Impact of a Dyadic Intervention on Family Supporter Involvement in Helping Adults Manage Type 2 Diabetes.
Impact of a Dyadic Intervention on Family Supporter Involvement in Helping Adults Manage Type 2 Diabetes.
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DOI：
10.1007/s11606-021-06946-8
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发表时间：
2022-03
影响因子：
5.7
通讯作者：
Rosland AM
中科院分区：
文献类型：
--
作者：
Zupa MF;Lee A;Piette JD;Trivedi R;Youk A;Heisler M;Rosland AM
家庭对成人糖尿病护理的支持与改善自我管理和结果相关，但医疗保健提供者缺乏有组织的方式来吸引这些支持者。评估患者-支持者糖尿病管理干预对支持者参与患者糖尿病护理、支持技术和护理体验的影响。多元回归模型检验了在一项更大的试验中观察到的与支持相关的测量的组间差异，该试验将参与者随机分为二元干预组和常规护理组。共有239名患有2型糖尿病、糖化血红蛋白8%或收缩压160毫米汞柱的成年人向家庭支持者登记。健康教练提供关于积极支持技术的培训，并促进自我管理、信息共享和目标设定。患者和支持者报告基线和12个月的糖尿病护理和护理经验中的支持者角色。在12个月时，接受干预的患者报告在以下方面增加了支持者的参与度：记住医疗预约(AOR 2.74，95%CI 1.44，5.21)、执行家庭测试(AOR 2.40，95%CI 1.29，4.46)、访问在线门户网站(AOR 2.34，95%CI 1.29，4.30)、决定何时联系医疗保健提供者(AOR 2.12，95%CI 1.15，3.91)和补充药物(AOR 2.10，95%CI 1.14，3.89)，但不是去看医生，也不是健康饮食和锻炼。被分配干预的患者报告了更多的支持者使用自主性支持性沟通(7分制中+0.27分，p=0.02)和目标设定技术(5分制中+0.30分，p=0.01)。在12个月时，衡量支持者对患者糖尿病或护理负担的痛苦程度的变化分数没有差异。被分配干预的支持者对卫生系统对他们的作用的支持的满意度有明显更大的提高(10分制中+0.88分，p=0.01)。在不增加照顾者压力的情况下，患者-支持者的二元式干预导致家庭支持者更多地参与糖尿病自我管理，并增加了积极支持技术的使用。网上版载有补充材料，可在10.1007/s11606-021-06946-8查阅。
Family support for adults’ diabetes care is associated with improved self-management and outcomes, but healthcare providers lack structured ways to engage those supporters. Assess the impact of a patient-supporter diabetes management intervention on supporters’ engagement in patients’ diabetes care, support techniques, and caregiving experience. Multivariate regression models examined between-group differences in support-related measures observed as part of a larger trial randomizing participants to a dyadic intervention versus usual care. A total of 239 adults with type 2 diabetes and either A1c >8% or systolic blood pressure >160mmHg enrolled with a family supporter. Health coaches provided training on positive support techniques and facilitated self-management information sharing and goal-setting. Patient and supporter reports at baseline and 12 months of supporter roles in diabetes care and caregiving experience. At 12 months, intervention-assigned patients had higher odds of reporting increased supporter involvement in remembering medical appointments (AOR 2.74, 95% CI 1.44, 5.21), performing home testing (AOR 2.40, 95% CI 1.29, 4.46), accessing online portals (AOR 2.34, 95% CI 1.29, 4.30), deciding when to contact healthcare providers (AOR 2.12, 95% CI 1.15, 3.91), and refilling medications (AOR 2.10, 95% CI 1.14, 3.89), but not with attending medical appointments or with healthy eating and exercise. Intervention-assigned patients reported increased supporter use of autonomy supportive communication (+0.27 points on a 7-point scale, p=0.02) and goal-setting techniques (+0.30 points on a 5-point scale, p=0.01). There were no differences at 12 months in change scores measuring supporter distress about patients’ diabetes or caregiving burden. Intervention-assigned supporters had significantly larger increases in satisfaction with health system support for their role (+0.88 points on a 10-point scale, p=0.01). A dyadic patient-supporter intervention led to increased family supporter involvement in diabetes self-management and increased use of positive support techniques, without increasing caregiver stress. The online version contains supplementary material available at 10.1007/s11606-021-06946-8.
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5.2
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