Given According to Knowledge, Motivation and Behavioral Skills (IMB Model) The Effect of Diabetes Education on Self-Care

Year 2022, Volume: 6 Issue: 3, 241 - 251, 29.12.2022

Bahar İnkaya , Tuba Yılmazer , Hilal Tüzer , Elif Yeter Erbil

https://doi.org/10.25048/tudod.1149785

Abstract

Aim: It has been determined that the education given according to the information, motivation, and behaviour model is effective in AIDS, chronic diseases, glucose control in diabetes, and self-care behaviours such as diet and exercise. The aim of this study, which is planned from this point of view, is to evaluate the effect of education given according to the information, motivation, and behaviour model on diabetic self-care management.
Material and Methods: This study was conducted as an experimental study with a nonrandomized control group that included 90 diabetes mellitus individuals, with 45 in the intervention group and 45 in the control group. The control group were given formal diabetes mellitus education. In contrast, the intervention group received an education based on the information, motivation, and behaviour model and diabetes mellitus cases were followed for six months. Data were collected with a questionnaire on the essential characteristics of the patients, an evaluation form on the level of knowledge about diabetes, an evaluation form on their motivation about diabetes, and a diabetes self-care activities questionnaire. An Independent Sample-t test was used to analyze the data, and Paired Sample-test statistics were used to compare two dependent groups. Mann-Whitney U test was used to compare the measurement values of two independent groups that did not have a normal distribution. Wilcoxon test statistics were used to compare two dependent groups.
Results: At the end of the study, it was determined that while HbA1c in the intervention group decreased for 6 months, knowledge scores, motivation levels and self-care skill scores increased (t=7.067, p<0.001; Z=-7.576, p<0.001; Z=-8.248, p<0.001; Z=-7.807, p<0.001; Z= -5.651, p<0.001; Z= -4.402, p<0.001; Z=- 6.818, p<0.001). Statistically significant differences were found between the 1st and 6th-month scores. It was determined that HbA1C control variables increased, knowledge score averages increased, motivation levels decreased, and self-care skill averages (except foot care) did not show a statistically significant difference within 6 months in the control group.
Conclusion: Education based on the information, motivation, and behaviour model improved the information, motivation and behaviour skills of diabetes mellitus patients, and additionally HbA1c outcomes, and was determined to contribute to disease management and self-care positively.

Keywords

Diabetes mellitus, Self-care, Nursing

Bilgi, Motivasyon ve Davranış Becerilerine (İMB Modeli) Göre Verilen Diyabet Eğitiminin Özbakım Üzerine Etkisi

Abstract

Amaç: Bilgi, motivasyon ve davranış modeline göre verilen eğitimin AIDS, kronik hastalıklar, diyabette ise glikoz kontrolü başta olmak üzere diyet, egzersiz gibi özbakım davranışlarında etkili olduğu saptanmıştır. Bu noktadn hareketle planlanan bu çalışmanın amacı, bilgi, motivasyon ve davranış modeline göre verilen eğitimin diyabetik öz bakım yönetimine etkisini değerlendirmektir
Gereç ve Yöntemler: Bu çalışma, müdahale grubunda 45, kontrol grubunda 45 olmak üzere toplam 90 diyabetes mellituslu bireyden oluşan randomize olmayan kontrol grubu ile deneysel bir çalışma olarak yürütülmüştür. Kontrol grubuna standart diyabet eğitimi verilirken, müdahale grubuna bilgi, motivasyon ve davranış modeline modeline göre eğitim verildi ve diyabetik olgular altı ay boyunca takip edildi. Veriler hastalara ait tanıtıcı özelliklere ilişkin anket formu, diyabet ile ilgili bilgi düzeyine ilişkin değerlendirme formu, diyabet ile ilgili motivasyonlarını değerlendirme formu ve diyabet özbakım aktiviteleri anketi ile toplandı. Verilerin analizinde Independent Sample-t test, iki bağımlı grubun karşılaştırılmasında Paired Sample-t test istatistikleri kullanılmıştır. Normal dağılıma sahip olmayan iki bağımsız grubun ölçüm değerleriyle karşılaştırılmasında Mann-Whitney U test, iki bağımlı grubun karşılaştırılmasında Wilcoxon test istatistikleri kullanılmıştır.
Bulgular: Araştırma sonunda, müdahale grubundaki metabolik kontrol değişkenleri 6 ay boyunca düşerken, bilgi puanları, motivasyon düzeyleri ve öz bakım beceri puanları arttğı saptandı. 1. ve 6. ay puanları arasında istatistiksel olarak anlamlı farklılıklar tespit edildi (t=7.067,p<0.001; Z=-7.576, p<0.001; Z=-8.248, p<0.001; Z=-7.807, p<0.001; Z=- 5.651, p<0.001Z= -4.402, p<0.001; Z=- 6.818, p<0.001). Kontrol grubunda 6 ay içerisinde metabolik kontrol değişkenlerinin arttığı, bilgi puanı ortalamalarının arttığı, motivasyon düzeylerinin düştüğü ve öz bakım beceri puan ortalamalarının (ayak bakımı dışında) istatistiksel olarak anlamlı farklılık göstermediği belirlendi.
Sonuç: Bilgi, motivasyon ve davranış modeline modeline dayalı olarak verilen eğitimin diyabetli hastaların bilgi, motivasyon ve davranış becerilerini ve ayrıca metabolik sonuçlarını iyileştirdiği, hastalık yönetimine ve öz bakıma olumlu katkı sağladığı belirlendi

