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| Name | Class |
|---|---|
| Grameen Caledonian College of Nursing | UNKNOWN |
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The global burden of chronic diseases is increasing and becoming a public health issue throughout the world. The use of telenursing is increasing significantly during and after the COVID-19 pandemic to treat and prevent chronic diseases. Study objectives: The objective of this study is to apply the self-management telenursing program and telenursing system developed by the researchers to Bangladesh and to evaluate its feasibility and efficacy (improved diabetes control in participants). Method: This is a pilot, quasi-experimental pre- and post-intervention study. Diabetes patients who will attend the Grameen Primary Health Care Centers (PHCs) in Bangladesh will be enrolled. Investigators include patients who have been diagnosed with type 2 diabetes, both sexes, age above 18-75 years old, all types of treatment, and willing to participate / give consent. Investigators exclude patients who have been diagnosed as gestational diabetes, diabetes as a secondary cause, complication of CKD stage 5, HbA1c is less than 7.0% for past 1 year with CKD stage 1 or 2, no complications or complications with good control, having enough knowledge (had education before) and implemented good practice regarding diabetes management assessed by the research nurses, and disabled persons who need other person's support for daily living. The sample size was calculated and found 70. Patients who meet the eligibility criteria will be introduced by physicians at the PHCs, and the nurses will contact the patients at the PHC. Written informed consent (ICFs) will be obtained from all the participants. Protocol including ICFs got approval from the Institutional Review Board of Bangladesh Medical Research Council (BMRC/NREC/2022-2025/336) on September 08, 2024. The outcome of this study is to evaluate the effects of telenursing intervention by controlling HbA1c. Investigators set various secondary endpoints including feasibility. By making self-supported decisions, the patients will be able to manage their diet, exercise and medication.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre- and post-intervention design | Experimental | After enrollment patients receive 'Health Education'. Then patients receive weekly follow up monitoring over phone call for 1st month, then biweekly from 2nd month to 6th month follow up over phone call and at the end of 6 month, group evaluation for 1 hour and endline data will be collected by the nurses at the PHC. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Health Education | Behavioral | Provide 'Health Education' for acquisition of self-management skills, acquiring knowledge of both the disease and self-care. By making self-supported decisions, the patients are able to manage their diet, exercise and medication. Patients will start implementing diabetes management right after the group education. Each patient will develop monthly goal settings (behavior change plan) related to their diabetes management, daily practice them, and record the results every day on the self-monitoring notebook. The nurses call each patient on the scheduled day, ask/evaluate his/her behavior changes and monitored data, then make "step-up goals" for the next month. In addition, based on his/her knowledge and practice level, the nurses provide education using the education booklet. Patients and the nurses repeat these activities during 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in HbA1c | Change HbA1c level between baseline and endline. | From enrollment to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change the self-efficacy | Self-efficacy is measured by the Diabetes Management Self-Efficacy Scale, 5 domain, 20 questions, scale 1-5, higher number indicates more self efficacy | From enrollment to 6 months |
| Operational feasibility of the system (Qualitative) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Grameen Caledonian College of Nursing (GCCN) | Dhaka | Bangladesh |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40343747 | Derived | Moriyama M, Huq KATME, Mondol L, Mita AR, Nahar NS. Telenursing Health Education and Lifestyle Modification Among Patients With Diabetes in Bangladesh: Protocol for a Pilot Study With a Quasi-experimental Pre- and Postintervention Design. JMIR Res Protoc. 2025 May 9;14:e71849. doi: 10.2196/71849. |
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IPD not be shared to maintain the individual participants privacy.
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| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D006266 | Health Education |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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A quasi-experimental pre- and post-intervention design will be implemented. Investigators will enroll the participants and collect baseline data and then investigators will educate participants, and after 6 months investigators will evaluate participants and compare the baseline (pretest) and endline (posttest) data of individual participants.
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Interview to the nurses, PHC staff Any issues and obstacles |
| From enrollment to 6 months |
| Patient feasibility (qualitative and quantitative) | Engagement rate, Follow-up rate, Satisfaction, Nurse education, Education booklet used, Self-monitoring booklet used, Material will be combined to report patient feasibility. Satisfaction scale has 6 items, 0-5 point, higher point indicates better outcome. | From enrollment to 6 months |
| Fasting blood sugar or random blood sugar | Change the value of fasting blood sugar or random blood sugar from baseline to endline | From enrollment to 6 months |
| Hospitalized by complication | Count the number of hospitalization | From enrollment to 6 months |
| Economical evaluation | Cost-effectiveness analysis by using questionnaire | At 6th month |
| Behavior modification (quantitative and qualitative) | Achievement of monthly set goals, Behavior change (Lifestyle behavior questionnaire), 0-5 score, higher is better | From enrollment up to 6 months |
| Blood pressure | Change the value of blood pressure from baseline to endline | From enrollment up to 6 months |
| Body mass index | Change the value of body mass index from baseline to endline | From enrollment up to 6 months |
| Non-high-density lipoprotein cholesterol | Change the value of non-high-density lipoprotein cholesterol from baseline to endline | From enrollment up to 6 months |
| Triglyceride | Change the value of triglyceride from baseline to endline | From enrollment up to 6 months |
| Estimated glomerular filtration (eGFR) | Change the value of estimated glomerular filtration (eGFR) from baseline to endline | From enrollment up to 6 months |
| Urine albumin | Change the value of urine albumin from baseline to endline | From enrollment up to 6 months |
| Newly diagnosed diseases (any) | Count the number of newly diagnosed diseases | From enrollment up to 6 months |
| Medication/treatment change | Count the times of medication/treatment change and describe the change (better or worse) | From enrollment up to 6 months |
| Death | Count the number of death participants | From enrollment up to 6 months |
| Adverse events | Count the number of all adverse events | From enrollment up to 6 months |
| Compliance of eye check (clinic visit), ECG (cardiovascular check) and Lab test | Count the number of participants who follow nurses' advice to visit eye check, ECG check and laboratory testing | From enrollment up to 6 months |
| D000099060 | Adherence Interventions |
| D055118 | Medication Adherence |
| D010349 | Patient Compliance |
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |