The Relationship between Quality of Life, Activity and Participation among People with Type 2 Diabetes Mellitus

Habit Formation Intervention to Improve Type 2 Diabetes Self-Management Behaviors: A Feasibility Study

IMPORTANCE

Self-management of lifestyle behaviors is the recommended focus for interventions to address Type 2 diabetes. Habit formation is an effective approach to changing personal behaviors, but evidence of success for Type 2 diabetes is limited.

OBJECTIVE

To examine the feasibility and preliminary effectiveness of occupation-based habit formation interventions for improving diabetes self-management behaviors.

DESIGN

Single-subject design with multiple participants providing 4 wk of baseline data followed by 10 wk of intervention data.

SETTING

Individual telehealth sessions.

PARTICIPANTS

Eight adults (ages 29-75 yr) with Type 2 diabetes, who had access to a telephone and who were not involved in other diabetes-related education or interventions voluntarily, enrolled into the study.

INTERVENTION

Participants engaged in 10 wk of habit formation intervention focused on four diabetes self-management domains: nutrition, blood glucose monitoring, medication management, and physical activity.

OUTCOMES AND MEASURES

Data gathered included findings on measures of diabetes self-care behaviors and habit formation.

RESULTS

There was a significant change in self-care behaviors for 6 of the 8 participants (p < .05 for 1 participant, and p < .01 for 5 participants). Group changes were statistically significant (p < .001). Habit strength significantly improved for all areas of diabetes self-management (p < .001 for nutrition, blood glucose monitoring, and medication management and p = .001 for physical activity).

CONCLUSIONS AND RELEVANCE

Findings suggest that the occupation-based intervention was feasible and showed promise for developing self-management behaviors. What This Article Adds: Habits are considered foundational to occupations, yet application of the science of habit formation is often not well understood by occupational therapists. This study considered the theoretical components of habit formation that have been neglected by prior studies and demonstrates the feasibility and preliminary effect estimates of a habit formation intervention when used with people with Type 2 diabetes.

Increasing occupational participation: A qualitative analysis within the “Occupational Self-Analysis” program

Introduction:

Occupational participation is a key element to increase the quality of life in the population. One of the effective interventions to increase occupational participation is the “Occupational Self-Analysis” program. The aim of this study was to analyze participant’s reported benefits about the “Occupational Self-Analysis” program.

Method:

This is a qualitative study with 26 participants (12 people with intellectual disability, 7 affected by acquired brain injury, and 7 students) who participated in weekly group sessions and one individual session. The outcomes were measured based on participant diaries and focus group transcriptions.

Results:

Two main themes emerged: (1) supports for occupational participation and (2) barriers for occupational participation. The thematic analysis of the categories was based on the Model of Human Occupation to increase applicability of the program in occupational therapy practice.

Conclusions:

The “Occupational Self-Analysis” program allowed participants to increase their knowledge of supports provided for and the barriers against occupational participation.

Describing Occupational Therapy Services in Primary Care Settings: A Qualitative Study

As occupational therapists gain recognition for their work in primary care, it is important to explore the services they provide within these settings. A qualitative study was employed whereby six licensed occupational therapists within the United States were invited via email to engage in semi-structured interviews. Interview transcripts were analyzed individually by six researchers and as a team using consensus coding. Four themes emerged: "Primary Care Benefits", "Occupational Therapy Process and Distinct Value", "Primary Care Interventions", and "Complexities of Primary Care: Patient Conditions and Challenges." Occupational therapists described a range of benefits to being positioned within primary care. Problem solving around patient barriers, funding and logistical challenges are important considerations. Emphasizing 'occupation-based practice' and 'doing' within therapy are vital for occupational therapists who wish to advocate for their services and apply their distinct skill set within primary care settings.

Depression and polypharmacy are risk factors for activity limitation in type 2 diabetes

OBJECTIVES

Individuals with type 2 diabetes are at risk for deficits in instrumental activities of daily living (IADL: e.g., managing medication, preparing healthy meals). Understanding which demographic and health factors contribute to decreased frequency of IADL performance is especially important to prevent age-related functional decline in type 2 diabetes. This study examined the relationships among demographic and health variables and frequency of IADL performance in adults with type 2 diabetes.

METHODS

For this cross-sectional study, we collected health, demographic, and activity information via self-report and electronic health record review from safety-net primary care patients with type 2 diabetes (n = 93). We used regression models to determine which factors were associated with IADL performance in three subscales (domestic, leisure/work, outdoor) and the overall score.

RESULTS

Depression was associated with decreased frequency of IADL performance for domestic, leisure/work, and outdoor activities. Each additional daily medication was associated with decreased frequency of domestic and outdoor IADL performance.

DISCUSSION

Depression and taking more daily medication were predictors of decreased IADL performance for adults with type 2 diabetes. Our findings suggest regular screening for depression and polypharmacy is important in the primary care of diabetes; especially as these are potentially modifiable risk factors.

Evaluation of ADL and BMI in the management of diabetes mellitus at secondary and tertiary health facilities

AIMS

Physical activities of daily living (ADL) constitutes one of diabetes management options. This study aimed to assess the extent that ADL and BMI are evaluated among diabetes patients in hospital practice.

METHOD

This was a clinical observational baseline study in two hospitals. Audit of medical files was performed to assess if BMI and occupations were recorded (N = 112). Afterwards, 'N = 38' who consented to participate in prospective study were conveniently sampled to assess ADL in relation to accessible metabolic syndrome tests. A validated questionnaire was used to collect data, which were analysed using SPSS version 20.

RESULTS

Audit shows 55/112 of clients' occupation were taken, of which 31% has BMI record. Those with lipid profile results are without blood pressure and vice versa. In the cross-sectional assessment, 74% are in physically demanding ADL occupations, but affirmed inactivity is 98% on leisure exercise. Further, 47% have BMI >25 kg/m² and were consistently less active on all leisure ADL relative to those with BMI <25 kg/m² (p < 0.02).

CONCLUSION

This report highlights oversight in clinical practice, whereby accessible metabolic syndrome parameters and occupation of clients living with diabetes are being assessed inconsistently. This implies an unmet need in the integration BMI and occupational information to improve diabetes self-management.