ABSTRACT
Objective To evaluate the effectiveness of a chronic disease self-management program (CDSMP) in the Nanjing community. Methods From April to June 2016, the volunteer patients with chronic diseases from National Basic Public Health Services Plan were recruited and agreed to enter the CDSMP. A total of 42 self-management groups were established. The Nanjing CDSMP was based on the model of the Shanghai CDSMP developed by Stanford University. Questionnaire surveys, anthropometric measurements, and laboratory examinations were collected at 3 measurement moments (baseline, after 6 months, and after 12 months). Qualitative data were obtained from 1-2 participants in each self-management group. Paired t-tests, paired Chi-square tests, generalized estimating equation, and content analysis were used to evaluate the effectiveness of the CDSMP. Results Among 562 eligible patients, 548 completed 3 questionnaire surveys, physical measurements, and laboratory examinations. Sixty-six interviewees completed qualitative evaluations. Compared with baseline, the time of stretching or strengthening exercise and aerobic exercise; the scores on communication with the medical doctor; self-efficacy to manage symptoms and manage disease in general; quality of life in physical component summary and mental component summary; and rate of glucose control were all higher after 6 months and after 12 months interventions, whereas the score of fatigue; pain, health distress; social/role activities limitation; and the value of body weight, systolic blood pressure, and triglyceride were all decreased (all P values<0.01). The satisfaction rate of CDSMP in general, and content were 87.9%, 90.9%, and 83.3%, respectively. Conclusion Overall, the Nanjing CDSMP was successful in improving knowledge and self-management skills, increasing self-management behaviors, self-efficacy, health status, and quality of life, and decreasing body weight, blood pressures, and lipids. It is suggested that CDSMP may be widely used in Nanjing communities.
ABSTRACT
Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.