Keywords

diyabet, IMB model, hemşirelik, özbakım

References

• 1. IDF Diabetes Atlas. (2020) Retrieved from http://www.ıdf.org.
• 2. World Diabetes Day. (2021) Retrieved from https://sggm.saglik.gov.tr/TR-76887/dunya-diyabet-gunu-2020.html
• 3. American Diabetes Association. Standards of Medical Care in diabetes. (2020) Retrieved from https://care.diabetesjournals.org/content/41/Supplement_1/S38.full-text.pdf.
• 4. Fisher JD, Fisher WA, Bryan AD, & Misovich, SJ. Information- Motivation-Behavioral Skills Model Based HIV Risk Behavior Change Intervention for Inner-City High School Youth. Health Psychology 2002; 21(2), 177-186.
• 5. Malow R, De´vieux JG, Stein JA, Rosenberg R, Lerner BG, Attonito J, & Villalba K. Neurological Function, Information–Motivation– Behavioral Skills Factors, and Risk Behaviors Among HIV-Positive Alcohol Users. AIDS and Behavior 2012; 16 297–2308 doi: 10.1007/s10461-012-0246-6.
• 6. Ndebele M, Kasese-Hara M, & Greyling M. Application of the information, motivation and behavioural skills model for targeting HIV risk behaviour amongst adolescent learners in South Africa, SAHARA-J: Journal of Social Aspects of HIV/AIDS 2012; 9:sup1 37-47. doi: 10.1080/17290376.2012.74490.
• 7. Walsh JL, Senn TE, & Scott-Sheldon LAJ. Predicting Condom Use Using the Information-Motivation- Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis. Annals of Behavioral. Medicine 2011; 42, 235–244. doi: 10.1007/s12160-011-9284.
• 8. Davis SA, Carpenter D, Doyle, MC, PharmD CL, Blalock SJ, Scott JE, Rodebaugh L, Ferreri SP, & Sleath B. Patient adoption of an internet-based diabetes medication tool to improve adherence: A pilot study. Patient Education and Counseling 2017; 100, 174-178. http://dx.doi.org/10.1016/j.pec.2016.07.024.
• 9. Jeon E, & Park HA. Development of the IMB Model and an Evidence- Based Diabetes Self-management Mobile Application. Health Informatics Research 2018; April 24(2), 125-138. doi: 10.4258/hir.2018.24.2.125.
• 10. Meuiner S, Coulombe S, Beaulieu MD, Cote J, Lesperance F, Chiasson JL, Bherer L, Lambert J, & Houle J. Longitudinal testing of the Information-Motivation-Behavioral Skills model of self-care among adults with type 2 diabetes. Patient Education and Counseling 2016; 99 1830-1836. doi: 10.1016/j.pec.2016.06.011.
• 11. Munshi MN, Segal AR, Suhl E, Ryan C, Sternthal A, Giustu J, Lee Y, Fitzgerald S, Staum E, Bonsignor P, DesRochers L, McCartney, R, & Weinger K. Assessment of barriers to improve diabetes management in older adults: a randomized controlled study. Diabetes Care 2013; March;36(3), 543-549. doi:0.2337/dc12-1303.
• 12. Kim JS & Kim CJ. Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis. Journal of Korean Academy Nursing 2020; Apr;50(2):271-285. doi: 10.4040/jkan.2020.50.2.271.
• 13. Toobert DJ, Hampson SE, & Glaskow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care 2000; July 23(7), 943-50.
• 14. Coşansu G. (Kuzu) Self-Care Activities in Type 2 Diabetes and Cognitive-Social Factors Related to Diabetes. T.R. Istanbul University, Institute of Health Sciences, Department of Public Health Nursing, Doctorate Thesis, 70 pages, Istanbul. Retrieved from https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp (Original work published in Turkish) 2009.
• 15. Gao J, Wang J, Zheng, P, Haaardörfer R, Kegler MC, Zhu Y, & Fu, H. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC Family Practice 2013; 14:66.
