| Objectives 1.To formulate a health education program based on teach-back method combined with wechat group video for diabetic patients who used insulin injection for the first time;2.To evaluate the effect of the program on knowledge and behavior of insulin injection in diabetic patients.Methods Seventy patients with type 2 diabetes who met the inclusion criteria and used insulin injection for the first time from August to December 2022 in the inpatient department of Endocrinology of a third-class A hospital in Jingzhou were selected as the study subjects.According to the random number table,random numbers were taken from row 19,column 25 to the right,and the repeated numbers were removed.A total of 70 random numbers were taken,and then the 70 random numbers were numbered according to their sizes.The numbers 1-35 were for the control group,and the numbers 36-70 were for the experimental group.Random numbers were written on strips of paper,and patients were randomly selected at admission.According to random numbers,patients were divided into control group and experimental group.The control group was given oral education and paper materials,and the experimental group was given health education combined with wechat group video based on the control group.The scores of "Simple insulin injection questionnaire","Diabetes Knowledge Scale(ADKnowl)" and the time consuming of health education were recorded before and after health education in two groups.The simple insulin injection questionnaire has not been translated into Chinese yet,but the original questionnaire was translated into Chinese in strict accordance with the Brislin translation model.After the data were checked by two people,the Excel2019 software was used for two-person input,and SPSS26.0 statistical software package was used for data analysis and processing.The measurement data were described by "mean ± standard deviation" and tested by t.The statistical data were described by frequency and percentage,using Pearsonχ2.The generalized estimation equation was used to analyze the repeated measurement results.When the test result was P<0.05,the difference was statistically significant.Results 1.The Chinese part of the questionnaire 1.1 Scale Debugging Change the correct behavior,"I always leave the needle on my skin for 5 to 10 seconds after pressing the button," to "I always leave the needle on my skin for >10 seconds after pressing the button," and change the dangerous behavior,"I don’t always leave the needle on my skin for 5 to 10 seconds or not." 1.2 Preliminary Survey Change the advice in the questionnaire: "It is recommended that you seek help from your healthcare professional as soon as possible" to "It is recommended that you seek help from your healthcare professional/agency as soon as possible".1.3 Quality Analysis 1.3.1 Reliability analysis In this study,retest reliability was used to measure the reliability of the scale.The retest reliability of this questionnaire was 0.735,indicating that the reliability of the Chinese version of the questionnaire for simple insulin technical injection was good.1.3.2 Validity analysis In this study,the Worldwide Injection Technique Questionnaire was used as a criterion tool to test the criterion association validity of the Chinese version of the simple insulin injection technique questionnaire.The Kappa coefficient was calculated to be 0.726,indicating that the Chinese version of the simple insulin injection technique questionnaire had good reliability.2.Application research 2.1 general data comparison both groups Among the 64 subjects in this study,the gender distribution was as follows: male dominated,accounting for 57.8%(37);Age distribution: Mainly 40~60 years old,accounting for 50%(32);Distribution of education level: mainly graduated from middle school,accounting for 39.1%(25);Monthly income distribution: 1000-5000 yuan,48.4%(31 people);Medical insurance: residents’ medical insurance was the majority,accounting for 48.4%(31 people);Family history of diabetes: 64.1%(41 cases)had a family history of diabetes.2.2 Diabetes-related knowledge and insulin injection skills of the two groups before intervention Before intervention,the diabetes knowledge score of the control group was 41.35±16.47,and that of the experimental group was 38.44±15.91,P=0.8995,the difference was not statistically significant(P>0.05).In the control group,there were 31 cases(93.9%)with risky behavior after insulin injection.There were 30 cases(96.8%)with risky behavior in the experimental group.There was no significant difference between the two groups in the risk behavior of insulin injection(P>0.05).2.3 Disease knowledge and insulin injection skills of the two groups before and after intervention In terms of diabetes knowledge,the score of the control group before intervention was 41.35±16.47,the score of the first intervention was 55.25±9.56 and the score of the second intervention was 49.16±14.53,and the score of the test group before intervention was 38.44±15.91 and the score of the first intervention was 58.73±8.36.After the second intervention,the score was 83.92±7.88;In terms of insulin injection skills,the number of patients in the control group who could correctly inject insulin was 2 cases before intervention,and the correct rate was 6.1%;after the first intervention,the correct number was 7 cases,and the correct rate was 21.2%;after the second intervention,the correct number was 13 cases,and the correct rate was 39.4%.The number of patients in the experimental group who could correctly inject insulin was 1 case,and the correct rate was 3.2%;after the first intervention,the correct number was 12 cases,and the correct rate was 38.7%;after the second intervention,the correct number was 26 cases,and the correct rate was 83.9%.2.4 Comparison of diabetic knowledge between the two groups after intervention The results showed that in terms of knowledge of diabetes mellitus,the difference of intervention of experimental group and control group and the difference of measurement stage calculated P values were all <0.001,and the differences were statistically significant(P<0.05).At the same time,B of the experimental group was 13.483,and P=0.015,the difference was statistically significant(P<0.05).B value was 13.422 for the first intervention and 25.438 for the second intervention.2.5 Comparison of insulin injection skills between the two groups after intervention Both the experimental group and the control group have undergone three times of evaluation,and there are continuous measurements,so the generalized estimation equation is used for analysis.Through calculation,under the independent variable structure,the QIC value is the lowest,which is 185.722.The results showed that in terms of insulin injection skill,P values calculated by different intervention stages of experimental group and control group were 0.015 and <0.001,respectively,and the differences were statistically significant(P<0.05).B=1.260 in test group and 0.015 in control group,the difference was statistically significant(P<0.05).The B value of the first intervention was 2.242 and that of the second intervention was 3.676.2.6 Comparison of the duration of health education between the two groups The health education time of the control group was 63.41±7.15 minutes,and the health education time of the experimental group was 66.37±4.13 minutes,and the difference was statistically significant(P<0.05).Conclusions Compared with conventional education methods,the teach-back method combined with wechat group video strengthens patients’ knowledge of insulin injection and standardizes their injection behavior.Meanwhile,it provides patients with insulin injection with convenient access to knowledge related to insulin injection and realizes effective continuous care,which is conducive to improving patients’ quality of life.It is a health education method worthy of clinical promotion. |
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