与对照组相比，干预组的参与者在HbA1c（β= 2.87; p <0.01）和生活质量（β= 7.69; p <0.01）方面的改善显着更大。自我效能提高（间接作用：β= 0.18，p <0.05）和治疗依从性改善（间接作用：β= 0.17，p <0.05）显着介导了干预与血糖控制和生活质量之间的关系；总体而言，该模型解释了HbA1c变异的52.5％和生活质量变异的34.2％。
Individuals with type 2 diabetes have a heightened risk of developing serious complications post hospital discharge. Web-based transitional care is a promising intervention to improve the glycemic control and quality of life of this patient group; however, whether web-based transitional care can improve the glycemic control and quality of life of this group remains unknown. Further, the mechanisms underlying the relationships between the intervention and both glycemic control and quality of life have not been fully explored.
The aims of this study were to develop a web-based transitional care program and evaluate its effects on the glycemic control and quality of life of Chinese patients with type 2 diabetes and to explore the mediating roles of self-efficacy and treatment adherence.
Randomized controlled trial.
Settings and participants
This study was conducted in a large regional hospital in Guangzhou City, China. Patients diagnosed with type 2 diabetes were included.
A total of 116 eligible participants were randomly assigned to receive either the 3-month web-based transitional care program or usual care. Assessments of hemoglobin A1c (HbA1c), self-efficacy, treatment adherence, and quality of life were conducted at baseline and at 3 months. Analysis followed the intention-to-treat principle. A generalized estimating equation was used to determine intervention effects on HbA1c and quality of life. Path analysis was used to assess the mediation of these effects by changes in self-efficacy and treatment adherence during the intervention.
Participants in the intervention group had significantly greater improvements in HbA1c (β = 2.87; p < 0.01) and quality of life (β = 7.69; p < 0.01) compared with the control group. The relationships between the intervention and both glycemic control and quality of life were significantly mediated by improved self-efficacy (indirect effect: β = 0.18, p < 0.05) and improved treatment adherence (indirect effect: β = 0.17, p < 0.05); overall, the model explained 52.5% of the variance in HbA1c and 34.2% of the variance in quality of life.
Our study identified beneficial effects of a web-based transitional care program on glycemic control and quality of life post hospital discharge in people with type 2 diabetes, and the underlying mediating mechanisms. The effectiveness and feasibility of this web-based intervention program suggests that its application should be promoted in community settings to reduce poor outcomes in people with type 2 diabetes.