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Menon U, Szalacha LA, Martinez GA, Graham MC, Pares-Avila JA, Rechenberg K, Stauber LS. Efficacy of a language-concordant health coaching intervention for latinx with diabetes. PATIENT EDUCATION AND COUNSELING 2022; 105:2174-2182. [PMID: 34895775 PMCID: PMC9142757 DOI: 10.1016/j.pec.2021.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To describe the effect of a language-concordant health coaching intervention for Spanish-speaking patients with limited English proficiency (LEP) and uncontrolled Type 2 Diabetes (T2D) on glycemic control, anxiety, depression, and diabetes self-efficacy. METHODS 64 patients with T2D were randomly assigned to a control or intervention group. Outcomes were assessed by blood work and surveys pre and post intervention. RESULTS The mean sample age was 47.8 years (SD=11.3) and 81% were female. HbA1c was not significantly different between groups at baseline. The intervention group's HbA1c was significantly lower at times 2 and 3 than in the control arm (p < .01 and p < .001). There were significant reductions in the intervention group's mean HbA1c levels from baseline 10.37 to midpoint 9.20, p < .001; and from baseline 10.42 to study end 8.14, p < .001. Depression and anxiety scores significantly decreased (p < .05 and p < .001), and diabetes self-efficacy significantly increased (p < .001). CONCLUSION Health coaching led to statistically significant and clinically meaningful decreases in HbA1c, depression, and anxiety scores among LEP Latinx adults with uncontrolled T2D. PRACTICE IMPLICATIONS Heath coaching can be conducted in primary care clinics by nurses or advanced practice nurses. The short-term intervention tested here could be adapted to the clinical setting.
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Affiliation(s)
- Usha Menon
- College of Nursing, University of South Florida, Tampa, FL, USA.
| | - Laura A Szalacha
- College of Nursing, University of South Florida, Tampa, FL, USA; Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Glenn A Martinez
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | | | - Jose A Pares-Avila
- College of Nursing, University of South Florida, Tampa, FL, USA; College of Nursing, University of Arizona, Tucson, AZ, USA
| | | | - Leah S Stauber
- College of Nursing, University of Arizona, Tucson, AZ, USA
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Clever SN, Baulig S, Benecke A. Psychologische Herausforderungen bei Erwachsenen mit Typ-1-Diabetes. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1338-4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ZusammenfassungMenschen mit Typ-1-Diabetes müssen immer wieder verschiedene Anpassungsleistungen erbringen, um ihre Erkrankung und deren Therapie in den Alltag integrieren zu können. Gelingt dies nicht, können daraus Probleme beim Selbstmanagement der Krankheit resultieren. Doch trotz strukturierter Schulungsprogramme und leitliniengerechter, individuell zugeschnittener Therapieempfehlungen leben einige Menschen mit Typ-1-Diabetes mit chronisch erhöhten Blutzuckerwerten. Dabei scheint der Diabetes-Distress als Reaktion auf die erlebten Herausforderungen eine wichtige Rolle zu spielen und im Zusammenhang mit Problemen bei der glykämischen Kontrolle wie auch einer Therapievermeidung zu stehen. Um eine Chronifizierung des Diabetes-Distress zu verhindern, empfiehlt es sich daher, ein Screening auf diabetesbezogene Belastungen in der Versorgung von Menschen mit Typ-1-Diabetes zu etablieren. Dies kann mittels Fragebogen oder der Thematisierung im persönlichen Gespräch geschehen. Diabetesspezifische psychologische Interventionen können sowohl die diabetesbezogene emotionale Belastung als auch die glykämische Kontrolle verbessern, sind jedoch in Deutschland noch nicht in der Regelversorgung verfügbar.
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Affiliation(s)
- Susan Norah Clever
- Psychotherapiepraxis, Diabetespraxis Blankenese, Hamburg, Germany
- CEO, Medical Psychology Consultancy, Hamburg, Germany
| | - Susanne Baulig
- Poliklinische Institutsambulanz für Psychotherapie, Johannes-Gutenberg-Universität Mainz, Germany
| | - Andrea Benecke
- Poliklinische Institutsambulanz für Psychotherapie, Johannes-Gutenberg-Universität Mainz, Germany
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3
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Heydarian NM, Brown-Podgorski B, Ramirez J. Visual Impairment and Self-Efficacy in Diabetes Management. Sci Diabetes Self Manag Care 2021; 47:346-354. [PMID: 34384299 PMCID: PMC10833884 DOI: 10.1177/26350106211033811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study is to examine the relationship between visual impairment and diabetes management self-efficacy. METHODS The present study utilized pooled cross-sectional data (2008-2018) from the Medical Expenditure Panel Survey Household Component and Diabetes Care Survey. Binary and generalized ordinal logit regression models were used to compare diabetes management self-efficacy between patients with and without visual impairments. RESULTS Compared to their non-visually impaired counterparts, visually impaired persons had a lower odds of reporting high diabetes management self-efficacy. Similarly, visually impaired adults with diabetes have a significantly lower odds of being very confident in their ability to manage their conditions compared with adults who reported being not confident, somewhat confident, or confident. Several control factors, including self-behaviors and receipt of diabetes self-management education (DSME), were also associated with diabetes management self-efficacy. CONCLUSIONS Visually impaired persons experience significant disparities in diabetes management self-efficacy. Given the relationship between self-efficacy and diabetes-related outcomes, it is crucial that DSME be tailored to effectively meet the individual needs of this population. Future research should explore the relationship between DSME and self-care behaviors, self-efficacy, and diabetes-related outcomes in visually impaired persons.
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Foroumandi E, Kheirouri S, Alizadeh M. The potency of education programs for management of blood pressure through increasing self-efficacy of hypertensive patients: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2020; 103:451-461. [PMID: 31558325 DOI: 10.1016/j.pec.2019.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 09/09/2019] [Accepted: 09/14/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify the effect of self-management education programs on the changes of self-efficacy and the management of blood pressure (BP) in hypertensive patients. METHODS PubMed, Google Scholar, Scopus, Trip database, Proquest, and Embase were searched. Trials that had examined the effect of self-management education programs on self-efficacy, systolic BP (SBP) and diastolic BP (DBP) in hypertensive patients were selected. RESULTS Fourteen studies with 2239 participants were analyzed. Self-management education programs led to a statistically-significant increase in the self-efficacy of the participants (SMD: 0.71; 95% CI: 0.34-1.07; I2 = 94%; P < 0.001), as well as significant decrease in SBP (MD: -5.37 mmHg; 95% CI: -8.53 to -2.22; P < 0.001) and DBP (MD: -3.87 mmHg, 95% CI: -5.84 to -1.90; P < 0.001) compared to control groups. CONCLUSION The findings indicated that self-management education programs can promote self-efficacy in hypertensive patients, possibly contributing to better management of BP. PRACTICE IMPLICATIONS Adoption of the self-management education program provides a basic concept to improve both quality and efficacy of strategies related to BP management. Policy makers should focus on improving self-efficacy via the implementation of policies useful for better educational outcomes concerning new technologies as well as appropriate theoretical methods.
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Affiliation(s)
- Elaheh Foroumandi
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sorayya Kheirouri
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Alizadeh
- Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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5
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Vyas C, Dalal L, Talaviya P, Saboo B. Multiple educational programs improves glycemic control, quality of life with diminishing the impact of diabetes in poorly controlled type 1 diabetics. Diabetes Metab Syndr 2017; 11 Suppl 2:S601-S606. [PMID: 28927968 DOI: 10.1016/j.dsx.2017.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
Abstract
AIMS The aim of present study was to assess the outcomes of multiple educational programs on glycemic control, quality of life and impact of diabetes in poorly controlled Type 1 Diabetic patients. PARTICIPANTS AND METHODS A 12 months diabetes education programs were conducted every week for first one month then followed by every 3 months with follow up on improvement of HbA1c and QOL in T1D patients (n=54). Clinical characteristics were recorded at baseline visit. The QOL was evaluated by 15 set DQOL questionnaires in 40 consecutive patients at baseline, 3, 6 and 12 months after education programs. The HbA1c level (%) was evaluated at same time point. Decrease in DQOL score was reported as improvement in QOL. RESULTS The rate of patients response to educational programs was noted 74.07% (n=40) at end of the study (12 months). The prevalence of T1D was reported higher in men than in women. The overall DQOL score and HbA1c% level was significantly (P<0.05) decreased at 3, 6 and 12 months after educational programs. Patients exhibited greater satisfaction and diminished impact of diabetes after educational programs was observed after 3 months and it was continue up to end of study. The frequencies of self-monitoring of blood glucose were increased. Numbers of hypoglycemic and DKA events were decreased after educational programs when compared to baseline. CONCLUSION Results of study revealed that the appropriate education and counseling diminish impact of diabetes, improve QOL and help to achieve desired glycemic (HbA1c) level in poorly control T1D patients.
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Affiliation(s)
- Chintan Vyas
- Saarathi Institute of Diabetes Sciences, Anand, Gujarat, 388 345, India.
| | - Lopa Dalal
- Saarathi Institute of Diabetes Sciences, Anand, Gujarat, 388 345, India
| | - Praful Talaviya
- Saarathi Institute of Diabetes Sciences, Anand, Gujarat, 388 345, India; DiaCare - An Advance Diabetes Care Center, Ahmedabad, Gujarat, 380 015, India
| | - Banshi Saboo
- DiaCare - An Advance Diabetes Care Center, Ahmedabad, Gujarat, 380 015, India
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6
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Fisher EB, Brownson CA, O'Toole ML, Shetty G, Anwuri VV, Fazzone P, Housemann RA, Hampton AD, Kamerow DB, McCormack LA, Burton JA, Orleans CT, Bazzarre TL. The Robert Wood Johnson Foundation Diabetes Initiative. DIABETES EDUCATOR 2017; 33:83-4, 86-8, 91-2, passim. [PMID: 17272795 DOI: 10.1177/0145721706297454] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the Diabetes Initiative of the Robert Wood Johnson Foundation is to demonstrate feasible and sustainable approaches to promoting diabetes self-management in primary care and community settings. METHODS The Diabetes Initiative of the Robert Wood Johnson Foundation includes 14 demonstration projects in primary care settings and in community-clinical partnerships. Projects serve predominantly indigent populations from varied cultural and linguistic backgrounds in urban, rural, and frontier settings around the United States. This report describes the Initiative, its ecological perspective on self-management, and implications for program development, sustainability, and dissemination. RESULTS Ecological perspectives stress varied levels of influence ranging from individuals to communities and policies. Based on this, the Initiative has identified key resources and supports for self-management (individualized assessment, collaborative goal setting, enhancing skills, follow-up and support, community resources, and continuity of quality clinical care). Lessons learned include the central roles of community health workers, integration of healthy coping and attention to negative emotion and depression in self-management, community partnerships, approaches to ongoing follow-up and support, organizational factors in sustaining programs, and the utility of a collaborative learning network for program development. Sustainability stresses organizational and policy supports for the program. Dissemination of lessons learned will stress collaboration among interested parties, stimulating consumer understanding and demand for self-management services as central to diabetes care. CONCLUSIONS The Diabetes Initiative demonstrates that effective self-management programs and supports can be implemented in real-world clinical and community settings, providing models of worthwhile, sustainable programs.
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Affiliation(s)
- Edwin B Fisher
- The Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill (Dr Fisher)
| | - Carol A Brownson
- National Program Office of the Diabetes Initiative of The Robert Wood Johnson Foundation, Division of Health Behavior Research, Departments of Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri (Ms Brownson, Dr O’Toole, Ms Shetty, Ms Anwuri)
| | - Mary L O'Toole
- National Program Office of the Diabetes Initiative of The Robert Wood Johnson Foundation, Division of Health Behavior Research, Departments of Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri (Ms Brownson, Dr O’Toole, Ms Shetty, Ms Anwuri)
| | - Gowri Shetty
- National Program Office of the Diabetes Initiative of The Robert Wood Johnson Foundation, Division of Health Behavior Research, Departments of Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri (Ms Brownson, Dr O’Toole, Ms Shetty, Ms Anwuri)
| | - Victoria V Anwuri
- National Program Office of the Diabetes Initiative of The Robert Wood Johnson Foundation, Division of Health Behavior Research, Departments of Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri (Ms Brownson, Dr O’Toole, Ms Shetty, Ms Anwuri)
| | - Patricia Fazzone
- The Department of Family Health and Community Health Nursing, School of Nursing, Southern Illinois University, Edwardsville, Illinois (Ms Fazzone)
| | - Robyn A Housemann
- The Health Promotion and Exercise Science Department, School for Professional Studies, Western Connecticut State University, Danbury (Dr Housemann)
| | - Andrea D Hampton
- The Health Promotion Department, US Naval Hospital, Okinawa, Japan (Ms Hampton)
| | - Douglas B Kamerow
- Health, Social, and Economics Research, RTI International, Research Triangle Park, North Carolina (Dr Kamerow, Dr McCormack, Mr Burton)
| | - Lauren A McCormack
- Health, Social, and Economics Research, RTI International, Research Triangle Park, North Carolina (Dr Kamerow, Dr McCormack, Mr Burton)
| | - Joseph A Burton
- Health, Social, and Economics Research, RTI International, Research Triangle Park, North Carolina (Dr Kamerow, Dr McCormack, Mr Burton)
| | - C Tracy Orleans
- The Robert Wood Johnson Foundation, Princeton, New Jersey (Dr Orleans and Dr Bazzarre)
| | - Terry L Bazzarre
- The Robert Wood Johnson Foundation, Princeton, New Jersey (Dr Orleans and Dr Bazzarre)
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7
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Guerrero EG, Heslin KC, Chang E, Fenwick K, Yano E. Organizational correlates of implementation of colocation of mental health and primary care in the Veterans Health Administration. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 42:420-8. [PMID: 25096986 DOI: 10.1007/s10488-014-0582-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study explored the role of organizational factors in the ability of Veterans Health Administration (VHA) clinics to implement colocated mental health care in primary care settings (PC-MH). The study used data from the VHA Clinical Practice Organizational Survey collected in 2007 from 225 clinic administrators across the United States. Clinic degree of implementation of PC-MH was the dependent variable, whereas independent variables included policies and procedures, organizational context, and leaders' perceptions of barriers to change. Pearson bivariate correlations and multivariable linear regression were used to test hypotheses. Results show that depression care training for primary care providers and clinics' flexibility and participation were both positively correlated with implementation of PC-MH. However, after accounting for other factors, regressions show that only training primary care providers in depression care was marginally associated with degree of implementation of PC-MH (p = 0.051). Given the importance of this topic for implementing integrated care as part of health care reform, these null findings underscore the need to improve theory and testing of more proximal measures of colocation in future work.
