Impact of the Problem on the Patient
People with T2DM have a higher risk of health problems such as stroke, kidney failure, and heart attack. Patients may also perceive a loss of independence and self-control. Treatment of T2D is very costly. Individuals diagnosed with T2D incur approximately $16,750 yearly in medicinal costs. Diabetes can even cause the death of a patient.
Impact of the Problem on the Organization
Increased hospital expenditure. About $1 in every $4 in health care is spent on patients diagnosed with T2D. Most expenses are associated with hospitalizations and medicines used to cure diabetes complications.
Identify the PICO components.
P – Novel DSME patient group with type 2 diabetes mellitus (T2DM)
I – Diabetes self-management education (DSME) programme
C – The traditional DSME group
O – Improved self-management behavior, social resources utilization, and hemoglobin
Evidence-Based Practice Question
In the novel DSME patient group with type 2 diabetes mellitus (T2DM), what is the effectiveness of a diabetes self-management education (DSME) programme based on multi-social utilization compared to a traditional DSME group in improving self-management behavior, social resources utilization, and HbA1c levels?
Research Article Title
The effectiveness of the self-management programme based on multilevel social resources utilization in diabetes mellitus patients
Background Introduction
Diabetes mellitus (DM) is among the most common chronic illnesses, whereby 90% of the affected individuals experience type 2 diabetes mellitus (T2DM) (Zhang et al., 2023). Most healthcare organizations have considered T2D diabetes self-management education effective in helping them live optimally in terms of health. Studies report that DSME is designed to reduce the inception and advancement of complications resulting from DM, to enhance lifestyle behaviors (like healthy eating and conducting more regular physical activities, to improve associated diabetes self-effectiveness), to facilitate healthy coping, to reduce undesirable emotions like depression and anxiety, and to mend the quality of life. Such benefits are particularly the outcome of diabetes self-management behavior gained through DSME. While researchers formally recognize the significance of DSME, it fails to assure long-standing effective DM self-management. At the same time, the management behavior level has proved to diminish after six months of the intervention.
Methodology
The study employed a randomized control trial. The authors recruited 118 participants suffering from T2DM from two different communities through a randomized sampling randomly assigned to the novel and the traditional DSME groups. The study implemented DSME focused on multilevel social resource use in the novel DSME group. The authors collected data at the baseline (T0), at the intervention’s end (T1), and three months after the intervention ended (T2).
Level of Evidence
The level of evidence for the research-based article is Level I (higher quality of evidence). It is a high-quality randomized trial, testing previously developed diagnostic criteria on sensible costs, consecutive patients, and values acquired in various studies with a multi-sensitivity analysis.
Data Analysis
The study performed data analysis using the IBM SPSS version. The authors conducted descriptive statistics to obtain a summary of the demographic and medical variables. The baseline characteristics of the participants were compared by employing an unpaired t-test. For ranked or categorical variables, the study used Person’s X2. The overall linear model with repetitive ANOVA measures investigated the impact of groups, variations with time, diabetes self-management tendency, DM self-management SRU, and hemoglobin levels.
Ethical Considerations
The ethical considerations in the research-based article involved guaranteeing the participant’s safety, accurately and honestly reporting the results, and adhering to the accepted protocols. In addition, the study sought approval from the Institutional Review Board (IRB) at West China Hospital of Sichuan University. Every participant gave informed written consent.
Quality Rating
The quality rating for this research-based article was Grade A. The certainty of evidence for the effectiveness of treatment is very high. The study’s high level of proof reflects the degree to which confidence in estimating the effect is satisfactory in supporting the recommendations.
Analysis of the Results / Conclusions
The novel DSME program focusing on multilevel social resource use can efficiently enhance self-management behaviors, social resource use, and lower levels of HbA1c T2DM among patients. More significantly, the effect can last longer.
Alignment to the EBP question
The results or conclusions of the study demonstrated that in the novel DSME patient group with type 2 diabetes mellitus (T2DM), the diabetes self-management education (DSME) programme based on multi-social utilization is effective compared to traditional DSME group in improving self-management behavior, social resources utilization and HbA1c levels.
Non-Research Article Title
Influence of the Model of Care on the Outcomes of Diabetes Self-Management Education Program
Background Introduction
Diabetes mellitus is among the most chronic infections globally and is the fifth leading cause of death in many developed nations and, hurriedly, becoming the most significant health issue. Type 2 diabetes accounts for about 95% of cases of diabetes (Kumah et al., 2021). The increasing T2DM prevalence has emphasized the need for evidence-based procedures for effective management, prevention, and treatment. Diabetes self-management education (DSME) can generate positive outcomes on a patient’s behavior in the status of their health.
Type of Evidence
The type of evidence used in the non-research-based article was a systematic review.
Level of Evidence
Due to its risk of bias because of increased heterogeneity, the evidence level in the non-research article was moderate.
Quality Rating
The quantity of rating in the non-research-based article was Grade B.
Author’s Recommendations
The author’s recommendation in the non-research-based article was to consider patient’s routine medical care providers throughout the design and application of DSME interventions. Researchers should also evaluate the effectiveness of DSME intervention to consider care providers’ potential influence on the policy effects.
Recommended Practice Change
Based on the research and the non-research-based articles, a practice change recommendation to improve self-management behavior, social resource use, and hemoglobin Alc (HbA1c) levels in patients with T2DM is that professionals must pay attention to the social resources use education to improve and solidify the self-management behavior of diabetic patients additionally. Particularly in regions with a large number of people and minimal medical help, encouraging patients to proactively tap and use potential and available resources to self-manage themselves would be effective and economical.
Key Stakeholders
As suggested by the research and the non-research article, the key stakeholders in improving self-management behavior, social resource use, and reducing hemoglobin Alc (HbA1c) levels in patients with T2DM include patients, clinicians, policymakers, doctors, healthcare managers, and the community.
Barrier to Implementation
A potential barrier to implementing the practice change recommendations is that there needs to be uniform and accepted common patient education perceived as effective for all individuals. There may also be a limited collaboration level between caregivers and patients and self-management educators, which might not allow for a comprehensive analysis of the effect of care providers’ engagement in SME interventions on the program outcome.
Strategy to Overcome the Implementation Barrier
The articles suggest various strategies to overcome implementation barriers, such as health education programs, capacity building, and advocacy, which are key to overcoming the barrier to implementing the DSME program.
Indicator to Measure the Outcome
Various indicators will show positive outcomes of implementing the DSME policy on T2DM patients. Some of them would be improved self-management behavior, utilization of social resources, and optimum glucose control.
References
Kumah, E., Afriyie, E. K., Abuosi, A. A., Ankomah, S. E., Fusheini, A., & Otchere, G. (2021). Influence of the model of care on the outcomes of diabetes self-management education program: a scoping review. Journal of Diabetes Research, 2021, 1-12.
Zhang, F., Fu, L., Wang, L., Xing, L., Liu, K., & Jiang, X. (2023). The effectiveness of the self-management programme based on multilevel social resources utilization in diabetes mellitus patients: A randomized controlled study. International Journal of Nursing Practice, e13138.
write