Incorporating Telephone and Text Messaging to Support a Cross Cultural Cardiac-Diabetes Self-Management Program

Friday, 3 August 2012: 8:50 AM

Chiung-Jung (Jo) Wu, RN, BN, MN, (ICU), DrHlthSc
School of Nursing and Midwifery, Institute of Health and Biomedical Innovation, Brisbane, Australia
Anne M. Chang, RN, DipNEd, BEdSt (Hons), MEdSt, PhD
Nursing Research Centre (inc. Queensland Centre for Evidence Based Nursing and Midwifery), Mater Health Services, Brisbane, Queensland, Australia
Mary Courtney, RN, PhD
School of Nursing, School of Nursing, Brisbane, Australia
Huei Chuan Sung, PhD, MSN, RN
Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan
Marilyn Ray, RN, PhD, CTN-A, Emeritus, Professor
Christine E Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL
Alexander M. Clark, PhD, BA, RN
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

Learning Objective 1: The learner will be able to gain greater understanding of development an intervention program for cardiac patients with diabetes in different cultural contexts.

Learning Objective 2: The learner will be able to gain knowledge to undertake an international collaborative research.


People with comorbidities such as cardiac disease and diabetes are particularly vulnerable to adverse health outcomes. Consequently, these people frequently demonstrate poor health-related quality of life.  Evidence demonstrates that self-management programs are effective in assisting patients to modify their lifestyle for better managing their conditions. However, limited evidence for programs addressing the needs of patients with these two major co-morbidities has been undertaken. Materials developed and used in the programs tend to focus on English-speaking patients, and more involvement in a culturally and linguistically diverse population is recommended to address this discrepancy. Using information technology to support self-management programs has potential to efficiently assist these patients in managing their conditions through the transition from hospitals to home.


To develop and test a Cardiac-Diabetes Self-Management Program (CDSMP) incorporating telephone and text-messaging follow-up support for patients in two different cultural contexts.


A Block randomised controlled trial is conducted to evaluate the relative effectiveness of modes of care: existing care (Group 1) and intervention group (Group2) to measure the main outcomes of self-care behaviour, self-efficacy levels, knowledge, and quality of life in Australian (English-speaking) and Taiwanese (Chinese speaking) participants.  [Clinical Trial Number: ACTRN12611001196932]

Results: Initial analysis revealed that participants (n=14 in Australia, n= 6 in Taiwan) in the intervention group had significantly improvement in self-efficacy levels (p< .05). Both control and intervention groups (n=52) had improved self-care behaviour, levels of knowledge and quality of life.  However, approximately 2 percent of patients had been readmitted to hospital within 28 days.


Findings support specific, targeted, educational intervention programs to address the needs of people with cardiac disease and diabetes are needed.