The Effects of Nurse-Led Multidisciplinary Team Management on Glycosylated Hemoglobin, Quality of Life, Hospitalization, and Help-Seeking Behavior of People with Diabetes Mellitus

Abstract

Aim . To evaluate the effect of community-nurse-led multidisciplinary team management on glycosylated hemoglobin (HbA1c), quality of life (QOL), hospitalization, and help-seeking behavior in people with type 2 diabetes mellitus (DM). Methods . A quasi-experimental trial was conducted among people with type 2 DM from two community centers in China. The intervention group (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>88</mml:mn></mml:math>) received community-nurse-led multidisciplinary team management for 2 years, while the control group (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>91</mml:mn></mml:math>) received usual care. Data regarding HbA1c, QOL (assessed by the SF-36), hospitalization, and help-seeking behavior were collected at baseline and at 6, 12, and 24 months. Results . During the 24-month project, the intervention group demonstrated 1.08% reduction in HbA1c, whereas the control group achieved an increase of 0.45%. The differences between the two groups were statistically significant (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:math>). The intervention group showed greater increased in QOL scores (from 66.43 to 70.47, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:math>), more decrease in hospitalization (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mtext>OR</mml:mtext><mml:mo>=</mml:mo><mml:mn>2.981</mml:mn></mml:math>, 95% CI: 1.016, 8.752 versus <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mtext>OR</mml:mtext><mml:mo>=</mml:mo><mml:mn>1.189</mml:mn></mml:math>, 95% CI: 0.411, 3.444; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.028</mml:mn></mml:math>) when compared with the control group. The percentage increase of seeking help from nurses in the intervention group (from 12.5% to 57.3%, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:math>) was significantly greater than that in the control group after the intervention. Conclusions . Nurse-led multidisciplinary team management is an effective intervention for improving glycemic control, QOL, hospitalization, and help-seeking behavior for people with DM in a community.