Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetes patients

Authors

  • Morteza Mansourian Ph.D. of Health Education and Promotion, Assistant Professor, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran ,Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran

Keywords:

Self-Care, Educational Intervention, Diabetes Type 2

Abstract

Background and Objective: Diabetes is a chronic disease in which patients require lifelong self-care behaviors. The present study offset to determine the effect of educational intervention based on the Health Belief Model (HBM) on promoting self-care behaviors of type 2 diabetes patients in Ilam, Iran 2014.  Methods: A quasi-experimental research was conducted based on HBM in which 70 type 2 diabetic patients from Ilam, western Iran in 2014 were selected by multi-stage random sampling. A self-designed questionnaire was used, and pre-test was administered, subsequently, the educational intervention sessions were provided in the form of presentation, questions and answers, group discussion, and practical demonstrations in four sessions over a period of one month. Two months after the intervention, the post-tests were administered. The data were analyzed via SPSS 20 applying independent samples t-test, paired samples t-test, and univariate and multivariate regressions at a significance level of less than 0.05.  Results: The mean scores of susceptibility, severity, perceived benefits and barriers, self-efficacy, and self-care behaviors were at average and lower levels before the intervention; nonetheless, after the educational intervention, the mean score of each HBM construct and the self-care behaviors significantly increased (p<0.001).  Conclusion: Health education through HBM promotes the self-care behaviors of patients with type 2 diabetes.

References

Gadsby R. Epidemiology of diabetes. Adv Drug Deliv Rev. 2002; 54(9): 1165-72.

Delavari A, Mahdavi Hazaveh A, Norozi Nejad A, Yarahmadi Sh, Taghipour M. The National Diabetes

Prevention and Control Programme. 2nd ed. Tehran: Seda Publishing Center; 2003: 24.

Abdoli S, Ashktorab K, Ahmadi F, Parvizy M. Barriers and facilitators the empowerment of people with

diabetes. Journal of Endocrinology and Metabolism. 2008; 10(5): 455-64.

Esteghamati AH, Halabchi F. Exercise therapy in patients with type 2 diabetes. Iran J Diabetes Lipid

Disord. 2008; 7(3): 251.

Bener A, Zirie M, Janahi IM, Al-Hamaq AO, Musallam M, Wareham NJ. Prevalence of diagnosed and

undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. Diabetes Res Clin

Pract. 2009; 84(1): 99-106. doi: 10.1016/j.diabres.2009.02.003. PMID: 19261345.

World Health Organization. Prevalence of diabetes in the Who Eastern Mediterranean Region Diabetes

Programme. 2006. Available from: http://www.who.int/diabetes/facts/world_figures/en/index2.html.

Funnel MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National Standards for Diabetes

Selfmanagement Education. Diabetes Care. 2010; 33(1): 97-104.

Bell RA, Arcury TA, Snively BM. Diabetes Foot Self-care Practices in a Rural Triethnic Population.

Diabetes Education. 2005; 31(1): 75-83. doi: 10.1177/0145721704272859. PMID: 15779248, PMCID:

PMC1613259.

Mody R, Kalsekar I, Kavookjian J, Lyer S, Rajagopalan R, Pawar V. Economic Impact of Cardiovascular

Co-morbidityin Patients with Type 2 Diabetes. J Diabetes Complications. 2007; 21(2): 75-83. doi:

1016/j.jdiacomp.2006.02.005. PMID: 17331855.

Anderson RM, Funnell M. Facilitating self-care through empowerment. Psychology in Diabetes Care.

; 10(4): 69-97.

Bidi F, Hassanpour K, Ranjbarzadeh A, Kheradmand A. Effectiveness of Educational Program on

Knowledge, Attitude, Self-Care and Life Style in patients with type II diabetes. Journal of Sabzevar

University of Medical Sciences. 2013; 19(4): 336-44.

Nadrian H, Morovati Sharifabad MA, Mirzaei A, Bahmanpur K, Moradzadeh R, Shariati AM. Relationship

between quality of life, health status and self-care behaviors in patients with rheumatoid arthritis in Yazd.

Journal of Ilam University of Medical Sciences. 2011; 19 (2): 15-25.

Baqudano IR, Dossantos MA, Martins TA, Zanetti ML. Self-care of Patients with diabetes mellituse cared

for at an emergency service in Mexico. Review Latin American Enfermagem. 2010; 18(6): 1195-202.

Nadkarni A. Implementation plans and selfmonitoring of blood glucose in diabetics. Dissertation, Michigan

University. 2009.

Jafarian Amiri SR, Zabihi A, Babaieasl F, Eshkevari N, Bijani A. Self-care Behaviors in Diabetic Patients

Referring to Diabetes Clinics in Babol City, Iran. Journal of Babol University of Medical Sciences. 2010;

(4): 72-8.

Hubley J. Patient Education in the Developing World. Patient Education Counseling. 2006; 61(1): 161-4.

Karimy M, Abedi AR, Niknami Sh, Aminshokravi F, Tavafian S. Preventing HIV Transmission among the

Opiate- Dependent Population in Zarandieh: Evaluation of the HBM-Based Educational Programs. Journal

of health Education and Health Promotion. 2013; 1(1): 2-10.

Clement S. Diabetes self-management education. Diabetes Care. 1995; 18: 1204-14. doi:

2337/diacare.18.8.1204. PMID: 7587866.

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ

Q. 1988; 15(2): 175-83. PMID: 3378902.

Sharifirad G. Hazaveyee S. Mohebi S. The effect ofeducational program based on Health Belief Model on

diabetic foot care. International Journal of Diabetes Development Ctries. 2007; 27: 18-23. doi:

4103/0973-3930.34753.

