title: Mobile phone-based education and counseling to reduce stress among patients with diabetes mellitus attending a tertiary care hospital of India.
abstract: BACKGROUND
  Stress among diabetic patients is much more as compared to normal individuals. A delayed recognition of stress undoubtedly worsens the prognosis for survival for many diabetic patients. Hence, this study was planned to develop an intervention model for the reduction of stress among diabetic patients and to evaluate the developed intervention model in the proposed group.
  
  
  METHODS
  This study was conducted in endocrinology outpatient department of a tertiary care hospital. Starting at random, the patients were allocated to control group and test group. Controls were given printed educational materials. Test group were counseled with intense lifestyle education using both printed materials and computers; they were contacted by telephones by the investigator every 3 weeks for 3 months and SMS were sent every week containing some educational tips.
  
  
  RESULTS
  Mean age was 54 ± 11.5 years overall ranging from 30 years to 80 years. About two-third of participants were males with similar distribution in both the groups (intervention = 66%, control = 64%). Half (50%) of the participants lived in joint families, followed by nuclear families (40%). Most (83%) were married and with either graduate or above graduate education (n = 39%). No significant difference was observed in socio-demographic characteristics among both control and intervention groups (P > 0.05). The average stress scores were similar (18.9) at baseline for control and intervention arms. At 3-month follow-up, however, these scores reduced to 17.05 in the intervention arm while they increased to 20.7 in the control arm. At 3 months follow-up, higher proportion of stress reduction was seen in the intervention group.
  
  
  CONCLUSIONS
  Intervention in the form of intensive lifestyle education and phone calls and SMS significantly decrease their stress score. Mobile-based education has great potential to improve their mental status and increase patient-provider communication, and to decrease stress.
authors.affiliation: Department of Community Medicine, IMS and SUM Hospital, S 'O' A University, Bhubaneswar, Khordha, Odisha, India.
authors.forename: Lipilekha
authors.initials: L
authors.lastname: Patnaik
authors.affiliation: Department of Health Services Research and Administration, Center for Global Health and Development, University of Nebraska Medical Center, College of Public Health, Omaha, NE, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Department of Community Medicine, IMS and SUM Hospital, S 'O' A University, Bhubaneswar, Khordha, Odisha, India.
authors.forename: Trilochan
authors.initials: T
authors.lastname: Sahu
keywords: Mobile phone-based education; SMS; stress