Perceptions of Chinese older adults with type 2 diabetes mellitus about self-management mobile platform: A qualitative study.

OBJECTIVE: To explore the perceptions of Chinese older adults with type 2 diabetes mellitus (T2DM) about the WeChat-based self-management mobile health (mhealth) platforms. METHODS: A semi-structured interview was conducted with a purposive sample of 20 older adults with T2DM. Interview data were summarized and refined with the NVivo 11.0 software. Content analysis was used for qualitative research. RESULTS: Three themes emerged from the interviews: Perception One: Better experience when using a self-management mobile platform; Perception Two: More practical functions of the platform; and Perception Three:Trust and assistance from others. CONCLUSION: Older adults with T2DM have a high willingness to use the WeChat-based self-management mhealth platform. To encourage them to use the platform more frequently, the following factors should be taken into consideration: the perceived experience, fundamental demand for self-management, and need for others' support and assistance. These age-appropriate approaches to self-management health reform may benefit older adults with T2DM.

Reliability and validity of the Chinese version of the LMC Skills, Confidence & Preparedness Index (SCPI) in patients with type 2 diabetes.

BACKGROUND: A variety of diabetes self-management instruments have been developed but few of them consist of the preparedness for diabetes self-management behavior. The novel psychometric evaluation tool "the LMC Skills, Confidence & Preparedness Index (SCPI)" measures three key aspects of a patient's diabetes self-management: knowledge of the skill, confidence in being able to perform skill and preparedness to implement the skill. The objective of this study was to translate, adapt and validate the SCPI for use in Chinese adult patients with type 2 diabetes. METHODS: This study followed the guideline recommended by the American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee (AAOS) to indigenize the scale. Forward and back translation, and cross-cultural language debugging were completed according to the recommended steps. A convenience sample of Chinese patients with type 2 diabetes (n = 375) were recruited from a university-affiliated hospital in Shanghai. The validity (criterion, discriminant validity, and construct validity), reliability (internal consistency and test-retest reliability) and the interpretability of the instrument were examined. The content validity was calculated by experts' evaluation. RESULTS: The Chinese version of SCPI (C-SCPI) has good internal consistency with a Cronbach's alpha of 0.92. The ceiling effects of the preparedness subscales is 21%. The criterion validity of three dimensions of C-SCPI was established with significantly moderate correlations between the DKT, DES-SF and SDSCA (p < 0.05). The S-CVI of the whole scale was 0.83. Except for entry 21, the I-CVI values of all entries were greater than 0.78. The C-SCPI has also shown good discriminative validity with statistically significant differences between the patients with good and poor glycemic control. Confirmatory factor analysis showed that modified results indicate that the fitting degree of the model is good, χ2/df = 2.775, RMSEA = 0.069, CFI = 0.903, GFI = 0.873, TLI = 0.889, IFI = 0.904. The test-retest reliability coefficient was 0.61 (p < 0.01). CONCLUSION: We established a Chinese version of SCPI through translation and cross-cultural adaptation. The C-SCPI is reliable and valid for assessment of the level of self-management in Chinese patients with type 2 diabetes.

Effect of Self-Acupoint Massage on Blood Glucose Level and Quality of Life in Older Adults With Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

The current study aimed to explore the effect of self-acupoint massage (SEAM) on blood glucose level and quality of life in community-dwelling older adults with type 2 diabetes mellitus (T2DM). Sixty-six older adults with T2DM were enrolled and randomly divided into observation and control groups. Participants in the control group received routine nursing interventions, whereas participants in the observation group received a SEAM intervention in addition to routine nursing interventions. After 12 weeks of SEAM, glycosylated hemoglobin (HbA1c) levels in the observation group decreased from 8.35% (SD = 1.84%) at baseline to 7.29% (SD = 1.38%) (p < 0.01). Total score of the Diabetes-Specific Quality of Life Scale (DSQLS) in the observation group improved from 45.96 (SD = 4.29) at baseline to 41.3 (SD = 3.89) (p < 0.01). The physiological dimension of the DSQLS in the observation group improved from 49.65 (SD = 7.33) at baseline to 38.54 (SD = 4.68) (p < 0.01). As SEAM effectively decreased older adults' HbA1c level and improved their quality of life, it can be used as a complementary approach to routine nursing interventions for community-dwelling older adults with T2DM. [Journal of Gerontological Nursing, 45(8), 43-48.].

