Effect Of Peer Education On Type2Diabetes Patients With Emotional Disorders

Aim:The aim of the study was to investigate the glycemic control, psychological stress, mood fluctuation, and quality of life of type2diabetes patients with emotional disorders. To test the effect of peer education on glycemic control, psychological stress, patient activity degree, and self-management in patients with type2diabetes and emotional disorders.Methods:Outpatients with type2diabetes and emotional disorders were screened from January2012to June2012in this study. Self-Rating Depression Scale and Self-Rating Anxiety Scale were used to access the psychological status of patients. Subjects were randomly divided in control group and peer group. Usual diabetes education was provided for both groups. In addition, peer group also received peer support, provided by the peer leader. Patients with type2diabetes, meeting several criteria, were eligible peer leaders. One leader was in charge with3-4peer education receivers according to age, gender, hobbies, residence, consisting of a peer group for a period of six months to provide peer support. During the period of the study, patients received four diabetes health education curriculums with materials related health knowledge, involving diabetes, health diet, regular exercise, medication and self-monitoring; complication of high blood glucose, harm of psychological and emotional fluctuation, smoking and alcohol. Peer leaders were required to attend training in advance, training period lasted four weeks, once a week, every50minutes. Centralized training includes blood glucose with diet, exercise, mental and self-management. Peer education group organized at least once a month to exchange experiences and discuss about diabetes diet, exercise, medication, psychological adjustment, regular life, quit drinking, and self-monitoring and other aspects of their feelings and experiences. Meanwhile, the peer leaders used various forms (telephone, E-mail, meetings, etc.) to link with the recipient and to exchange the experience of diet, exercise, and monitoring of blood glucose and lessons focusing on providing psychological counseling, psychological support, psychological care, and a pleasant interpersonal environment, a healthy regular life mode. Peer leaders should record the progress of each activity and problems. They can contact with researchers when they can not deal with the problems encountered at any time. After six months, metabolic parameters, diabetes related knowledge, patient activity measure, self-management, diabetes-related distress, and psychological factors were examined in order to evaluate the effect of peer education on type2diabetes patients with emotional disorders.Results:This study133cases were recruited,68cases in the usual group,65in the peer group.6cases were lost at the end of the study. Then64cases in the usual group and63in the peer group completed the study. There were no significant differences in the general demographic data, metabolic parameters (P>0.05).After the end of the study, there were no significant differences in glycemic control, lipids, blood pressure and body measure index in the two groups. The differences were statistically significant in diabetes related knowledge (18.8±2.46vs.16.3±2.08, t=2.55,p=0.01), patient activity measure (66.87±9.26vs.60.27±11.80,t=3.50,p <0.01), self-rating depression (53.27±7.97vs.62.81±7.52, t=6.94, p<0.01), self-rating anxiety (50.93±9.65vs.60.00±8.48, t=5.62, p<0.01), diabetes related distress (2.06±1.05vs.2.55±1.15, t=2.45, p=0.02) and self-management (82.65±4.26vs.71.86±5.76, t=11.98,p<0.01) in the peer group and the usual group.Gonclusion:This study has demonstrated that there was no significant difference in glycemic control blood lipids, BMI and blood pressure between the two groups. There were significantly different in patient activity measure, self-management, and psychology between the two groups, due to the activity of learning in patients with diabetes knowledge, acquired skills and improved self-management. Peer group had less emotional disorders at the end of the study, due to the peer leaders to provide patients with a relaxed, pleasant environment and increasing the patient’s sense of security. Peer leaders provided a positive role model and actively sharing experience, so that patients came out from a depressed mood to positively face the reality and actively involved in the glycemic control and self-management. Peer group increased interpersonal and communication opportunities, and improved mood disorders, and proved the positive role of peer education.