Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 3, 2024
Date Accepted: Aug 30, 2024
Effectiveness of King's Theory of Goal Attainment in Blood Glucose Management for Newly Diagnosed Type 2 Diabetes Patients: Randomized Controlled Trial
ABSTRACT
Background:
Diabetes poses a significant public health challenge in China and globally, with the number of patients expected to reach 592 million by 2035, notably in Asia. In China alone, an estimated 140 million individuals are living with diabetes, and a significant portion are non-adherent to medications, underscoring the urgency of effective management strategies. Recognizing the necessity of early and comprehensive management for newly diagnosed Type 2 diabetes patients, this study leverages an online teach-back method and 'Internet + Nursing' platform based on King's Theory of Goal Attainment. The approach aims to enhance glycemic control and reduce fear and misconceptions about the disease, addressing both the educational and emotional needs of patients.
Objective:
The primary aim of this study was to assess the effectiveness of King's Goal Attainment Theory in the management of newly diagnosed Type 2 diabetes patients. This research sought to develop a collaborative model for blood glucose management, integrating the expertise and roles of physicians, nurses, and patients. The model is designed to enhance the synergy in healthcare provision, ensuring a comprehensive approach to diabetes management.
Methods:
In this study conducted at Changzhou Traditional Chinese Medicine Hospital between January 2022 and February 2023, eligible patients were randomized into a control group or an online feedback group. The control group received standard care, while the online feedback group participated in a King's Theory of Goal Attainment-based online teach-back program, enhanced by 'Internet + Nursing' strategies. This included an interactive platform for goal planning, video content sharing, comprehension assessment, misconception correction, and patient-driven recaps of disease information. Health monitoring was facilitated through the 'Internet + Nursing' platform. The study focused on comparing changes in glucose metabolism and emotional disorder symptoms between the groups to evaluate intervention effectiveness.
Results:
Following a 24-week intervention, we observed substantial disparities in critical metrics between the online feedback group and the control group. The online feedback group exhibited noteworthy reductions (P<0.05) in fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and hemoglobin A1c (HbA1c), along with diminished levels of hypoglycemia-related anxiety and alexithymia. In contrast, the control group displayed relatively higher values for these metrics at the identical time point (P<0.05).
Conclusions:
The online teaching-back method, guided by King's Theory of Goal Attainment, effectively enhances glycemic control, reducing FPG, 2hPG, and HbA1c levels in newly diagnosed type 2 diabetes patients. Simultaneously, it alleviates hypoglycemia-related anxiety and mitigates alexithymia. This approach merits widespread promotion and implementation in clinical settings. Clinical Trial: Approval Number: 2022-L-L-035(s)
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