Effect of health management under the transtheoretical model and stages of change on diabetes mellitus patients with obesity / 中华健康管理学杂志

ABSTRACT

Objective:To study the effect of health management based on the transtheoretical model and stages of change on patients with diabetes mellitus complicated by obesity.Methods:A total of 122 patients with type 2 diabetes mellitus (T2DM) complicated by obesity and admitted to Guangdong Second Provincial General Hospital between January 2019 and June 2020 were recruited to participate in the study. They were divided into two equal groups at random, the observation group and the control group —with 61 patients in each group. Both groups were subjected to individualized health management based on conventional drug treatment. The control group received routine health education and psychological support, while the observation group was subjected to the transtheoretical model and stages of change interventions for six months. The independent-samples t-test was used to compare blood glucose, body weight, and self-efficacy in the two groups after interventions, and the χ 2 test or Fisher′s precise test was used to compare behavior habit compliance rates in the two groups after interventions. Results:FBG with (6.27±0.92) mmol/L and (6.58±0.91) mmol/L, 2hPG with (8.53±1.39) mmol/L and (8.53±1.39) mmol/L, and HbA1c with (6.49±0.91)% and (6.78±0.96)% in the two groups were significantly lower at six months of interventions than those before ( P<0.05), but the differences between the two groups were not statistically significant ( P>0.05). BMI, waist circumference, and body fat rate with (30.46±2.51) kg/m 2, (91.72±10.45) cm, and (34.09±3.84)% of the observation group at six months of interventions were significantly lower than those before interventions ( P<0.05), whereas there were no significant changes in the control group before and after interventions ( P>0.05). The observation group′s BMI and body fat rate were lower than those of the control group ( P<0.05). The General Self-Efficacy Scale (GSES) scores in the two groups were (31.62±2.59) points and (28.75±2.48) points, which were significantly higher than those before interventions ( P<0.05). The observation group′s GSES score was higher than that of the control group ( P<0.05). At six months of interventions, the compliance rates of diet control (92.98% and 77.97%), reasonable exercise (87.72% and 71.19%), adherence to medication (98.25% and 91.53%), quitting smoking and alcohol (94.74% and 81.36%), blood glucose monitoring (91.23% and 94.92%), and regular review (100.00% and 98.31%) were all significantly higher in the two groups than those before interventions ( P<0.05). Additionally, the compliance rates of diet control, reasonable exercise, and quitting smoking and alcohol in the observation group were higher than those of the control group ( P<0.05). Conclusion:The use of the transtheoretical model and stages of change for the self-management intervention of diabetes mellitus patients with obesity is beneficial to improve self-efficacy, behavioral habits, and weight control effectiveness.