Development of a Program to Promote Self-Management Aimed at Changing the Schema of Diabetes Patients - Verification of Effects on Remote Islands

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K10787
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58060:Clinical nursing-related
• Research Institution: Kagoshima University
• Principal Investigator: NISHIO IKUKO 鹿児島大学, 医歯学域医学系, 教授 (80402163)
• Co-Investigator(Kenkyū-buntansha): 根路銘 安仁 鹿児島大学, 医歯学域医学系, 教授 (00457657) ; 中條 雅美 鳥取大学, 医学部, 教授 (20382426) ; 谷口 晋一 鳥取大学, 医学部, 教授 (30304207) ; 仲道 雅輝 愛媛大学, 教育・学生支援機構, 准教授 (90625279)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 糖尿病 / スキーマ / 離島 / 自己管理

Outline of Final Research Achievements

We also found that there are four patterns of schemas in diabetic patients, including dependence, ethical blame, problem avoidance, and helplessness, and that these schemas are factors that hinder self-management behavior. We developed a draft of a self-management promotion program incorporating instructional design (IDs) to transform the schemas that are factors that hinder self-management in diabetic patients. The draft incorporates internal and external motivations and ARCS model of IDs, as well as an educational design based on the cycle of the ADDIE model. We also used a brochure prepared by the applicant as the teaching material to be used. Furthermore, we coordinated with facilities to conduct the first and final verification at a remote island clinic on a remote island (Amami Oshima) where medical resources are physically scarce, there are many elderly people, and the schema is expected to be firmly established, but it could not be conducted due to the novel coronavirus crisis.

Free Research Field

糖尿病看護

Academic Significance and Societal Importance of the Research Achievements

糖尿病の発病は、患者に糖尿病の病態や食事・運動・薬物療法に関するスキーマ(体験に基づく認知の歪み)を形成し、スキーマ存在が大きく影響することを明らかにした。そこで、申請者は患者自身の内的・外的動機づけを高めるインストラクショナルデザイン(ID)を導入した糖尿病患者のスキーマの変容を目指した自己管理促進プログラムの原案を開発した。今回、研究実施期間はコロナ禍であったため、離島での効果検証ができなかった。今後、効果検証ができれば、糖尿病患者のスキーマが改善し、食事・運動・薬物療法の糖尿病自己管理の成功体験の獲得、継続への自信を身につけることが出来ると考える。