Impact of "Conversation Maps" on diabetes distress and self-efficacy of Chinese adult patients with type 2 diabetes: a pilot study

Fan Li,1,* Ping Yao,2,* Cunyi Hsue,3 Jin Xu,4 Qingqing Lou11Department of Health Education, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu, People’s Republic of China; 3Hangzhou 9th Middle School, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Bioengineering, University of Washington, Seattle, WA, USA*These authors contributed equally to this workAbstract: The objective was to compare Diabetes Conversation Maps-based education and traditional education in Chinese patients with type 2 diabetes. A total of 53 outpatients were randomized to the intervention group (Diabetes Conversation Maps-based education) and control group (traditional education). In the intervention group, six 1-hour sessions covering diabetes overview, living with diabetes, risk factors and complications of diabetes, starting insulin treatment, foot care, and healthy eating and exercise were provided during 4 weeks. The participants had to attend at least four sessions, followed by a monthly follow-up telephone call in the subsequent 3 months. In the control group, six 1-hour diabetes classes covering similar topics as those in the intervention group were provided over 4 weeks. Each participant needed to attend at least four sessions. A1C was assessed at baseline, 3 months and 6 months after the last educational session/class. Psychosocial metrics and self-care activities were evaluated at baseline and 6 months after the last educational session/class. Forty-six participants finished the study. After 6 months, the total score of diabetes distress scale was significantly lower and total score of diabetes empowerment scale-short form was significantly higher in the intervention group than the control group. The 3 months A1C was significantly lower in the intervention group than the control group. However, the 6 months A1C did not reach a statistically significant difference between groups. Compared to traditional education, Diabetes Conversation Maps were more effective in improving psychosocial metrics and 3-month A1C.Keywords: type 2 diabetes, education, conversation map, psychosocial metric