Jadga Kh, Zareban I, Alizadeh-Siuki H, Izadirad H. The Impact of Educational Intervention Based on

Health Belief Model on Promoting Self-Care Behaviors in Patients with Smear Positive Pulmonary TB.

Journal of Health Education and Health Promotion Summer. 2014; 2(2): 143-52.

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results

from7 studies and a revised scale. Diabetes Care. 2000; 23(7): 943-50. doi: 10.2337/diacare.23.7.943.

PMID: 10895844.

Zareban I, Niknami Sh, Hidarnia A, Rakhshani F, karimy M, Kuhpayehzadeh J, et al. Predictors of self- care behavior and its effective factors among women's with type 2 diabetes patients in Zahedan via Health

Belief model. Journal of Health System Research. 2014: 1797-805.

Beranth C. The health belief model applied to glycemic control. The Diabetes Educator. 1999; 21(4): 321- 9.

Shamsi M, Sharifirad G, Kachoyee A, Hassanzadeh A. The Effect of Educational Program Walking Based

on Health Belief Model on Control Sugar in Woman by Type 2 Diabetics. Iranian Journal of Endocrinology

& Metabolism. 2010; 11(5): 490-9.

Baghiani Moghadam MH, Taheri GH, Fallah Zadeh H, Parsa M. The effect of instructional designed SMS

based on Health Belief Model (HBM) on adoption of self-care behavior of patients with type II diabetes.

Modern Care. 2014; 11(1): 10-8.

Gahanloo SH, Ghofranipour F, Vafaei M, Kimiagar M, Heidarnia AR, Sobhani AR, et al. Assessment

HBM structures along with DBA1C in diabetic patients with optimum and un favorable diabet. Journal of

Hormozgan Medical School. 2008; 12(1): 37-42.

Cismaru M. Using protection motivation theory to increase the persuasiveness of public service

communications. Regina: Saskatchewan Institute of Public Policy; 2006: 5-27.

Daniel M, Messer LC. Perceptions of disease severity and barriers to self-care predict glycemic control in

aboriginal persons with type 2 diabetes mellitus. Chronic Disease Cancer. 2002; 23: 130-8.

Ghafari M. Comparing the efficacy of Health Belief Model and it’s integrated model in AIDS education

among male high school students in Tehran. Tarbiat Modares University. 2007: 95-187.

Asadpour M. Promotion and maintenance of preventive behaviors from HIV, HBV and HCV infections in

health care worker with using constructs of Health Belief Model in Precede-Proceed model. Tarbiat

Modares University. 2005: 151-232.

Wai CT, Wong ML, Ng S. Utility of Health Belief Model in predicting compliance of screening in patients

with chronic hepatitis B. Aliment Pharmacology Therapy. 2005; 21(10): 1255-62. doi: 10.1111/j.1365- 2036.2005.02497.x. PMID: 15882247.

Tan MY. The relationship of health beliefs and complication prevention behaviors of chinese individuals

with Type 2 diabetes mellitus. Diabetes Research Clinic Practice. 2004; 66(1): 71–7.

Becker MH. The health belief model and personal health behavior. Health Education Monographs. 1974; 2:

-473.

Rosenstock IM. The health belief model and preventive health behavior. Health Education Monographs.

; 2(4): 354-86.

Agha Molaei T, Eftekhar H, Mohammad K. Application of health belief model to behavior change of

diabetic patients. Payesh. 2005; 4(4): 263-9.

Shamsi M, Bayati A. A survey of the prevalence of self-medication and the factors affecting it in pregnant

mothers referring to health centers in Arak city. Jahrom Medical Journal. 2010; 7(3): 34-42.

Koch J. The role of exercise in the African- American woman with type 2 diabetes mellitus: application of

the Health Belief Model. Journal of American Academic Nurse Practice. 2002; 14(3): 126-9. doi:

1111/j.1745-7599.2002.tb00103.x.

Asghari T. The effect of educational program safety on based health belief model in workers. Dissertation

Esfahan School of Public Health. 2006.

Karimi M, Zareban I, Montazrei A, Aminshokravi F. the impact of education based on Health Belif Model

in preventive behavior of unwanted pregnancy. IJOGI. 2012; 15(23): 18-27.

Dizaji MB, Taghdisi MH, Solhi M, Hoseini SM, Shafieyan Z, Qorbani M, et al. Effects of educational

intervention based on PRECEDE model on self-care behaviors and control in patients with type 2 diabetes

in 2012. Journal of Diabetes & Metabolic Disorders. 2014; 13: 72. doi: 10.1186/2251-6581-13-72. PMID:

, PMCID: PMC4114427.

Borhani M, Rastgarimehr B, Shafieyan Z, Mansourian M, Hoseini SM, Arzaghi SM, et al. Effects of

predisposing, reinforcing and enabling factors on self-care behaviors of the patientswith diabetes mellitus

in the Minoodasht city, Iran. J Diabetes Metab Disord. 2015; 14; 14-27.

Olayemi SO, Oreagba IA, Akinyede A. Educational intervention and the health seeking attitude and

adherence to theraphy by tuberculosis patients from an urban slum in Lagos Niger Postgrad. Niger postgrad

Medy. 2009; 16(4): 231-5.

Sarani M. The Study for Health Belief Model efficiency in adopting preventive behaviors in the Sistan

region tuberculosis patients 2009-2010. Medical Sciences and Health Services Zahedan. 2011; 1: 152-3.

Taheriaziz M. Survey of effectiveness of designed health educational package on tuberculosis patient’s

healthy behaviors at Pasteur institute spring 2004. Tarbiat Modares University. 2004; 1: 231.

Published

2022-02-12