摘要
Objectives:To examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabetes.Methods:Quasi-experimental,two-group,pretest-posttest design was applied.Using random geographic cluster sampling,older adults who met the inclusion criteria were assigned to two groups,62 in the intervention group and 71 in the control group.The intervention group received the comprehensive health education plus village health volunteer monitoring support program.The control group received only the comprehensive health education program.Study outcomes,including blood glucose level,knee pain and range of motion,body weight,physical ability(Timed Up and Go Test),fatigue,depressive symptoms,quality of sleep,and quality of life,were assessed at baseline,3 months,and 6 months after enrollment and analyzed using descriptive statistics and multivariate analysis of variance.Results:One hundred and ten participants completed the study(55 participants in each group).Most patient outcomes in the two groups showed general improvement with statistical significance(P<0.001):pain decreased,physical ability improved,less depressive symptoms and fatigue,quality of life and sleep improved.The interaction effect(the group and time)demonstrated statistically significant differences between the intervention and control groups on pain,knee range of motion,and fatigue according to each time follow-up(P<0.001).Conclusions:The comprehensive health education plus village health volunteer monitoring support program promotes good patient outcomes in this population.The integrated health education resource and support for older adults with knee osteoarthritis and type 2 diabetes is an effective,non-surgical treatment that highlights professional nursing roles and non-professional rolesdvillage health volunteers.Nurses should consider implementing a health education plus monitoring support program to mitigate the effects of chronic diseases and improve patients’quality of life.
目的研究综合健康教育联合乡村健康促进志愿者支持项目在合并2型糖尿病和膝关节骨性关节炎老年超重患者中应用的效果。方法采用两组前后对照类实验研究设计。按照所在地理位置,将符合纳入标准的老年人分为两组,干预组62例,对照组71例。干预组接受综合健康教育联合乡村健康促进志愿者支持项目干预,对照组仅接受综合健康教育。入组时及入组3个月、6个月时对患者结局指标进行评估,包括血糖、膝关节疼痛和活动度、体质量、身体活动能力(起立-行走计时测试)、疲劳、抑郁症状、睡眠质量和生活质量,使用多元方差分析方法进行统计分析。结果共110例患者完成了研究(每组55例)。两组患者在干预6个月后疼痛状况、身体活动能力、抑郁症状、疲劳状况、睡眠质量和生活质量均有改善,差异有统计学意义(P≤0.001);患者疼痛状况、膝关节活动度和疲劳情况存在组间与时间交互效应(P<0.001)。结论针对合并膝关节骨性关节炎和2型糖尿病的老年超重患者的综合健康教育联合健康促进志愿者支持项目有效改善了患者结局,显示了护理专业人员和非专业人员——乡村健康志愿者的作用。应考虑通过实施综合健康教育联合乡村健康促进志愿者支持项目,以改善慢性病患者状况,提高其生活质量。
基金
This study was funded by the National Research Council of Thailand(NRCT/2019).
