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Mshunqane N1, Stewart AV2
1University of Pretoria, Physiotherapy, Pretoria, South Africa, 2University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa
Background: Type 2 diabetes mellitus is growing rapidly worldwide despite advances in quality of care and its complications pose a challenge for physiotherapists. Research from developing countries, have shown that poor adherence to medication and resistance to behavior change is associated with poor glycaemic control, development of complications and increased health care utilization. Currently, family support and self-management strategies are recommended to be useful in improving diabetes care. However the effects of a family based intervention on health related quality of life in developing countries is not yet known.
Purpose: This study aimed to establish the effects of a family based intervention which used diabetes self-management education strategies to improve the health related quality of life.
Methods: A prospective randomized controlled trial was used, whereby a total of 135 patients with type 2 diabetes were followed up for 12 months. Participants were randomly assigned into three groups, namely: the family supported group, the no family supported group and a control group. A six minute walk test, specific characteristics, random blood levels of blood glucose, total cholesterol, HDL-C, LDL-C and triglycerides were determined at baseline, six and 12 months. Diabetes Impact Measurement Scale (DIMS) was used to establish health related quality of life. A 4-point Likert scale was used to establish emotions about type 2 diabetes diagnoses to further describe the conclusions drawn from DIMS. The six month intervention for group 1 incorporated a family member who was called once a month, group education programme, a home walking programme plus education booklets given at the hospital. Group 2 had no family support but the rest of the programme was the same and group 3 had the education booklets only.
Results: Knowledge scores (p=0.04); distance walked (p=0.04); total cholesterol, (p=0.003) and LDL-C, (p=0.0002) improved significantly after six months and this change was maintained for 12 months in group 1 compared to group 3 and group 2. Blood glucose levels decreased by 1.3% in group 1 compared to 0.3% reduction in group 3 and 1% increase in group 2. HDL-C, triglycerides, and BMI did not change. Symptoms domain scores improved from 73 to 80 in group 1 compared to 72 to 77 in group 3 and 74 to 79 in group 2. Emotions about diabetes improved from 53% of unacceptance to 12% in group 1 compared to 44% to 23.8% in group 3 and 37% to 19.5% in group 2, all these improvements were sustained for 12 months.
Conclusion(s): A 12 months family based intervention improved knowledge, distance walked, total cholesterol and LDL-C. Emotions about diabetes and symptom domain of health related quality of life improved.
Implications: This intervention had an impact on HRQoL and self-care behaviors because the effects were sustained for 12 months.
Keywords: Family based intervention, HRQoL, Type 2 diabetes
Funding acknowledgements: National Research Foundation funding via the university of the Witwatersrand, Gauteng, South Africa
Purpose: This study aimed to establish the effects of a family based intervention which used diabetes self-management education strategies to improve the health related quality of life.
Methods: A prospective randomized controlled trial was used, whereby a total of 135 patients with type 2 diabetes were followed up for 12 months. Participants were randomly assigned into three groups, namely: the family supported group, the no family supported group and a control group. A six minute walk test, specific characteristics, random blood levels of blood glucose, total cholesterol, HDL-C, LDL-C and triglycerides were determined at baseline, six and 12 months. Diabetes Impact Measurement Scale (DIMS) was used to establish health related quality of life. A 4-point Likert scale was used to establish emotions about type 2 diabetes diagnoses to further describe the conclusions drawn from DIMS. The six month intervention for group 1 incorporated a family member who was called once a month, group education programme, a home walking programme plus education booklets given at the hospital. Group 2 had no family support but the rest of the programme was the same and group 3 had the education booklets only.
Results: Knowledge scores (p=0.04); distance walked (p=0.04); total cholesterol, (p=0.003) and LDL-C, (p=0.0002) improved significantly after six months and this change was maintained for 12 months in group 1 compared to group 3 and group 2. Blood glucose levels decreased by 1.3% in group 1 compared to 0.3% reduction in group 3 and 1% increase in group 2. HDL-C, triglycerides, and BMI did not change. Symptoms domain scores improved from 73 to 80 in group 1 compared to 72 to 77 in group 3 and 74 to 79 in group 2. Emotions about diabetes improved from 53% of unacceptance to 12% in group 1 compared to 44% to 23.8% in group 3 and 37% to 19.5% in group 2, all these improvements were sustained for 12 months.
Conclusion(s): A 12 months family based intervention improved knowledge, distance walked, total cholesterol and LDL-C. Emotions about diabetes and symptom domain of health related quality of life improved.
Implications: This intervention had an impact on HRQoL and self-care behaviors because the effects were sustained for 12 months.
Keywords: Family based intervention, HRQoL, Type 2 diabetes
Funding acknowledgements: National Research Foundation funding via the university of the Witwatersrand, Gauteng, South Africa
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: University of the Witwatersrand, Gauteng, South Africa
Ethics committee: The Committee for Research for Human Subjects
Ethics number: M060955
All authors, affiliations and abstracts have been published as submitted.