• 16. Wu Y, Yao X, Vespasiani G, Nicolucci, A, Dong Y, Kwong J, Li L, Sun X, Tian H, & Li S. Mobile app-based interventions to support diabetes self-management: a systematic review of randomized controlled trials to identify functions associated with glycemic efficacy. Journal Of Medical İnternet Research 2017; M health Uhealth, March 14:5, (3):e35. doi: 10.2196/mhealth.6522.
• 17. Choi S. Structural Equation Modeling of Self - Management Behavior in Older Adults With Type 2 Diabetes Mellitus. [Dissertation] Seoul National University. 2012.
• 18. Bian C, Xu S, Wang H, Li N, Wu J, Zhao J, Li, P,& Lu, H. A Study on the Application of the Information-Motivation-Behavioral Skills (IMB) Model on Rational Drug Use Behavior among Second-Level Hospital Outpatients in Anhui, China. Plos One 2015; 10(8) 1-11. e0135782. doi:10.1371/journal.pone.0135782.
• 19. Jeon N, & Park HA. Experiences of Patients With a Diabetes Self-Care App Developed Based on the Information-Motivation-Behavioral Skills Model: Before-and-After Study. Journal Of Medical İnternet Research Dıabetes 2019; 4(2), doi:10.2196/11590.
• 20. Ameri M, Mohaved E, & Forakhzadian J. Effect of information, motivation, and behavioral skills model on adherence to medication, diet, and physical activity in HIV/ADIS patients: A health promotion strategy. Journal of Educational Health Promotion 2020; 9(317) 1-15. doi: 10.4103/jehp.jehp_188_20.
• 21. Gavgani RM, Poursharifi H, & Aliasgarzadeh, A. Effectiveness of IMB skill model in improving self-care behaviours&HbA1c measure in adults with Type 2 diabetes in Iran-Tabriz. Procedia Social and Behavioral Sciences 2010; 5, 1868-1873. https://doi.org/10.1016/j.sbspro.2010.07.380.
• 22. Ferrari M, Speight J, Beath A, Browne JL, & Mosely K. The information-motivation-behavioral skills model explains physical activity levels for adults with type 2 diabetes across all weight classes. Psychology Health Med 2021; Mar;26(3), 381-394. doi: 10.1080/13548506.2020.1749292.
• 23. Bakir E, Cavusoglu H, &Mengen E. Effects of the information–motivation–behavioral skills model on metabolic control of adolescents with type 1 diabetes in Turkey: Randomized controlled study. Journal of Pediatrics Nursing, 2021; 58, 19-27, https://doi.org/10.1016/j.pedn.2020.11.019.
• 24. Yao X, Zhang L, Du J, & Gao L. (2021) Effect of Information-Motivation-Behavioral Model Based on Protection Motivation Theory on the Psychological Resilience and Quality of Life of Patients with Type 2 DM. Psychiatric Quarterly 2021; Mar;92(1), 49-62. doi: 10.1007/s11126-020-09783.
• 25. Sun X, Huang X, Yuan C, & Chui Y. The influence of health belief and coping style on self-management behavior in patients with type 2 diabetes mellitus [Chinese]. Journal of Nursing 2012; 19(1A) 8–11.
• 26. Liu T, Wu D, Wang J, Li C, Yang R, Ge S, Du Y, & Wang Y. Testing the information-motivationbehavioural skills model of diabetes self-management among Chinese adults with type 2 diabetes: a protocol of a 3-month follow-up study. BMJ Open 2018; 81-10.
• 27. Sinan O, Kaplan S, Sahin S, & Peksoy S. Assessment of the effectiveness of genital infection awareness training provided to women based on the IMB model. Nigerian Journal of Clinical Practice 2020; Mar;23(3), 408-415. doi: 10.4103/njcp.njcp_205_18.
• 28. Huang J, Liu Y, Zhang Y, &Yao H. Correlation between self-management and knowledge of and attitude to diabetes in type 2 diabetes mellituspatients in Changsha [Chinese]. Journal of Central South University. Medical Sciences 2013; 38, 176–81. DOI: 10.3969/j.issn.1672-7347.2013.02.011.
• 29. Kim Y, Lee H, & Seo JM. Integrated Diabetes Self-Management Program Using Smartphone Application: A Randomized Controlled Trial. Western Journal of Nursing 2021; Research Mar 3, doi: 10.1177/0193945921994912.