|
Winners of the 2003 DESG Awards |
|
|
|
|
Page 1 of 3 Best two abstracts on Therapeutic Patient Education presented during the 18th IDF Congress, Paris, 2003:
E. Haapa, J. Marttila: From recommendation to practice: implementation of the new recommendation on sugar and its impact on attitude, liking and knowledge. (Abstract No 233)
Diabetes Center, Finnish Diabetes Association, Tampere, Finland.
Background and Aims: In year 1988 the Finnish Diabetes Association gave a new diabetes diet recommendation in which sugar in moderate amounts was considered as a normal incredient of the daily diet. The aim of this study was to detect the changes in use of sugar and sugar containing foods, in attitude and liking of sweet taste and in knowledge.
Materials and Methods: The data was collected by a questionnaire from the patient population coming to the courses in the Diabetes Center in 1988 (N=157), 1990 (N=190), 1994 (N=168) and 1998 (N=131). The control group consisted of the personnel of two working sites in 1988 (N=89) and 1999 (N=53). Attitude, liking and use were measured with a 0 – 100 scale, other aspects were measured with 20 five point Likert scale items. The statistical analysis consisted of a chi2 test, student’s t-test, correlation analysis and factor analysis.
Results: The use of sugar and sugar containing foods increased from 1988 to 1998 form 27±20 to 46±21(p<0,001) (controls 74±17 and 63±23, p<01,01 ) on the scale. The increase in the use of sugar was not significant before 1994. The use increased significantly also from 1994 to 1998 (p<0,01). The use of other nutritive or non-nutritive sweeteners did not change. There was a trend towards a more favourable attitude (p<0,06) and increased liking (p<0,02), almost reaching the level of controls in 1998. The use of sugar, attitude and liking, were strongly intercorrelated in the control population in 1988 and 1998. Among diabetic patients only attitude and liking correlated in 1988, but 1998 also the use of sugar correlated with attitude (p<0,001) and liking (p<0,001). Those treated with diet or 1-2 injections of insulin increased the use of sugar, but attitude or liking did not change. Those having 3 or more injections had higher use of sugar than the former group, and attitude and liking increased among them significantly through the years.
Through factor analysis two factors interpreted as “threat” and “suspicion” emerged. The use of sugar was strongly negatively correlated (p<0,001) with both factors 1988 and 1999. Among patients treated with diet or 1 insulin injection “threat” did not change but “suspicion” decreased significantly (p<0,001) from 1988 to 1998. Patients with 2 or more insulin injections felt in 1998 significantly less “threat” and “suspicion” than in year 1988 (p<0,001) and compared to the former group they felt less “threat” and “suspicion” in year 1988 but only less "suspicion" in 1998. Knowledge about the use of sugar and sugar containing foods increased over the years. In 1998 there was a significant negative correlation between knowledge and “suspicion”.
Conclusion: The implementation of the new diet recommendation has taken many years. Ten years after the recommendation there was a significant increase in the use of sugar and sugar containing foods, positive changes in attitude and liking, and a trend towars reduced feeling of "threat" and "suspicion". The changes were much smaller in patients treated only with diet or 1 insulin injection, perhaps reflecting less intensive or less knowledgeable education of this group.
|