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To identify patterns of dyadic engagement in type 2 diabetes care, describe their characteristics, and explore their association with glycated haemoglobin.
In chronic conditions, patient self-care and caregiver contribution should be considered a dyadic phenomenon. However, patterns of dyadic engagement in type 2 diabetes care have not yet been identified.
Multicentre observational cross-sectional study.
Patient self-care and caregiver contribution were assessed using the Self-Care of Diabetes Inventory and the Caregiver Contribution to Self-Care of Diabetes Inventory. Patterns of dyadic engagement in type 2 diabetes care were identified by latent class analysis. Associations between patient-caregiver characteristics and class membership were estimated using multinomial regression. The association between classes and glycated haemoglobin levels was assessed using linear regression.
251 dyads of patients with type 2 diabetes and their primary informal caregivers were enrolled. Patients were mostly male (55%, median age 72) and caregivers mostly female (71%, median age 64). Three patterns of dyadic engagement were identified: ‘equally engaged-low care’ (14%), ‘mostly patient engaged-middling care’ (25%), and ‘equally engaged-high care’ (61%). Patient characteristics (sex, education, self-efficacy) and caregiver characteristics (burden, chronic diseases) were associated with pattern membership. Membership in the ‘mostly patient engaged-middling care’ and ‘equally engaged-high care’ patterns was associated with decreased glycated haemoglobin compared to ‘equally engaged-low care’.
The three identified patterns of dyadic engagement in type 2 diabetes showed differences in patient and caregiver characteristics and were associated with glycated haemoglobin.
The study identified and described patterns of dyadic engagement in type 2 diabetes care. The three identified patterns showed differences in characteristics and in patient glycemic control. Healthcare professionals should consider these patterns for tailoring interventions focused on both dyad members.
STROBE checklist was followed.
Patients and their informal caregivers were recruited to participate in the study.
An abnormal composition of gut bacteria along with alterations in microbial metabolites and reduced gut barrier integrity has been associated with the pathogenesis of chronic autoimmune and inflammatory rheumatic diseases (AIRDs). The aim of the systematic review, for which this protocol is presented, is to evaluate the clinical benefits and potential harms of therapies targeting the intestinal microbiota and/or gut barrier function in AIRDs to inform clinical practice and future research.
This protocol used the reporting guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. We will search Embase (Ovid), Medline (Ovid) and the Cochrane Library (Central) for reports of randomised controlled trials of patients diagnosed with an AIRD. Eligible interventions are therapies targeting the intestinal microbiota and/or gut barrier function including probiotics, synbiotics, faecal microbiota transplantation, live biotherapeutic products and antibiotics with the intent to modify disease activity in AIRDs. The primary outcome of the evidence synthesis will be based on the primary endpoint of each trial. Secondary efficacy outcomes will be evaluated and selected from the existing core domain sets of the individual diseases and include the following domains: disease control, patient global assessment, physician global assessment, health-related quality of life, fatigue, pain and inflammation. Harms will include the total number of withdrawals, withdrawals due to adverse events, number of patients with serious adverse events, disease flares and deaths. A meta-analysis will be performed for each outcome domain separately. Depending on the type of outcome, the quantitative synthesis will encompass both ORs and standardised mean differences with corresponding 95% CIs.
No ethics approval will be needed for this systematic review. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to disseminate the study results through a peer-reviewed publication.
CRD42025644244.
FreshRSS 