The Effect Of PRECEDE-PROCEED Model In Older Adults With Diabetes About The Misperception Self-management

ObjectivesThe aims are to evaluate the effectiveness of PRECEDE-PROCEED model in older adults with diabetes about the misperception self-management.MethodThis research was performed in two consecutive phases.The first phase was to form a questionnaire of the misperception self-management in older adults with diabetes:This phase results from literature consulting, semi-structured interviews of 20 older adults with diabetes, then through six experts reviewing and a pre-research on 39 older adults with diabetes, to form the questionnaire of the misperception self-management in older adults with diabetes.The second phase was intervention part:66 older adults with diabetes in a top three hospital in Zhengzhou City were selected, and were randomly assigned into intervention group and control group according to the order of admission, 33 patients in the intervention group, and 33 patients in the control group. The patients in intervention group received PRECEDE-PROCEED model o by researchers. The patients in control group have been received routine clinical nursing care.Data were collected by researcher in the follow time points:Pre-intervention, after intervention and 3 months post intervention. The evaluation tools were questionnaires of the misperception self-management in older adults with diabetes, diabetes specific quality of life scale, and biochemical markers of Hb A1 c, fasting blood glucose, 2 h plasma glucose and incidence of hypoglycemia. The data of Hb A1 c were collected in the follow time points: pre-intervention, 3 months post intervention.Data were analyzed with SPSS17.0, using the descriptive statistics, chi-square Text, T test, Mann-whitny U and the repetitive measurement deviation analysis.ResultsThe results of the first phase: the content validity of the questionnaire is 0.9, and the content validity satisfying.The results of second phase:(1) Differences of blood glucose level were compared post intervention:After intervention, the incidence of hypoglycemia was 3 in the intervention group p, but it was 10 in the control group, and the results of chi-square Text indicated that the difference was significant(P<0.05). The difference of the fasting blood glucose and 2 h plasma glucose was significant(P<0.05)between the two groups after intervention.The the difference of 2 h plasma glucose and the Hb A1 c was significant(P<0.05)between the two groups after 3 months later,but not the fasting blood glucose( P>0.05).The results of repetitive measurement indicated that the fasting blood glucose and 2 h plasma glucose(P<0.01) dropped faster than the control group, and the difference was significant(P<0.05).(2) Differences of the scores of the questionnaires of the misperception self-management in older adults with diabetes were compared post intervention: The difference of the scores of the questionnaires of the misperception self-management in older adults with diabetes, and the misperception in diet, exercise, drugs, self-monitoring and perception was significant(P<0.05)between the two groups after intervention. The difference of the scores of the questionnaires of the misperception self-management in older adults with diabetes, and the misperceptionin diet, exercise, self-monitoring and perception was significant(P<0.05)between the two groups after 3 months later, but not the scores of the misperception in drugs(P>0.05). The results of repetitive measurement indicated that the scores of the questionnaires of the misperception self-management in older adults with diabetes, and the misperception in diet, exercise, drugs, self-monitoring and perception dropped faster than the control group, and the difference was statistically significant(P<0.01), and there was interaction effect with the two factors of time and group(P<0.05).(3) Differences of the scores of the questionnaires of diabetes specific quality of life scale were compared post intervention:The difference of the scores of the scores of the questionnaires of diabetes specific quality of life scale, the psychological mental and social relationships was significant(P<0.05)between the two groups after intervention, but not the scores of physiological functions and the scores of treatment(P>0.05). The difference of the scores of the scores of the questionnaires of diabetes specific quality of life scale, the psychological mental and treatment was significant(P<0.05)between the two groups after 3 months later, but not the scores of physiological functions and social relationships(P>0.05).ConclusionsIt’s effectiveness of PRECEDE-PROCEED model in older adults with diabetes about the misperception self-management.