Effectiveness of a Problem-Solving Program in Improving Problem-Solving Ability and Glycemic Control for Diabetics with Hypoglycemia.

Fei-Ling Wu,Jyuhn-Huarng Juang,Chia-Hung Lin,Chia-Ling Lin

doi:10.3390/ijerph18189559

Abstract

The purpose of this study was to evaluate the effects of a hypoglycemia problem-solving program (HPSP) on problem-solving ability and glycemic control in diabetics with hypoglycemia. This was a prospective, quasi-experimental study with two groups, using a pre- and post-repeated measures design. A total of 71 diabetic patients with hypoglycemia were purposively assigned to an experimental group (n = 34) and a control group (n = 37). The experimental group participated in an 8-week HPSP, and each weekly session lasted approximately 90 min, while the control group received usual care. Participants were assessed at baseline, 1, 3, and 6 months after intervention care. In the experimental group, 6 months after the HPSP intervention, HbA1c was superior to that before the intervention. In both groups, the score obtained using the hypoglycemia problem-solving scale (HPSS) was low before the intervention. In the experimental group, HPSS tracking improved at all stages after the intervention compared to before the intervention. In the control group, the HPSS score improved slightly in the first month and sixth months after usual care. There were significant differences between and within groups in HbA1c levels and HPSS score over time. The intervention based on the HPSP effectively improves HbA1c level and hypoglycemia problem-solving ability in patients with hypoglycemia.

Highlights

In 2016, the World Health Organization issued a global call for action on dedicating greater attention to diabetes and identifying relevant solutions [1]
The training provided in the hypoglycemia problem-solving program (HPSP) in this study focused on problem-solving guidance
The results suggest that, the provision of conventional health education through medical and nursing personnel improved the participants’ problem-solving ability or compliance with health education, addressing hypoglycemia-related problems requires a clear goal that is developed according to patients’ daily information

Summary

Introduction

In 2016, the World Health Organization issued a global call for action on dedicating greater attention to diabetes and identifying relevant solutions [1]. Diabetesrelated medical treatments and health care in Taiwan continue to improve, a survey on type 2 diabetes in 2018 revealed that 2.2 million people in Taiwan had diabetes, with the prevalence being 9.32%, and the number of new patients being nearly 160,000 annually. Because of the continual increase in the number of patients with diabetes, the pursuit of optimal glycemic control and reduction of possible complications has long been a major goal in diabetes care [2]. According to statistics from the National Health Insurance (NHI) database in Taiwan, the use of insulin regimens increased annually until 2014, with 4.67% of people with diabetes using insulin injections alone, and. A global survey of patients receiving insulin treatment indicated that the incidence of hypoglycemia is as high as 78.3% [6]. The cost of achieving effective glycemic control may increase the incidence of hypoglycemia

Objectives

Methods

Results

Discussion

Conclusion