title: Effectiveness of lifestyle counseling by certified expert nurse of Japan for non-insulin-treated diabetic outpatients: a 1-year randomized controlled trial.
abstract: We examine whether one-to-one lifestyle counseling for non-insulin-treated diabetic outpatients by a Certified Expert Nurse (CEN) can improve patients' health outcomes. Participants were randomly assigned to a 1-year lifestyle intervention (n=67) or to a usual care group (n=67). Main outcome measures were changes from baseline in: HbA(1C) and score of health related quality of life scales (SF-36 and Problem Areas in Diabetes Scale). Cognitive/behavioral modification for 1 year and satisfaction in CEN counseling was also measured by self-produced items. We found no significant differences in HbA(1C), BMI, blood pressure, serum lipids, or health related quality of life over 1 year between the two groups. Patients in the intervention group, however, showed modest but more favorable modification of cognition (p=0.004) and behavior (p<0.001) than subjects in usual care group. The low attrition rate (9%), more frequent hospital visit (12+/-2 times versus 11+/-3 times; p=0.03) and high degree of satisfaction (95%) in the intervention group indicate feasibility of the monthly CEN counseling in the outpatient settings of Japanese hospitals. Future research should confirm the long-term effectiveness of the CEN counseling on clinical outcomes and the cost effectiveness of a possibly time-consuming intervention.
authors.affiliation: Institute of Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba-shi, Ibaraki 305-8575, Japan. taiga@md.tsukuba.ac.jp
authors.forename: Taiga
authors.initials: T
authors.lastname: Shibayama
authors.forename: Koji
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Akiko
authors.initials: A
authors.lastname: Takano
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Kazuma
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D037001:Directive Counseling; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007564:Japan; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009740:Nursing Staff; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000193:education; D010353:Patient Education as Topic
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids