title: The impact of patient narratives on self-efficacy and self-care in Australians with type 2 diabetes: stage 1 results of a randomized trial.
abstract: A randomized-controlled trial (RCT) was conducted from September 2009 to June 2011. National Diabetes Services Scheme registrants diagnosed with type 2 diabetes and aged 30-70 years were invited to participate in a 3-week intervention programme with follow-up at 4 weeks and 6 months. Data were collected using self-report questionnaires in the participant's homes. The intervention group received diabetes factsheets and a DVD comprising patient stories (narratives) of type 2 diabetes management. The control group (CG) received factsheets only. The RCT evaluated the impact of patient narratives on the study outcomes, self-efficacy and self-care, using the Aust/English Diabetes Management Self-efficacy Scale and the Summary Diabetes Self-care Activities measure. Participants were randomly assigned to the intervention or CG using block randomization. The study was not blinded. Six hundred and seventy people enrolled into the study with 335 allocated to each group. At 4 weeks, data were available for 598 participants. t-tests were used to analyse the results. The mean difference between the groups for self-efficacy was 7.2 units (P < 0.001, 95% Confidence Interval (CI) 3.8, 10.7) favouring the intervention group. Change in self-care behaviours during the previous 7 days was also significantly greater for the intervention group: general diet (0.31 days, 95% CI 0.13, 0.48), specific diet (0.26 days, 95% CI 0.05, 0.46), exercise (0.51 days, 95% CI 0.23, 0.80), blood glucose (0.52 days, 95% CI 0.19, 0.85) and foot care (0.38 days, 95% CI 0.06, 0.71). Narrative communication shows promise as a valuable component of type 2 diabetes self-management programmes.
  
  
  BACKGROUND
  ACTRN 12609000210279.
authors.affiliation: Melbourne School of Population Health, Centre for Health Policy, Programs and Economics, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, Australia c.campbell6@student.unimelb.edu.au.
authors.forename: Tina
authors.initials: T
authors.lastname: Campbell
authors.affiliation: Melbourne School of Population Health, Centre for Health Policy, Programs and Economics, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Dunt
authors.affiliation: School of Social and Political Sciences, The University of Melbourne, Melbourne, VIC Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Fitzgerald
authors.affiliation: Statistical Consulting Centre, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: I
authors.initials: I
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D033262:Narration; D012107:Research Design; D012648:Self Care; D020377:Self Efficacy; D057566:Self Report
keywords: narrative communication; self-efficacy; self-management; type 2 diabetes