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Affiliation(s)
- Erick G Guerrero
- School of Social Work, University of Southern California, Los Angeles, CA, USA,
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8
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Montague MC, Nichols SA, Dutta AP. Self-management in African American Women With Diabetes. DIABETES EDUCATOR 2016; 31:700-11. [PMID: 16203854 DOI: 10.1177/0145721705280414] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose This study describes demographic and medical characteristics, self-efficacy, locus of control, self-managementd defined by functional status, hemoglobin HbA1c outcomes, and the relationships among these variables based on age group differences (25-44 years, 45-64 years, and 65-84 years) in African American women with type 2 diabetes. Methods Subjects (n = 75) in community medical practices were interviewed to complete a demographic and medical form, the Diabetes Self-efficacy Outcomes Expectancy Questionnaire (DSEQ), the Diabetes Locus of Control Scale, and the Medical Outcomes–Short Form 36 (SF-36). A venous blood sample was taken following the interview. Data were analyzed for the total sample and separately for age groups. Results Scores on the self efficacy (DSEQ) and the locus of control (LOC) were above average for all 3 groups. Significant correlations were found among subscales of the LOC, SF-36, and HbA1c. HbA1c scores were abnormally high across groups. Significant group differences were found in duration of diabetes and number of medications used. Conclusions Despite high levels of internal locus of control and self-efficacy and scores indicating good mental, physical, emotional, and social health, self-management amongthe women was inadequate, as indicated by abnormally high HbA1c levels.
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Affiliation(s)
- Mamie C Montague
- The College of Pharmacy, Nursing, and Allied Health Sciences, Division of Nursing, Howard University, Washington, DC
| | - Sheryl A Nichols
- The College of Pharmacy, Nursing, and Allied Health Sciences, Division of Nursing, Howard University, Washington, DC
| | - Arjun P Dutta
- The College of Pharmacy, Nursing, and Allied Health Sciences, Division of Nursing, Howard University, Washington, DC
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Peyrot M, Peeples M, Tomky D, Charron-Prochownik D, Weaver T, AADE Outcomes Project and AADE/UPMC Diabetes Education Outco. Development of the American Association of Diabetes Educators' Diabetes Self-management Assessment Report Tool. DIABETES EDUCATOR 2016; 33:818-26. [DOI: 10.1177/0145721707307614] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mark Peyrot
- Loyola College, Baltimore, Maryland, , Johns Hopkins University School of Medicine, Baltimore,
Maryland
| | - Malinda Peeples
- American Association of Diabetes Educators, Chicago,
Illinois
| | - Donna Tomky
- Department of Endocrinology, Lovelace Medical Group,
Albuquerque, New Mexico
| | | | - Todd Weaver
- International Diabetes Center, Park Nicollet Health
System, Minneapolis, Minnesota
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10
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Whittemore R, Melkus GD, Sullivan A, Grey M. A Nurse-Coaching Intervention for Women With Type 2 Diabetes. DIABETES EDUCATOR 2016; 30:795-804. [PMID: 15510531 DOI: 10.1177/014572170403000515] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this pilot study was to determine the efficacy of a 6-month nurse-coaching intervention that was provided after diabetes education for women with type 2 diabetes. METHODS In this pilot study, 53 women were randomized to the nurse-coaching intervention or a standard care control condition. The nurse-coaching intervention consisted of 5 individualized sessions and 2 follow-up phone calls over 6 months. The nurse-coaching sessions included educational, behavioral, and affective strategies. Data were collected on physiologic adaptation (hemoglobin A1c [A1C] and body mass index [BMI]), self-management (dietary and exercise), psychosocial adaptation (diabetes-related distress and integration), and treatment satisfaction at baseline, 3 months, and 6 months. RESULTS Women in the treatment group demonstrated better diet self-management, less diabetes-related distress, better integration, and more satisfaction with care, and had trends of better exercise self-management and BMI. The A1C levels improved in both groups at 3 months, yet the difference between the groups was not significant. Attendance at nurse-coaching sessions was 96%. CONCLUSIONS This nurse-coaching intervention demonstrates promise as a means of improving self-management and psychosocial outcomes in women with type 2 diabetes.
