. S. S.,Motzer, S. A.,Bridges, E. J.(2005).Cardiac nursing.Philadelphia, PA:Lippincott Williams & Wilkins.