I have been invited to take part in a research study titled:
This study is being conducted by , who can be contacted at:
I understand that my participation is voluntary and that I can refuse to participate or stop taking part any time without giving any reason and without facing any penalty. Additionally, I have the right to request the return, removal, or destruction of any information relating to me or my participation.
PURPOSE OF STUDY
I understand that the purpose of the study is to investigate the effectiveness of tele-monitoring and patient education as compared to routine diabetes care for patients (adults) diagnosed with diabetes.
PROCEDURES
I understand that if I volunteer to take part in this study, I will be asked to:
Task3 : Adhere to patient education-diet, physical exercise and medication adherence
BENEFITS
I understand that the benefits I may gain from participation include:
Improved diabetes self-efficacy
Improved management of diabetes
Continuous post-discharge diabetes care
Optimal management and control of blood sugar
Understand to optimally use tele-monitoring in self-diabetes monitoring
RISKS
I understand that the risks, discomforts, or stresses I may face during participation include:
N/A: The study poses no risk
CONFIDENTIALITY
I understand that the only people who will know that I am a research subject are members of the research team. No individually-identifiable information about me, or provided by me during the study will be shared with others except when necessary to protect the rights and welfare of myself and others (for example, if I am injured and need emergency care, if the provided information concerns suicide, homicide, or child abuse, or if revealing the information is required by law).
FURTHER QUESTIONS
I understand that any further questions that I have, now or during the course of the study can be directed to the researcher ( ).
My signature below indicates that the researchers have satisfactorily answered all of my current questions about this study and that I understand the purpose, procedures, benefits, and risks described above. I have also been offered a copy of this form to keep for my own records.
Participant Printed Name
