Abstract
Background: To mobilize family's positive involvement in improving and sustaining self-management activities of older adults with diabetes, we developed a couple-based collaborative management model (CCMM) for community-dwelling older Chinese.Methods: The model was developed stepwise through applying theoretical models, interviewing older couples and community healthcare workers, as well as incorporating expert reviews. A 3-month pilot study was conducted to test the model's feasibility and its treatment effects by linear regression on 18 pairs of older couples aged 60 years+, who were equally divided into a couple-based intervention arm and a patient-only control arm.Results: The developed CCMM covered four theory-driven intervention modules: dyadic assessment, dyadic education, dyadic behavior-change training, and dyadic monitoring. Each module was delivered by community healthcare workers and targeted at older couples as the management units. Based on interviews with older couples and healthcare workers, 4 weekly education and training group sessions and 2-month weekly behavior change booster calls were designed to address older adults' main management barriers. These modules and session contents were evaluated as essential and relevant by the expert panel. Furthermore, the CCMM showed good feasibility and acceptability in the pilot, with non-significant yet more positive changes in physiological outcomes of diabetic participants and couples' well-being and exercise levels of these in the intervention arm than their controlled counterparts.Conclusion: We systematically developed a couple-based collaborative management model of diabetes, which was well-received by healthcare practitioners and highly feasible among older Chinese couples living in the community. The model's treatment effects need to be verified in fully powered randomized controlled trials.Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=42964, identifier: ChiCTR1900027137.
Highlights
China’s ever-increasing diabetes burden of the older population exceeds its capacity of healthcare services [1]
The couple-based collaborative management model (CCMM) was developed based on Berg and Upchurch’s dyadic model of coping with chronic illness (DMCCI) [18] and Bandura’s social cognitive theory (SCT) [19]
Our study developed CCMM of type 2 diabetes mellitus (T2DM) based on theoretical models and tailored to the care needs of older couples with diabetes in China
Summary
China’s ever-increasing diabetes burden of the older population exceeds its capacity of healthcare services [1]. Evidence-based interventions addressing behavioral and environmental barriers should be identified to promote self-management activities of older adults with diabetes. Accumulating evidence has suggested that family-engaged interventions, especially these motivating support from the spouse [6], significantly improved the self-management activities of older people with diabetes [7]. Previous couple-based interventions on chronic disease management have revealed significant treatment effects on the depressive symptom, pain, and marital functioning of the patients [8], while evidence has been inconclusive regarding improvements in the patients’ or their spouse’s physical health [9,10,11] or their health behavior [12]. To mobilize family’s positive involvement in improving and sustaining self-management activities of older adults with diabetes, we developed a couple-based collaborative management model (CCMM) for community-dwelling older Chinese
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
