1Full professor nursing, Departman of medical surgical nursing, School of nursing and midwifery, Tehran University of Medical sciences, Tehran, Iran
2Instructor of nursing, Departman of medical surgical nursing, School of nursing and midwifery, Zanjan University of Medical sciences, Zanjan, Iran
3Instructor of nursing, Departman of medical surgical nursing, School of nursing and midwifery, Tehran University of Medical sciences, Tehran, Iran
4Associate professor of Medical Statistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical sciences, Tehran, Iran
5Associate professor of Endocrinology, Endocrinology and Metabolism Research Center, Tehran University of Medical sciences, Tehran, Iran
6Instructor of nursing, Department of medical surgical nursing, School of nursing and midwifery, Alborz University of Medical sciences, Karaj, Iran
Background: Diabetes control needs more effective educational programs. Self-care education is an important factor in diabetes control. It seems that the symptoms can be the proper stimulus for the direction toward self-care. Aim: To evaluate the effects of the using SFMM on HbA1c, knowledge, self care practices, and symptoms of type2 diabetic patients. Methods: Seventy type 2 diabetic patients were randomly assigned to the intervention and control groups. Data was assessed using four-part questionnaire, diabetic knowledge, self-care practices and symptoms of patients. HbA1c was also measured. The subjects in the intervention group received 3-4 individual educational sessions, which lasted 60-90 minutes. The educational sessions were focused on the self-management behaviors. The subjects in the control group received routine educations. After 3 months, the above mentioned variables were measured again. Data was analyzed with SPSS 15.0 and STATA using paired T-tests, GLM, fisher-test, and covariance. Results: The finding presented in this study showed a decrease in HbA1c levels in the experimental group, however, this decrease did not reach statistical significance (P=0/06). There was a significant increase in the knowledge of diabetes (P<0/001) and self-care practices such as diet (P=0/02). The intervention group experienced a decrease in hyperglycemia and hypoglycemia symptoms (P=0/02, nP=0/02). However, no statistical differences were observed in foot-care (P=0/56), physical activity (P=0/3), blood glucose control (P=0/4), and medication (P=0/35) self-care practices. The differences in frequency of sensational symptoms (P=0/33), and other symptoms of patients between two groups were not significant (P=0/12). Conclusion: The results showed that application of this model (SFMM) is effective in the education of type 2 diabetes. In addition, this model suggested the need for designing educational programs.
1. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2009; 32 (Suppl.1): 13-61.
2. Ahmadi A, Hasanzadeh J, Rajaeifard AAR. Metabolic Control and Care Assessment in Patients with Type 2 Diabetes in Chaharmahal & Bakhtiyari Province 2008. Iran J Endocrinol Metab (IJEM) 2009; 11 (1): 33-9. (Persian)
3. Kashfi SM, Khani Jeyhouni A, Bahadori Khalili R, Hatami M. Evaluation of the Effects of Educating About Nutrition and Jogging on the Blood Sugar of Type II Diabetic Patients of a Clinic in Shiraz, Iran. Hakim Res J 2009; 12(3):54-60. (Persian)
4. Azimi-Nezhad M, Ghayour-Mobarhan M, Parizadeh MR, Safarian M, Esmaeili H, Parizadeh SM, et al.Prevalence of Type 2 Diabetes Mellitus in Iran and Its Relationship with Gender, Urbanisation, Education,Marital Status and Occupation. Singapore Med J 2008; 49(7): 571-6.
5. Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, et al. Prevalence of Diabetesand Impaired Fasting Glucose in the Adult Population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes Care 2008; 31(1): 96-8.
6. Amini M, Khadivi R, Haghighi S. Costs of Type 2 Diabetes in Isfahan, Iran in 1998. Iran J Endocrinol Metab 2002; 14(4): 97-104. (Persian)
7. Fowler MJ. Microvascular and Macrovascular Complications of Diabetes. Clin Diabetes 2008; 26: 77-82.
8. Skelly AH, Leeman J, Carlson J, Soward A CM, Burns D. Conceptual Model of Symptom Focused Diabetes Care for African Americans. J Nurs Scholarsh 2008; 40(3): 261–7.
