| Purpose:To evaluate the effect of peer support on diabetes distress and HbAlc and provide the evidence of a diabetes education and management model which is suitable for China.Methods:It is a cluster randomized controlled trial. Eight communities were selected in July 2012 and then randomized into the intervention group and control group of Xuanwu district, Nanjing. Each group selected type 2 diabetic patients who met the inclusion criteria. The intervention group received peer support and conventional education for 12 months. The control group received conventional education for 12 months. All data were collected at baseline and 12 month and used to evaluate effectiveness and feasibility of peer support to improve diabetes distress.Results:1. A total of 410 type 2 diabetic patients participated in this study,214 cases of the intervention group and 196 cases of control group.2. A total of 366 peers finished all data collection,169 peers of the intervention group and 167 peers of control group. Data between two groups was not statistically significant (P> 0.05) at baseline.3. At 12 months, the scores of total score, Physician-related distress, Regimen-related distress, Interpersonal-related distress of peer support group were significantly lower than conventional education group (P<0.05), the score of Emotional burden between two groups was not statistically significant (P> 0.05). The cases of Regimen-related distress, Interpersonal-related distress were statistically significant (P<0.05), cases of no distress or little distress were more than conventional group. The cases of total score, Emotional burden, Physician-related distress were not statistically significant (P> 0.05).4. The score of total score, Emotional burden, Physician-related distress, Regimen-related distress were significantly lower than pre-intervention of peer support group (P<0.05). The score of Interpersonal-related distress was higher than pre-intervention of peer support group. The cases of all diabetes distress were not statistically significant of peer support group (P> 0.05). The score of Emotional burden was significantly lower than pre-intervention (P<0.01) of conventional group. The score of Interpersonal-related distress was significantly higher than pre-intervention (P<0.001) of conventional group. There were no statistically significant difference of total score, Physician-related distress and Regimen-related distress between after and pre-intervention of conventional group (P>. 0.05). The cases of total score were statistically significant of conventional group (P<0.05), cases of no distress or little distress were more than pre-intervention. There were no statistically significant differences of Emotional burden, Physician-related distress, Regimen-related distress and Interpersonal-related distress than pre-intervention (P> 0.05).5. At 12 months, the differences of HbAlc between two groups were not statistically significant (P>0.05).6. There were no statistically significant differences of HbAlc between after and pre-intervention of two groups (P>0.05).Conclusions:1. The overall effectiveness in improving diabetes distress of peer support is superior than conventional education.2. Conventional education is conducive to improve Emotional burden, while additional peer support failed to improve the emotional burden further.3. Peer support is more superior than conventional education in improving Physician-related distress and Regimen-related distress.4. Conventional education and peer support can not improve Interpersonal-related distress effectively. Conventional education may increase Interpersonal-related distress.5. Peer support fail to improve levels of HbAlc which is at goal. |
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