护士主导的社交媒体干预糖尿病自我管理的评价：一项混合方法研究

摘要（仅供参考）

目标

本研究旨在调查护士主导的社交媒体干预对 2 型糖尿病患者糖尿病自我管理的健康行为和血糖控制的有效性和过程。

设计

本研究采用解释性顺序混合方法设计，进行随机对照试验和定性访谈。

方法

共有 89 名诊断为 2 型糖尿病的患者被随机分配到干预组或对照组。干预组的患者被邀请加入由护士主导的封闭式社交媒体平台，其中包括糖尿病信息、行动计划、无节制聊天以及问答。在基线、3 个月和 6 个月时测量糖尿病自我护理行为、血红蛋白 A1c (HbA1c) 百分比、空腹血糖水平 (FBS)、收缩压和舒张压以及甘油三酯 (TG) 和总胆固醇水平的结果. 使用线性混合模型来分析随着时间的推移干预的有效性。从对参与干预的七名患者的访谈中收集定性数据，并使用定性内容分析进行分析。

发现

6 个月后，接受社交媒体干预的胰岛素使用者的 FBS 和 TG 水平显着低于接受常规护理的人（135.80 ± 12.37 vs. 175.82 ± 15.34 mg/dL，p  = 0.049；206.85 ± 38.26 vs. 387.50 ± 56.19 毫克/分升，p  = 0.013；分别）。尽管在社交媒体干预后，胰岛素和非胰岛素使用者的 HbA1c 水平随时间下降的速度相似，但与对照组相比，非胰岛素使用者在 3 个月和 6 个月时的下降幅度明显更大（6.38 ± 0.34 对 7.25 ± 0.24，p  = 0.040；6.31 ± 0.37 与 7.28 ± 0.26，p = 0.036; 分别）。对参与干预的七名患者的采访表明，他们参与干预主要取决于他们接受管理糖尿病的作用。参与干预后，患者受益于信息共享和互动支持以激发他们的自我保健、护士的专业建议以改变他们的行为，以及行动计划以在行为改变方面取得进展.

结论

护士主导的社交媒体干预的积极成果表明，社交媒体平台是在临床护理实践中实施糖尿病自我管理的有效策略。

临床相关性

护士将成功实施社交媒体干预，以促进患者接受他们在糖尿病管理中的作用，并利用关键服务获得糖尿病信息、支持、专业建议和行动计划。

Abstract

Aims

This study aimed to investigate the effectiveness and understand the process of a nurse-led social media intervention for health behavior and glucose control for diabetes self-management among patients with type 2 diabetes mellitus.

Design

This study had an explanatory sequential mixed methods design, with a randomized controlled trial and qualitative interviews.

Methods

A total of 89 patients diagnosed with type 2 diabetes mellitus were randomly assigned to an intervention or a control group. Patients in the intervention group were invited to join the closed nurse-led social media platform that included diabetes information, action planning, unmoderated chat, and questions and answers. The outcomes of diabetes self-care behavior, hemoglobin A1c (HbA1c) percentage, fasting blood sugar level (FBS), systolic and diastolic blood pressure, and triglyceride (TG) and total cholesterol levels were measured at baseline, 3 months, and 6 months. A linear mixed model was used to analyze the effectiveness of the intervention over time. Qualitative data were collected from interviews with seven patients engaged in the intervention and analyzed using qualitative content analysis.

Findings

After 6 months, insulin users who were provided with the social media intervention had significantly lower FBS and TG levels than those with usual care (135.80 ± 12.37 vs. 175.82 ± 15.34 mg/dL, p = 0.049; 206.85 ± 38.26 vs. 387.50 ± 56.19 mg/dL, p = 0.013; respectively). Although a similar rate of decrease in the HbA1c level over time was observed among insulin and noninsulin users after the social media intervention, this decrease was significantly greater among noninsulin users at 3 and 6 months compared with the control group (6.38 ± 0.34 vs. 7.25 ± 0.24, p = 0.040; 6.31 ± 0.37 vs. 7.28 ± 0.26, p = 0.036; respectively). Interview with seven patients who engaged in the intervention revealed that their engagement in the intervention was primarily determined by their acceptance of the role of managing their diabetes. Being engaged in the intervention, patients benefited from information sharing and interactive support to motivate their self-care, nurses' professional advice to modify their behaviors, and action planning to make progress toward behavioral change.

Conclusions

The positive outcomes of the nurse-led social media intervention indicate that the social media platform is an effective strategy to implement diabetes self-management in clinical nursing practice.

Clinical Relevance

The social media intervention would be successfully implemented by nurses to facilitate patients accepting their role in diabetes management and employing key services for diabetes information, support, professional advice, and action planning.

原文链接：

https://doi.org/10.1111/jnu.12770

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