9. Tabatabaimalazi O, Peyman M, Heshmat R, Pajohi M. Diabetes Care in Elderly Patients with Diabetes Referred to Diabetes Clinic of Shariati Hospital. Iran J Diabetes Lipid Disord 2009; 10(2): 161-9. )Persian(
10. Shamsi M, Shrifi Rad Gh, Kachouee A, Hsanzadeh A, Dejam S. Knowledge, Attitude and Practice of Female Patients with Type 2 Diabetes About Walking Out. Payesh Health Monit 2011;10(4):477-84. (Persian)
11. Golchin M, Ghorbani A. Knowledge and Practice on Insulin Self Injection Procedure in Diabetic Patients at Qazvin Diabetes Unit (Short Report). J Qazvin Univ Med Sci 2008; 12(1): 89-91. (Persian)
12. Stover J, Skelly A, Holditch-Davis D, Dunn P. Perceptions of Health and Their Relationship to Symptoms in African American Women with Type 2 Diabetes. Appl Nurs Res 2001; 14(2): 72–80.
13. Naegeli AN, Stump TE, Hayes RP. A Psychometric Evaluation of the Diabetes Symptom Checklist-Revised (DSC-R) Cognitive Distress, Fatigue, Hyperglycemia, and Hypoglycemia Subscales in Patients with Type 1 and Type 2 Diabetes. Diabetes Metab Syndr Obes 2010; 3: 27–30.
14. Diabetes Complications and Control Trial Research Group. The Effect of Intensive Therapy for Diabetes on the Development and Progression of Long-Term Complications. N Engl J Med 1993; 329: 977–86.
15. Teel CS, Meek P, McNamara AM, Watson L. Perspectives Unifying Symptom Interpretation. J Nurs Scholarsh 1997;29: 175–81.
16. Skelly AH, Carlson JR, Leeman J, Holditch-Davis D, Soward A. Symptom-Focused Management for African American Women with Type 2 Diabetes: A Pilot Study. Appl Nurs Res 2005; 18(4): 213-20.
17. Mahmodi A. Effect of Self-Care Practice Education on HbA1c In Diabetic Patients. Med Sci J Islamic Azad Univ Tehran Med Branch 2006; 16(3): 171-6. (Persian)
18.Scain SF, Santos BL, Friedman R, Gross JL. Type 2 Diabetic Patients Attending a Nurse Educator Have Improved Metabolic Control, Diabetes Res Clin Pr 2007; 77 (3): 399–404.
19. Gallegos EC, Ovalle-Berumen F, Gomez-Meza MV. Metabolic Control of Adults with Type 2 Diabetes Mellitus Through Education and Counseling. J Nurs Scholarsh 2006; 38:344–51.
20. Shamsi M, Sharifirad G, Kachoyee A, Hassanzadeh A. Influence of Walking Training on Hemoglobin Glocosile and Fasting Blood Sugar Levels in Women With Type 2 Diabetes. Koomesh 2010; 11(5): 99-106. (Persian)
21. Shabbidar S, Fathi B. Effects of Nutrition Education on Knowledge and Attitudes of Type 2 Diabetic Patients. J Birjand Univ Med Sci 2007; 14(1): 9-15. (Persian)
22. Van Den Arend HJM, Stolk RP, Ruttent G, schrijvers g. Education Integrated Into Structured General Practice Care for Type 2 Diabetic Patients Results In Sustained Improvement of Disease Knowledge and Self-Care. Diabetic Med 2000; 17: 190-7.
23. Gallegos EC, Ovalle-Berumen F, Gomez-Meza MV. Metabolic Control of Adults with Type 2 Diabetes Mellitus Through Education and Counseling. J Nurs Scholarsh 2006; 38: 344–51.
24. Miller CD, Phillips LS, Ziemer DC, Gallina DL, Cook CB, El-Kebbi IM. Hypoglycemia in Patients with Type 2 Diabetes Mellitus. Arch Intern Med 2001; 161(13): 1653.
25. Mousavifar SA, Zolfaghari M, Pedram S, Haghani H. The Impact of Nurse Short Message Services and Telephone Follow-Ups on Diabetic Adherence. Iran J Diabetes Lipid Disord 2012; 10(4): 407-18. (Persian).
26. Shahbazian HB, Hashemi SJ, Arghideh M, Fardad F, Latifi SM. Prevalence of Gastrointestinal Symptoms in Type 2 Diabetic Patients and Its Association with Glycemic Control and Duration of Diabetes. Iran J Endocrinol Metab2012; 13(5): 459-66. (Persian).
27. Van der Does FE, De Neeling JND, Snoek FJ, Kostense PJ, Grootenhuis PA, Bouter LM, Heine RJ. Symptoms and Well-Being in Relation to Glycemic Control in Type II Diabetes. Diabetes Care 1996; 19(3): 204-10.
28. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2005; 28: S4-42.