The Impact of M-Health on the Self-Management of Diabetes: A - PowerPoint PPT Presentation

The Impact of M-Health on the Self-Management of Diabetes: A preliminary study Annie Chang Associate Professor School of Nursing Fooyin University, Taiwan

Introduction Diabetes mellitus [1-3] • is a life-long chronic disease; • can damage all regions of the body; • needs on-going process of self-management; • used traditional education and learning methods.

Introduction M-health [4] • abbreviation for mobile health, • 2/3 population owns a mobile phone Functions • building community 、 • delivery of healthcare information 、 • real-time monitoring 、 • direct provision of care

Introduction Minimal Psychological Intervention (MPI) [5-7] • Applying principles of self-management and cognitive behavioral therapy

Purpose of this study • To explore the impact of this m-health programme on diabetes patients  Diabetes Knowledge,  Psychological distress, and  Self-care behaviours.

Methods • One-group pretest-posttest pre-experimental design • Selection criteria were: 1) diagnosis of diabetes; 2) age over 20 years; 3) no serious condition; 4) internet access via smartphone, • A total of 30 patients were recuited

M-Health Programme • Facebook with Private/Closed group  Receiving online-lectures and quizzes,  Sharing experiences, and  Communicating with each other  Providing diabetes APP • A total of 10 online thematic activities

Facebook Welcome Group’s name Community Activities Sharing

Themes MPI Design Wk Cognitive section 1. Cognition: relationships of diet and Understand diabetes diet diabetes  2 Design my plate daily 2. Affect: triggering motivation to change  3. Skill: self-assessment of consciousness Affective section 1. Cognition: taking control of diet 4 Understand new tool for diet control 2. Affect: triggering motivation to change  Plate-app to plan calories daily 3. Skill: aroused affection, app usage  Psychological section 1. Cognition: taking control of emotions Understand emotions and diabetes related to diabetes  7 Practise relaxation techniques 2. Affect: adjusting mentality  3. Skill: music therapy and meditation Behavioural section 1. Cognition: posttest questionnaire Experience sharing 2. Affect: support from each other 10  Fill the questionnaire 3. Skill: overview of programme 

Week 4 APP Design my plate Step by step Discussion

Week 3 Excercise Video to follow communication Who readied it

Instruments • Sociodemographic data • Diabetes Knowledge: CVI >.8 • Self-care behaviours scale: Cronbach’s α=.86 • Psychological health: Cronbach’s α = .85

Data collection • Approved by the Human Research Ethics Committee (NCKU HREC-E-105-182-2) • A written consent form to indicate their willingness to join the study • Using SPSS statistical package version 22 for data analyses

Results Demographic characteristics • A total of 30 participants • Gender: 80% female • Age: 46 ± 8.9 years • Education: 100% completed primary school • Employment: 80% employed • Only, 22 participants completed the m-health programme • Withdrawal reasons: not familiar with media devices or Facebook, apps, and weekly lectures, etc.

Results Pretest-posttest findings Pretest Posttest Variables T P Mean SD Mean SD Diabetes knowledge 6.09 1.68 6.09 1.15 .970 .00 Psychological health 46.4 19.8 39.8 16.3 .090 1.78 Diabetes self-care behaviours 113.3 31.1 128.5 20.5 .010 -2.61 Foot care 20.4 5.8 23.1 4.7 .024 -2.43 Diet Control 41.8 13.5 49.7 6.6 .010 -2.84 Exercise 8.3 4.3 10.2 3.3 .017 -2.58 Medication Compliance 7.0 1.1 7.4 1.2 -.95 .355 Self-monitoring blood sugar 27.3 7.4 29.2 5.6 -1.37 .185

Discussion • Significant improvement in diabetes self-care behaviours and • Slight changes in psychological distress • Psychological distress • emotional problems ( p <.05) • diet-related problems ( p >.05) • No changes in diabetes knowledge • Pre-test score of 6.09 (total score:7)

Several limitations • Research design, • Instruments, and • Selection bias.

Implication further research • Feasibility, • Usability, and • Acceptability

Conclusion • This study provided a platform for diabetes patients to keep them posted with updated information, lectures, discussion, and social interaction, so that they maybe more willing to engage in their self-care activities

References 1. International Diabetes Federation, IDF Diabetes Atlas, International Diabetes Federation 2017 retrieved from: [http://www.diabetesatlas.org/]. 2. M.E. Murphy, M. Byrne, R. Galvin, F. Boland, T. Fahey, S.M. Smith, Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings, BMJ Open 7 (2017), e015135. 3. T. Al Slamah, B.I. Nicholl, F.Y. Alslail, C.A. Melville, Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review, PLoS One 12 (2017), e0189160. 4. C. Free, G. Phillips, L. Galli, L. Watson, L. Felix, P. Edwards, V. Patel, A. Haines, The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review, PLoS medicine 10 (2013), e1001362. 5. C.J. Chiu, Y.H. Hu, L.A. Wray, E. A. Beverly, Y.C. Yang, J.S. Wu, F.H. Lu, Dissemination of evidence-base minimal psychological intervention for diabetes management in Taiwan adults with type 2 diabetes. International Journal Of Clinical And Experimental Medicine 9 (2016): 14489-14498. 6. C.C. Jonkers, F. Lamers, H. Bosma, J. F. Metsemakers, & J. T. M.van Eijk, The effectiveness of a minimal psychological intervention on self-management beliefs and behaviors in depressed chronically ill elderly persons: a randomized trial. International psychogeriatrics 24 (2012), 288-297. 7. B.H. Chew, R.C. Vos, M.I. Metzendorf, R.J. Scholten, G.E. Rutten, Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus. Cochrane Database Syst Rev 27 (2017): CD011469.

Thanks for your attention Annie Chang Associate Professor School of Nursing Fooyin University