Effect of Elastic-band Baduanjin exercise on older adults with type 2 diabetes mellitus in China: protocol for a randomised controlled trial.

INTRODUCTION: In China, older adults have the highest incidence of type 2 diabetes mellitus (T2DM). Bone, joint and physical endurance limit the types of exercise available to older adults with T2DM. Baduanjin is recommended and encouraged as an exercise option. However, Baduanjin exercise alone cannot account for the loss of muscle mass. Resistance training is recommended in the guidelines and offers new options for increasing muscle strength. The purpose of this study is to compare the effects of Elastic-band Baduanjin exercise training with those of Baduanjin alone. METHODS AND ANALYSIS: This study is a reworking exercise programme, consisting of Baduanjin combined with elastic band resistance exercise training. A 12-week randomised controlled trial will be conducted. Patients aged 60-80 years with T2DM will be assigned to the Elastic-band Baduanjin (intervention) and Baduanjin (control) groups using cluster random sampling. A sample of 70 participants will be conducted. Indicators of muscle strength, body composition, blood glucose and balance function will be collected before and after the intervention. Meanwhile, exercise will be monitored using the International Physical Activity Questionnaire. ETHICS AND DISSEMINATION: The trial was approved by the Chinese Ethics Committee of Registering Clinical Trials on 19 June 2022 (ChiECRCT20220210). The research results will be published in peer--reviewed publications. TRIAL REGISTRATION NUMBER: Chinese Clinical Trials Registry (ChiCTR2200062424).

Exercise Adherence and Compliance and Its Related Factors Among Elderly Patients with Type 2 Diabetes in China: A Cross-Sectional Study.

Purpose: To explore exercise adherence and compliance as well as its related factors among elderly patients with type 2 diabetes mellitus (T2DM) to provide a basis for clinical intervention strategies. Patients and Methods: The present study was a cross-sectional study of 205 elderly patients with T2DM who regularly visited a Shanghai community health center from August 2020 to July 2021. Exercise adherence and compliance was measured using an exercise adherence and compliance questionnaire, and potential correlates were explored using multiple linear regression analysis. Results: The mean total score of the exercise adherence and compliance questionnaire was 16.72±5.08. The stepwise regression results revealed that exercise adherence and compliance was positively correlated with self-monitoring (F=3.510, P=0.005), exercise knowledge (r=0.784, P<0.001), exercise willingness (r=0.556, P<0.001), professional support (r=0.426, P<0.001), and self-efficiency (r=0.5, P<0.001). There was a negative correlation between hypoglycemia and exercise adherence and compliance (F=-3.672, P<0.001). Conclusion: Low exercise adherence and compliance was related to low glucose self-monitoring frequency, increased hypoglycemia, less exercise knowledge, less exercise willingness, less professional support, and less self-efficiency. When developing exercise instructions adapted to the cognitive and volitional needs of diabetic patients, it is essential to focus on their daily self-management habits and extrinsic motivation to improve exercise adherence and compliance.

Teaching Health Assessment Symptomatology Using a Flipped Classroom Combined With Scenario Simulation.

BACKGROUND: Symptom assessment is difficult to understand and be retained by second-year bachelor's nursing students. A flipped classroom combined with scenario simulation (FCSS) is a new potential teaching model. This study compares the teaching effect and knowledge retention between the FCSS approach and the traditional flipped classroom (FC) approach. METHOD: Second-year bachelor's nursing students were selected as research participants. One group (n = 59) adopted an FCSS approach, whereas the other group (n = 68) adopted an FC approach. We evaluated student mastery and retention of knowledge through two tests: one before the next class, the other after 2 months. RESULTS: Regarding knowledge mastery, the FC group had a higher score than the FCSS group both in total score (66.29 ± 15.27 versus 59.42 ± 10.76) and group learning score (46.06 ± 13.25 versus 38.47 ± 8.22) in the first test (p < .05). The retention of knowledge in the FCSS group was better than that in the FC group (p < .001), represented by the variable of test score difference before and after 2 months. CONCLUSION: When teaching symptomatology, FCSS is helpful to enhance self-learning and improve student long-term memory. [J Nurs Educ. 2020;59(8):448-452.].