J Korean Clin Nurs Res.  2022 Dec;28(3):277-288. 10.22650/JKCNR.2022.28.3.277.

Effects of the Insulin Therapy Adherence Program for Patients with Type 2 Diabetes: A Randomized Controlled Trial

• Park KM
• Son JT

• KMID: 2537793
• DOI: http://doi.org/10.22650/JKCNR.2022.28.3.277

Abstract

Purpose
This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus.
Methods
This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c).
Results
Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group.
Conclusion
INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

Keyword

Diabetes Mellitus; Insulin; Medication Adherence; Psychosocial Intervention; Transtheoretical Model