Diabetes Sigurdardottir, A., Benediktsson, R.,

Diabetes

Sigurdardottir, A., Benediktsson, R., Jonsdottir, H. (2009). Instruments to tailor care of people with Type 2 diabetes. Journal of Advanced Nursing. 65 (10): 2118-2130.

Print & Use to Rapidly Critically Appraise Randomized Clinical Trials (RCTs)

Are the results of the study valid?

Were the subjects randomly assigned to the experimental and control groups?

Was random assignment concealed from the individuals who were first enrolling subjects into c.

Were the subjects and providers blind to the study group?

Were reasons given to explain why subjects did not Yes No Unknown

Yes No Unknown

Yes No Unknown

Yes No Unknown

Were the follow-up assessments conducted long enough to fully study the effects of the intervention? Yes No Unknown

f.

Were the subjects analyzed in the group to which they were randomly assigned?

g.

Was the control group appropriate?

h. Were the instruments used to measure the outcomes valid and reliable?

Were the subjects in each of the groups similar on demographic and baseline clinical variables? (overabundance of younger demographics)

2. What are the results?

a.

How large is the intervention or treatment effect

(NNT, NNH, effect size, level of significance)? Intervention not as effective as anticipated. Some possible theories to reasons given, but short follow up (6 months) and variable results did not allow for treatment effect to be adequately measured.

b.

How precise is the intervention or treatment (CI)?

Measurements were quite precise, but the difference in HbA1c reduction was lower than expected from previous studies and literature review.

Yes

No

Unknown

Yes

No

Unknown

Yes

No

Unknown

Yes

No

Unknown

3. Will the results help me in caring for my patients?

a. Were all clinically important outcomes measured? Yes No Unknown

b.

What are the risks and benefits of the treatment?

Few risks, numerous benefits. Short educational interventions are indeed beneficial for people with diabetes. When caring for diabetic patients, instruments that focus on the identification of self-care needs are quite helpful in monitoring the psychological, as well as the medical sense of well-being, but only when combined with clinical medicine and high research standards.

c.. Is the treatment feasible in my clinical setting? Yes No Unknown

d. What are my patients/family's values and expectations for the outcome that is trying to be prevented and the treatment itself?

There are several implications from this study:

Identification of self-care needs are important to patients; mitigation of stronger, more invasive treatment options are thus prevented. However, some instruments are more useful than others in encouraging self-care or monitoring behavioral change.

Use of these treatment protocols and self-care instrumentation and measurement tends to create a more patient-centered care paradigm so that healthcare providers can focus on the more serious, medical care issues. Additionally, when educating people who have diabetes, effective time management protocols should focus on specific instruments that are individually tailored to that patient's needs and capacity for responsibility for their own issues.

The research did show two major effects:

Answers from measurement issues help create a more robust dialog between nurses and patients.