The Effect of Culturally Appropriate Self Care Intervention on Health Literacy, Health Related Quality of Life and Glycemic Control in Iranian Patients with Type 2 Diabetes: A Controlled Randomized Clinical Trial

Behnaz Amoozadeh, Akram Parandeh, Feryal Khamseh, Mohammad Ali Sheikh Beig Goharrizi

Abstract


Background: Cultural and language differences are necessary factors for diabetes management and self‑care education programs in patients suffering from diabetes. This study aims to investigate the effectiveness of culture‑based self‑care intervention on health literacy, quality of life, and glycemic parameters in patients with type 2 diabetes.

Materials and Methods: This randomized clinical trial has been carried out in selected centers in Darreh Shahr, Iran; 80 participants were randomly assigned into intervention and control groups. The intervention group received an educational program for 6 sessions twice a week, but the control group only received routine services. Data were collected using health literacy and life quality scales for diabetic patients, which were completed by both groups before, immediately after, and 3 months after the intervention; hemoglobin A1C (HbA1c) was checked before and 3 months after the intervention. SPSS software was also analyzed data using χ2, Fisher’s exact, independent t, and repeated measures analysis of variance tests.

Results: There were no significant differences between the 2 groups before the study (p >0.05) goes forward. But, mean scores of health literacy (F2,40 = 5.61, p =0.007), quality of life (F2, 40 = 4.09, p =0.01), and HbA1c levels (t, 39 = 6. 91, p <0.001) have shown significant differences between the 2 groups immediately and 3 months after the intervention have been applied.

Conclusions: Culturally appropriate intervention should be offered as a part of the nurse’ care program for diabetic to control HbA1c, and improve their life quality and health literacy.


Keywords


Culture, diabetes mellitus, education, health literacy, quality of life, self care

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References


Esteghamati A, Ismail Beigi F, Khaloo P, Moosaie F, Alemi H, Mansournia MA, et al. Determinants of glycemic control: Phase 2 analysis from nationwide diabetes report of National Program for Prevention and Control of Diabetes (NPPCD 2018). Prim Care Diabetes 2020;14:222 31.

World Health Organization. Noncommunicable diseases country profiles 2018. https://apps.who.int/iris/handle/10665/274512. [Last acceesed on 2021 Jan 10].

Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005 2011. Diabetes Res Clin Pract 2014;103:319 27.

Mokhtari Z, Gheshlagh RG, Kurdi A. Health related quality of life in Iranian patients with type 2 diabetes: An updated meta analysis. Diabetes Metab Syndr 2019;13:402 7.

Zurita Cruz JN, Manuel Apolinar L, Arellano Flores ML, Gutierrez Gonzalez A, Najera Ahumada AG, Cisneros Gonzalez N. Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: A cross sectional study. Health Qual Life Outcomes 2018;16:94.

Chollou KM, Gaffari fam S, Babazadeh T, Daemi A, Bahadori A, Heidari S. The association of health literacy level with self care behaviors and glycemic control in a low education population with type 2 diabetes mellitus: A cross sectional study in Iran. Diabetes Metab Syndr 2020;13:1685 93.

Nutbeam D, McGill B, Premkumar P. Improving health literacy in community populations: A review of progress. Health Promot Int 2018;33:901 11.

MacLeod S, Musich S, Gulyas S, Cheng Y, Tkatch R, Cempellin D, et al. The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. Geriatr Nurs 2017;38:334 41.

Seyedoshohadaee M, Kaghanizade M, Nezami M, Hamedani B, Barasteh S. The relationship between health literacy and general health in patients with type 2 diabetes. Iran J Diabetes Lipid Disord 2016;15:312 9.

Negarandeh R, Mahmoodi H, Noktehdan H, Heshmat R, Shakibazadeh E. Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Prim Care Diabetes 2013;7:111 8.

Hejazi S, Peyman N, Tajfard M, Esmaily H. The impact of education based on self efficacy theory on health literacy, self efficacy and self care behaviors in patients with type 2 diabetes. Iran J Health Educ Health Promot 2017;5:296 303.

Tol A, Pourreza A, Rahimi Foroshani A, Tavassoli E. Assessing the effect of educational program based on small group on promoting knowledge and health literacy among women with type 2 diabetes referring to selected hospitals affiliated to Tehran University of Medical Sciences. Razi J Med Sci 2013;19:10 9.

Williams JS, Walker RJ, Lynch CP, Voronca D, Egede LE. Meaning of illness and self care in patients with type 2 diabetes. Diabetes Educ 2015;41:301 8.

Calvillo E, Clark L, Ballantyne JE, Pacquiao D, Purnell LD, Villarruel AM. Cultural competency in baccalaureate nursing education. J Transcult Nurs 2009;20:137 45.

Choi TST, Walker KZ, Palermo C. Culturally tailored diabetes education for Chinese patients: A qualitative case study. J Transcult Nurs 2017;28:315 23.

Brunton M, Cook C. Dis/Integrating cultural difference in practice and communication: A qualitative study of host and migrant Registered Nurse perspectives from New Zealand. Int J Nurs Stud 2018;83:18 24.

Zilberman Kravits D, Meyerstein N, Abu Rabia Y, Wiznitzer A, Harman Boehm I. The impact of a cultural lifestyle intervention on metabolic parameters after gestational diabetes mellitus a randomized controlled trial. Matern Child Health J 2018;22:803 11.

Navodia N, Wahoush O, Tang T, Yost J, Ibrahim S, Sherifali D. Culturally tailored self management interventions for South Asians with type 2 diabetes: A systematic review. Can J Diabetes 2019;43:445 52.

Huang YC, Garcia AA. Culturally tailored interventions for chronic disease self management among Chinese Americans: A systematic review. Ethn Health 2020;25:465 84.

Adarmouch L, Elyacoubi A, Dahmash L, El Ansari N, Sebbani M, Amine M. Short term effectiveness of a culturally tailored educational intervention on foot self care among type 2 diabetes patients in Morocco. J Clin Transl Endocrinol 2017;7:54 9.

Leininger MM, McFarland MR. Transcultural Nursing: Concepts, Theories, Research and Practice. New York City: McGraw Hill Education: 2002.

Almasi M. Determinants of the Elderly’s healthy lifestyle in Ilam. Iran J Nurs 2018;31:75 85.

Moayed MS, Amoozadeh B, Parandeh A. Assessing healthcare needs of patients with diabetes in Iran’s healthcare system: A modified delphi method study. J Educ Health Promot 2020;9:42.

Burroughs TE DR, Waterman BM, Gilin D, McGill J. Development and validation of the diabetes quality of life brief clinical inventory. Diabet Spectrum 2004;17:41 9.

Nasihatkon A, Pishva A, Habibzade F, Tabatabae M, Hojat F, Hafeze E. Reliability and validity of the clinical summary of diabetic quality of life (DQOL) in Farsi. Diabetes and Lipid Disorders Journal of Iran 2012;11:483-7.

Ishikawa H, Takeuchi T, Yano E. Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care 2008;31:874 9.

Reisi M, Mostafavi F, Javadzade H, Mahaki B, Tavassoli E, Sharifirad G. Communicative and critical health literacy and self care behaviors in patients with type 2 diabetes. Iran J Diabetes Metab 2016;14:199 208.

Liu XN, Xia QH, Fang H, Li R, Chen YY, Yan YJ, et al. Effect of health literacy and exercise focused interventions on glycemic control in patients with type 2 diabetes in China. Zhonghua Liu Xing Bing Xue Za Zhi 2018;39:357 62.[in Chinese]

Cavanaugh K, Wallston KA, Gebretsadik T, Shintani A, Huizinga MM, Davis D, et al. Addressing literacy and numeracy to improve diabetes care: Two randomized controlled trials. Diabetes Care 2009;32:2149 55.

Ebrahimi H, Ashrafi Z, Rudsari DM, Parsayekta Z, Haghani H. Effect of Family Based Education on the quality of life of persons with type 2 diabetes: A randomized clinical trial. J Nurs Res 2018;26:97 103.

Yarmohammadi S, Momenyan S, Ghaffari M, Ali R, Azizpour M. Impact of functional, communicative and critical health literacy on glycemic control among patients with type 2 diabetes, and the mediating role of self care. Psychol Res Behav Manag 2019;12:427 35.

Pamungkas R, Chamroonsawasdi K, Vatanasomboon P. A systematic review: Family support integrated with diabetes self management among uncontrolled type II diabetes mellitus patients. Behav Sci 2017;7:62. doi: 10.3390/bs7030062.


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