The Impact of M-Health on the Self-Management of Diabetes: A preliminary study

Transcription

1 The Impact of M-Health on the Self-Management of Diabetes: A preliminary study Annie Chang Associate Professor School of Nursing Fooyin University, Taiwan

2 Introduction Diabetes mellitus [1-3] is a life-long chronic disease; can damage all regions of the body; needs on-going process of self-management; used traditional education and learning methods.

3 Introduction M-health [4] abbreviation for mobile health, 2/3 population owns a mobile phone Functions building community delivery of healthcare information real-time monitoring direct provision of care

4 Introduction Minimal Psychological Intervention (MPI) [5-7] Applying principles of self-management and cognitive behavioral therapy

5 Purpose of this study To explore the impact of this m-health programme on diabetes patients Diabetes Knowledge, Psychological distress, and Self-care behaviours.

6 Methods One-group pretest-posttest pre-experimental design Selection criteria were: 1) diagnosis of diabetes; 2) age over 20 years; 3) no serious condition; 4) internet access via smartphone, A total of 30 patients were recuited

7 M-Health Programme Facebook with Private/Closed group Receiving online-lectures and quizzes, Sharing experiences, and Communicating with each other Providing diabetes APP A total of 10 online thematic activities

8 Facebook Welcome Group s name Community Activities Sharing

9 Wk Themes MPI Design Cognitive section 1. Cognition: relationships of diet and Understand diabetes diet diabetes 2 Design my plate daily 2. Affect: triggering motivation to change Affective section Understand new tool for diet control Plate-app to plan calories daily Psychological section Understand emotions and diabetes Practise relaxation techniques Behavioural section Experience sharing Fill the questionnaire 3. Skill: self-assessment of consciousness 1. Cognition: taking control of diet 2. Affect: triggering motivation to change 3. Skill: aroused affection, app usage 1. Cognition: taking control of emotions related to diabetes 2. Affect: adjusting mentality 3. Skill: music therapy and meditation 1. Cognition: posttest questionnaire 2. Affect: support from each other 3. Skill: overview of programme

10 Week 4 APP Design my plate Step by step Discussion

11 Week 3 Excercise Video to follow communication Who readied it

12 Instruments Sociodemographic data Diabetes Knowledge: CVI >.8 Self-care behaviours scale: Cronbach s α=.86 Psychological health: Cronbach s α =.85

13 Data collection Approved by the Human Research Ethics Committee (NCKU HREC-E ) A written consent form to indicate their willingness to join the study Using SPSS statistical package version 22 for data analyses

14 Results Demographic characteristics A total of 30 participants Gender: 80% female Age: 46±8.9 years Education: 100% completed primary school Employment: 80% employed Only, 22 participants completed the m-health programme Withdrawal reasons: not familiar with media devices or Facebook, apps, and weekly lectures, etc.

15 Results Pretest-posttest findings Variables Pretest Posttest Mean SD Mean SD T P Diabetes knowledge Psychological health Diabetes self-care behaviours Foot care Diet Control Exercise Medication Compliance Self-monitoring blood sugar

16 Discussion Significant improvement in diabetes self-care behaviours and Slight changes in psychological distress Psychological distress emotional problems (p <.05) diet-related problems (p >.05) No changes in diabetes knowledge Pre-test score of 6.09 (total score:7)

17 Several limitations Research design, Instruments, and Selection bias.

18 Implication further research Feasibility, Usability, and Acceptability

19 Conclusion This study provided a platform for diabetes patients to keep them posted with updated information, lectures, discussion, and social interaction, so that they maybe more willing to engage in their self-care activities

20 References 1. International Diabetes Federation, IDF Diabetes Atlas, International Diabetes Federation 2017 retrieved from: [ 2. M.E. Murphy, M. Byrne, R. Galvin, F. Boland, T. Fahey, S.M. Smith, Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings, BMJ Open 7 (2017), e T. Al Slamah, B.I. Nicholl, F.Y. Alslail, C.A. Melville, Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review, PLoS One 12 (2017), e C. Free, G. Phillips, L. Galli, L. Watson, L. Felix, P. Edwards, V. Patel, A. Haines, The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review, PLoS medicine 10(2013), e C.J. Chiu, Y.H. Hu, L.A. Wray, E. A. Beverly, Y.C. Yang, J.S. Wu, F.H. Lu, Dissemination of evidence-base minimal psychological intervention for diabetes management in Taiwan adults with type 2 diabetes. International Journal Of Clinical And Experimental Medicine 9(2016): C.C. Jonkers, F. Lamers, H. Bosma, J. F. Metsemakers, & J. T. M.van Eijk, The effectiveness of a minimal psychological intervention on self-management beliefs and behaviors in depressed chronically ill elderly persons: a randomized trial. International psychogeriatrics 24(2012), B.H. Chew, R.C. Vos, M.I. Metzendorf, R.J. Scholten, G.E. Rutten, Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus. Cochrane Database Syst Rev 27(2017): CD

21 Thanks for your attention Annie Chang Associate Professor School of Nursing Fooyin University