Effects of multifaceted nurse-coaching intervention on diabetic complications and satisfaction of persons with type 2 diabetes.
OBJECTIVE
To examine the effects of multifaceted nurse-coaching intervention on diabetic complications which were assessed by HbA1c, blood pressure, LDL-C levels and satisfaction with nursing intervention of persons with type 2 diabetes.


METHODS
Quasi-experimental design study was conducted from October 2007 to March 2008. Forty participants with type 2 diabetes of two Red Cross Health Stations in Bangkok, Relief and Public Health Bureau of the Thai Red Cross Society, were selected by purposive sampling and matched pair The participants of the 11th Red Cross Health Station were the control group (n=20) who received the usual care while the participants of the 2nd Red Cross Health Station were the experimental group (n=20) who received the multifaceted nurse-coaching intervention over 12 weeks. A multifaceted nurse-coaching intervention was performed on a trail basis on the coaching model of Eaton and Johnson (2001). The coaching process included assessment, goal definition, analysis, exploring, action plan, learning and feedback and consisted of 3 individualized sessions and 2 follow-up phone calls over 12 weeks. The community nurses were trained to be involved in the intervention. Data from each participant were collected by using a questionnaire related to their personal demography and signs or risk factors of diabetic complications including HbA1c, blood pressure and LDL-C testing, and interviewing satisfaction with nursing intervention questionnaire. The data were analyzed using dependent samples t-test, and independent sample t-test.


RESULTS
Both groups were similar in age, sex and duration of diabetic history. After 12 weeks, the mean average of HbA1c of the experimental group was significantly lower than that of the control group (x(exp) = 7.10, SD = .67 vs. x(cont) = 7.72, SD = .97; p < or = 0.5). There was no statistically significant difference in blood pressure between the experimental group and the control group (systolic blood pressure: x(exp) = 121.0, SD = 10.28 vs. x(cont) = 127.4, SD = 15.30; p > 0.5, diastolic blood pressure: x(exp) = 81.30, SD = 9.18 vs. x(con) = 79.4, SD = 19.43; p > .05). There was also no difference between the two groups in average mean of LDL-C level (x(exp) = 123.60, SD = .45.53 vs. X(cont) = 110.40, SD = 25.60; p > .05). The participants in the experimental group had significantly higher satisfaction score than the control group (x(exp) = 4.91, SD = 0.91 vs. x(cont) = 2.49, SD = 0.18; p < 0.5).


CONCLUSIONS
The multifaceted nurse-coaching intervention could reduce HbA1c and increase satisfaction but could not decrease blood pressure and LDL-levels in persons with type 2 diabetes who received the intervention for 12 weeks.
Navicharern
Rungrawee
R
Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand. nrungrawee@yahoo.com
Aungsuroch
Yupin
Y
Thanasilp
Sureeporn
S
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D048909:Diabetes Complications / Q000451:nursing / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000517:prevention & control*; D006442:Glycated Hemoglobin; D015277:Hotlines; D006801:Humans; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013785:Thailand
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin