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Clinical implication of diabetes education program declaring a goal in life for patients with diabetes mellitus
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
team; iv) resources support to facilitate link-nurses to provide patient teaching. Purposive sampling was employed. The Diabetes Link-nurse Perceived Role Competency Questionnaire was administered to the nurses before and after the program. Participation in diabetes education was counted by the number of staff and patient education reported. Results: Twenty nurses completed the program. Sixty percent of the link-nurses had delivered more than one episode of diabetes education to patients, and 44% of them had shared their knowledge and information with their colleagues. Link-nurses had shown significant improvement in perceived role competency (p < 0.01), especially in the areas of teaching patients on common oral anti-diabetic drugs and identifying diabetic issues or problems for discussion. However, the improved perceived competency did not correlate with link nurses’ years of nursing experience, educational level, previous specialty training nor academic level. Conclusion: The results concluded that the Diabetes Linknurse Program is effective in enhancing link-nurses’ participation in educating patients and colleagues on diabetes. The education, support and resources provided also increased linknurses’ confidence in performing their roles in communication and patient care. PG-18 Clinical implication of diabetes education program declaring a goal in life for patients with diabetes mellitus Nagaaki TANAKA1,2 *, Hiroko HIGASHIYAMA2, Shinji UENO1, Soudai KUBOTA1, Saki OKAMOTO1, Yui SAKURAMACHI1, Hitoshi KUWATA1,3, Kouin WATANABE1, Takanori HYO1, Chihiro KOUNO4, Satoko HAMASAKI4, Tomoko MENYA4, Hisako NODA4, Naoki HIROSE5, Tomoko OKAMOTO6, Hiroko HASHIMOTO7, Yoshikazu HIRASAWA8, Tomoko AWA9, Naomi KITATANI5, Daisuke YABE1,3,5, Yoshiyuki HAMAMOTO1,3, Takeshi KUROSE1,3, Yutaka SEINO1,3. 1Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, 2Division of Medical Education, Kansai Electric Power Medical Research Institute, 3Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, 4Department of Nursing, Kansai Electric Power Hospital, 5Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, 6Department of Pharmacy, Kansai Electric Power Hospital, 7Department of Clinical Laboratory, Kansai Electric Power Hospital, 8Department of Rehabilitation, Kansai Electric Power Hospital, 9Department of Ophthalmology, Kansai Electric Power Hospital, 10Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan Objectives: For patients with diabetes mellitus, individualized diabetes education program (DEP) is created and used to facilitate the knowledge, skills, and ability necessary for diabetes self-care management in many Japanese hospitals. We have newly developed “My Goals Sheet” (MG Sheet), which is a self-evaluation tool for declaring a patient’s goals to achieve within shorter, intermediate and longer period and self-directed goal setting in healthy eating, physical activity, medication and reducing risks for micro- and macro-vascular complications. The aim of this study is to investigate whether declaration of individual goals for patient’s life affect the subsequent glycemic control. Methods: Retrospective, observational study was conducted with 138 patients who participated in DEP and completed their own MG Sheet (male/female = 76/62, mean ± SD age: 60.2 ± 14.2 years; BMI: 25.9 ± 5.6 kg/m2; HbA1c: 9.4 ± 2.0%). The participants were categorized into four groups according to their goals of life: “to live a long life/die in peace (group A)”, “to improve their health (group B)”, “to enjoy their job or hobby (group C)” and “to dedicate to others (group D)”. HbA1c level in each group was followed-up until 6 months after the admission with DEP.
S165
Results: Among the participants, 4 patients were excluded from the study because they did not complete their MG Sheet correctly. Fifty-eight (43.6%) patients were categorized into group B. In male, group A was predominant to group C (group A, B, C, D = 34.7%, 41.7%, 15.3%, 8.3%), whereas group C was predominant to group A in female (group A, B, C, D = 21.3%, 45.9%, 31.1%, 1.6%) (P = 0.0334). There was no difference with category distribution: patients lower than 70 years of age (group A, B, C, D = 25.5%, 47.9%, 21.3%, 5.3%), patients in 70 years and higher (group A, B, C, D = 35.9%, 33.3%, 25.6%, 5.1%). With respect to glycemic control, changes in HbA1c at baseline and at 6 month were as follows: group A; 9.2% and 7.1%, group B; 9.4% and 7.5%, group C; 9.6% and 7.1%, group D; 10.0% and 7.1%, respectively. Achievement rate of HbA1c <7.0% within 6 months in the 4 categories were as follows: group A, B, C, D = 51.4%, 46.3%, 41.4%, 42.9%, respectively. Conclusions: Patients who participated in DEP achieved good glycemic control irrespective of any category of individual goal in life. PG-19 Efforts to improve the enrollment of education and quality of care in type 2 diabetes: experience of a community hospital Cheng-Yang HSIEH1 *, Yi-Lin HSIEH2, Su-Yu HUANG2, Hsiu-Chuan LU2, Tzu-Ping FANG2, Hsi-Jung HOU2, Tung-Pi WU3. 1Department of Neurology, Tainan Sin Lau Hospital, 2 Community Health Center, Tainan Sin Lau Hospital, 3 Superintendent’s Office, Tainan Sin Lau Hospital, Tainan, Taiwan Background: Although an educational program may be helpful for disease management and quality of care for type 2 diabetes mellitus, the enrollment rate of our patients into such a program was less satisfactory. Purpose: To determine whether a multi-discipline approach could improve the enrollment rate of education and quality of care for patients with type 2 diabetes mellitus in a community hospital. Methods: After H2 of 2014, we initiated several strategies focusing on patients and health care providers to increase enrollment. Eligible but not enrolled diabetic patients were informed for our education program through visual teaching materials and direct telephone contact. Lists of potentially eligible patients were also pre-notified to the nurses and physicians before the start of outpatient clinic. We chose four process indicators including the completeness of urine albumin/creatinine ratio (UACR), fundoscopy, blood LDL-c and HbA1c tests, and three outcome indicators including rate of HbA1c < 7%, BP < 140/90 mmHg, and LDL-c < 100 mg/dL, before and after the implementation of our quality improvement strategies (H1 of 2015 vs. H1 of 2014). Results: The enrollment rate was higher in the H1 of 2015 than in the H1 of 2013 (42.3% vs. 35.4%, p < 0.001). The process indicators also improved for the completeness of UACR (45.8% vs. 41.5%, p < 0.001), fundoscopy (30.4% vs. 28.4, p = 0.025), LDL-c (67.6% vs. 64.6%, p = 0.001), and HbA1c (86.9% vs. 82.6%, p < 0.001). Quality indicators of diabetes care also improved for the rate of HbA1c < 7% (48.4% vs. 43.1%, p < 0.001), BP < 140/ 90 mmHg (11.9% vs. 10.9%, p = 0.048), and LDL-c < 100 mg/dL (67.2% vs. 61.8%, p < 0.001). Conclusion: Our multi-discipline strategies improved both the enrollment rate and quality of care for patients with type 2 diabetes. Further study is needed to determine whether such improvement could maintain thereafter. PG-20 Effectiveness of the food craving management tool in Korean adolescents Sun-Young LIM1, Jin-Hee LEE1, Hae-Kyung YANG2, Cho-Eun CHUNG2, Borami KANG2, Eun Young LEE2, Yeoree YANG2, Kun-Ho YOON1,2*. 1Catholic Institute of U-Healthcare, The Catholic University of Korea, 2Department of
team; iv) resources support to facilitate link-nurses to provide patient teaching. Purposive sampling was employed. The Diabetes Link-nurse Perceived Role Competency Questionnaire was administered to the nurses before and after the program. Participation in diabetes education was counted by the number of staff and patient education reported. Results: Twenty nurses completed the program. Sixty percent of the link-nurses had delivered more than one episode of diabetes education to patients, and 44% of them had shared their knowledge and information with their colleagues. Link-nurses had shown significant improvement in perceived role competency (p < 0.01), especially in the areas of teaching patients on common oral anti-diabetic drugs and identifying diabetic issues or problems for discussion. However, the improved perceived competency did not correlate with link nurses’ years of nursing experience, educational level, previous specialty training nor academic level. Conclusion: The results concluded that the Diabetes Linknurse Program is effective in enhancing link-nurses’ participation in educating patients and colleagues on diabetes. The education, support and resources provided also increased linknurses’ confidence in performing their roles in communication and patient care. PG-18 Clinical implication of diabetes education program declaring a goal in life for patients with diabetes mellitus Nagaaki TANAKA1,2 *, Hiroko HIGASHIYAMA2, Shinji UENO1, Soudai KUBOTA1, Saki OKAMOTO1, Yui SAKURAMACHI1, Hitoshi KUWATA1,3, Kouin WATANABE1, Takanori HYO1, Chihiro KOUNO4, Satoko HAMASAKI4, Tomoko MENYA4, Hisako NODA4, Naoki HIROSE5, Tomoko OKAMOTO6, Hiroko HASHIMOTO7, Yoshikazu HIRASAWA8, Tomoko AWA9, Naomi KITATANI5, Daisuke YABE1,3,5, Yoshiyuki HAMAMOTO1,3, Takeshi KUROSE1,3, Yutaka SEINO1,3. 1Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, 2Division of Medical Education, Kansai Electric Power Medical Research Institute, 3Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, 4Department of Nursing, Kansai Electric Power Hospital, 5Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, 6Department of Pharmacy, Kansai Electric Power Hospital, 7Department of Clinical Laboratory, Kansai Electric Power Hospital, 8Department of Rehabilitation, Kansai Electric Power Hospital, 9Department of Ophthalmology, Kansai Electric Power Hospital, 10Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan Objectives: For patients with diabetes mellitus, individualized diabetes education program (DEP) is created and used to facilitate the knowledge, skills, and ability necessary for diabetes self-care management in many Japanese hospitals. We have newly developed “My Goals Sheet” (MG Sheet), which is a self-evaluation tool for declaring a patient’s goals to achieve within shorter, intermediate and longer period and self-directed goal setting in healthy eating, physical activity, medication and reducing risks for micro- and macro-vascular complications. The aim of this study is to investigate whether declaration of individual goals for patient’s life affect the subsequent glycemic control. Methods: Retrospective, observational study was conducted with 138 patients who participated in DEP and completed their own MG Sheet (male/female = 76/62, mean ± SD age: 60.2 ± 14.2 years; BMI: 25.9 ± 5.6 kg/m2; HbA1c: 9.4 ± 2.0%). The participants were categorized into four groups according to their goals of life: “to live a long life/die in peace (group A)”, “to improve their health (group B)”, “to enjoy their job or hobby (group C)” and “to dedicate to others (group D)”. HbA1c level in each group was followed-up until 6 months after the admission with DEP.
S165
Results: Among the participants, 4 patients were excluded from the study because they did not complete their MG Sheet correctly. Fifty-eight (43.6%) patients were categorized into group B. In male, group A was predominant to group C (group A, B, C, D = 34.7%, 41.7%, 15.3%, 8.3%), whereas group C was predominant to group A in female (group A, B, C, D = 21.3%, 45.9%, 31.1%, 1.6%) (P = 0.0334). There was no difference with category distribution: patients lower than 70 years of age (group A, B, C, D = 25.5%, 47.9%, 21.3%, 5.3%), patients in 70 years and higher (group A, B, C, D = 35.9%, 33.3%, 25.6%, 5.1%). With respect to glycemic control, changes in HbA1c at baseline and at 6 month were as follows: group A; 9.2% and 7.1%, group B; 9.4% and 7.5%, group C; 9.6% and 7.1%, group D; 10.0% and 7.1%, respectively. Achievement rate of HbA1c <7.0% within 6 months in the 4 categories were as follows: group A, B, C, D = 51.4%, 46.3%, 41.4%, 42.9%, respectively. Conclusions: Patients who participated in DEP achieved good glycemic control irrespective of any category of individual goal in life. PG-19 Efforts to improve the enrollment of education and quality of care in type 2 diabetes: experience of a community hospital Cheng-Yang HSIEH1 *, Yi-Lin HSIEH2, Su-Yu HUANG2, Hsiu-Chuan LU2, Tzu-Ping FANG2, Hsi-Jung HOU2, Tung-Pi WU3. 1Department of Neurology, Tainan Sin Lau Hospital, 2 Community Health Center, Tainan Sin Lau Hospital, 3 Superintendent’s Office, Tainan Sin Lau Hospital, Tainan, Taiwan Background: Although an educational program may be helpful for disease management and quality of care for type 2 diabetes mellitus, the enrollment rate of our patients into such a program was less satisfactory. Purpose: To determine whether a multi-discipline approach could improve the enrollment rate of education and quality of care for patients with type 2 diabetes mellitus in a community hospital. Methods: After H2 of 2014, we initiated several strategies focusing on patients and health care providers to increase enrollment. Eligible but not enrolled diabetic patients were informed for our education program through visual teaching materials and direct telephone contact. Lists of potentially eligible patients were also pre-notified to the nurses and physicians before the start of outpatient clinic. We chose four process indicators including the completeness of urine albumin/creatinine ratio (UACR), fundoscopy, blood LDL-c and HbA1c tests, and three outcome indicators including rate of HbA1c < 7%, BP < 140/90 mmHg, and LDL-c < 100 mg/dL, before and after the implementation of our quality improvement strategies (H1 of 2015 vs. H1 of 2014). Results: The enrollment rate was higher in the H1 of 2015 than in the H1 of 2013 (42.3% vs. 35.4%, p < 0.001). The process indicators also improved for the completeness of UACR (45.8% vs. 41.5%, p < 0.001), fundoscopy (30.4% vs. 28.4, p = 0.025), LDL-c (67.6% vs. 64.6%, p = 0.001), and HbA1c (86.9% vs. 82.6%, p < 0.001). Quality indicators of diabetes care also improved for the rate of HbA1c < 7% (48.4% vs. 43.1%, p < 0.001), BP < 140/ 90 mmHg (11.9% vs. 10.9%, p = 0.048), and LDL-c < 100 mg/dL (67.2% vs. 61.8%, p < 0.001). Conclusion: Our multi-discipline strategies improved both the enrollment rate and quality of care for patients with type 2 diabetes. Further study is needed to determine whether such improvement could maintain thereafter. PG-20 Effectiveness of the food craving management tool in Korean adolescents Sun-Young LIM1, Jin-Hee LEE1, Hae-Kyung YANG2, Cho-Eun CHUNG2, Borami KANG2, Eun Young LEE2, Yeoree YANG2, Kun-Ho YOON1,2*. 1Catholic Institute of U-Healthcare, The Catholic University of Korea, 2Department of