@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(3):187-193

Background
One of the challenges for diabetics is following a treatment regimen. Educating the patient at home increases the ability to take care of themselves.
Previous Studies
Diabetes is one of the most well-known chronic diseases in the world [1, 2], which is divided into two general categories, type one and two. There are 415 million patients with type 2 diabetes, which makes it one of the major growing health problems [3, 4]. … [5-20]. Home care is one of the interventions emphasizing on the continuation of care that has started in different centers and should continue at home [21]. According to Lancaster, home care is the best way to provide educational programs for an individual in the family [22]. … [23].
Aim(s)
The aim of this study was to determine the effect of home care program on the therapeutic adherence of patients with type 2 diabetes.
Research type
This research was a quasi-experimental study.
Research society, place and time
This study was performed on 80 patients with type 2 diabetes referred to the Diabetes Research Center of Hamadan in 2019 who were selected by convenience sampling method.
Sampling method and number
…. [24]. Considering the 95% confidence level, the test power of 80%, the 100% adherence rate in the intervention group and 84% in the control group, and 10% probable attrition, the sample size in each group was estimated to be at least 37 people, which increased to 40 people in each group in order to increase the test power.
Used devices&materials
The research tool was a two-part questionnaire; the first part was a demographic information and disease profile questionnaire and the second part was the adherence to diabetes treatment questionnaire by Hernandez [25] used in Windsor, USA (1997) [26]. The forms were completed by the patient and under the supervision of the researcher. Home care training program to provide nursing care was done using books, magazines, and valid nursing care standards [27, 28]. Training based on educational content both theoretically and practically using face to face and practical demonstration for the patient was performed with the presence of at least one family member (preferably the main caregiver) using educational equipment, such as educational booklets, posters, educational videos and educational replicas in two 40-min sessions of home visits and two telephone follow-ups once a week. The patient then reviewed them and performed at home. In total, the training program lasted one month, with two home visits per week and two telephone calls once a week. According to some sources, reassessment of treatment adherence was considered two months after the educational intervention [29]. After sampling in the intervention group, the patients in the control group were given an educational booklet to observe ethical considerations. Data were analyzed using SPSS 16 software and chi-square, Fisher's exact test, paired t-test, and one-way analysis of covariance.
Findings by Text
The mean age in the intervention group was 54.73 ± 7.80 and in the control group was 58.95 ± 7.84 years. Most of the patients in the intervention and control groups were women, married, housewives, and had a below diploma education. Most patients had middle income in the intervention group and low income in the control group. The current treatment of most patients in both groups was oral medication. The mean body mass index was 27.68 ±3.95 kg/m2 in the intervention group and 26.93 ± 4.10 kg/m2 in the control group. Most patients in the control group and half of the patients in the intervention group had a family history of diabetes. The studied cases in the intervention and control groups were homogeneous in terms of demographic variables except for age (p = 0.018), and no significant difference was observed between the two groups (Table 1).Before the home care stage, the mean score of treatment adherence of patients in the control group at the beginning of the study was higher than the intervention group. By adjusting the heterogeneous variables between the two groups, this difference between the two groups was statistically significant (p <0.001). While after home care, the mean score of treatment adherence in the intervention group was higher than the control group and by adjusting the heterogeneous variables, the two groups showed a significant difference in terms of mean score of treatment adherence after home care (p <0.001; Table 2).
Main comparison to the similar studies
… [30]. The findings of the present study indicated that the intervention group showed a higher treatment adherence after home care than the control group. Gonzalez et al. found that adherence to the treatment regimen in patients with type 2 diabetes was low and that there was an association between treatment adherence and glycosylated hemoglobin (HbA1C) in patients; this means that the lower the adherence, the higher the value of this index [31]. … [32-34]. The results of the present study were consistent with the study by Adicosoma & Kiam. They aimed at determining the effect of SMS-based education on treatment adherence of diabetic patients, and showed a positive effect of SMS on the adherence of patients with diabetes in the intervention group [34]. … [35-40].
Suggestions
None to declare.
Limitations
One of the limitations of the present study was the possibility of obtaining informal information through the media by the samples.
Conclusions
Implementation of home care program in patients with type 2 diabetes improves the therapeutic adherence of these patients.
Acknowledgments
We would like to thank the Vice-Chancellor for Research and Technology of Hamadan University of Medical Sciences, the cooperation of the experts of Hamadan Diabetes Center, and all the families who helped us in the implementation of this research.
Conflict of interest
None to declare.
Ethical Permissions
This research was approved by the Hamadan University of Medical Sciences (IR.UMSHA.REC.1397.769).
Funding Sources
This research was extracted from a master's thesis approved and supported by the Hamadan University of Medical Sciences.

TABLES and CHARTS

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