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Steed L, Lankester J, Barnard M, Earle K, Hurel S, Newman S. Evaluation of the UCL Diabetes Self-management Programme (UCL-DSMP): A Randomized Controlled Trial. J Health Psychol 2016; 10:261-76. [PMID: 15723895 DOI: 10.1177/1359105305049775] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Self-management has been described as the cornerstone of care for diabetes. Many self-management studies are limited by poor methodology and poor descriptions of the intervention. The current study developed a theoretically based self-management programme for patients with type 2 diabetes, which was evaluated via a randomized controlled trial. At immediate post-intervention and three-month follow-up the intervention group showed significant improvement relative to controls on self-management behaviours, quality of life and illness beliefs. A trend towards improved HbA1c was also observed. Documentation in a manual and development of a training programme for facilitators ensures the programme is replicable.
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Affiliation(s)
- Liz Steed
- Royal Free & University College Medical School, London, W1N 8AA, UK
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Krichbaum K, Aarestad V, Buethe M. Exploring the Connection Between Self-Efficacy and Effective Diabetes Self-f Management. DIABETES EDUCATOR 2016; 29:653-62. [PMID: 13677176 DOI: 10.1177/014572170302900411] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE the purpose of this study was to review the existing empirical evidence about factors that contribute to effective diabetes self-management as indicated by healthy outcomes in persons with the disease, with a specific focus on self-efficacy, to determine the link between learned self-efficacy and effective diabetes self-management in adults. METHODS A systematic review was conducted of the extant literature from 1985-2001 that described factors related to effective self-management of diabetes. The review included theoretical and empirical articles. The search engines included CINAHL, MEDLINE, PUBMED, and COCHRANE. RESULTS Empirical evidence supports the following factors to improve the education outcomes for adults with diabetes: involve people with diabetes in their own care, guide them in actively learning about the disease, explore their feelings about having the disease, and teach them the skills necessary to adjust their behavior to control their own health outcomes. Thus, the goal for educating people with diabetes is to improve their individual self-efficacy and, accordingly, their self-management ability. CONCLUSIONS Education sessions need to involve fewer lectures and more practical, interactive exercises that focus on developing specific skills. Follow-up contact is a valuable method for helping people make a healthy adjustment to living with diabetes.
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Affiliation(s)
- Kathleen Krichbaum
- The School of Nursing, University of Minnesota, Minneapolis (Dr Krichbaum and Ms Buethe)
| | - Vivian Aarestad
- Ms Aarestad was formerly at the Diabetes Education Center, Fairview-Southdale Hospital, Edina, Minnesota
| | - Marie Buethe
- The School of Nursing, University of Minnesota, Minneapolis (Dr Krichbaum and Ms Buethe)
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13
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Self-Efficacy and Hemoglobin A1C Among Adults With Serious Mental Illness and Type 2 Diabetes: The Roles of Cognitive Functioning and Psychiatric Symptom Severity. Psychosom Med 2016; 78:263-70. [PMID: 27111458 PMCID: PMC10148242 DOI: 10.1097/psy.0000000000000295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Self-efficacy is a core element of diabetes self-care and a primary target of diabetes interventions. Adults with serious mental illness (SMI) are twice as likely as adults among the general population to have Type 2 diabetes. This population faces substantial barriers (i.e., cognitive impairment, psychiatric symptoms) to optimal diabetes self-care, but the relationship of these barriers to both self-efficacy and glycemic control (hemoglobin A1C [A1C]) is not clearly understood. METHODS Data collected from adult participants with SMI (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) and Type 2 diabetes (n = 92) were used to examine the moderating effects of cognitive functioning and psychiatric symptoms (i.e., positive and negative symptoms) on the association between self-efficacy and A1C. RESULTS The relationship between self-efficacy and A1C was moderated by cognitive functioning (B = -4.03, standard error = 1.54, p = .011). Greater self-efficacy was associated with better glycemic control when cognitive functioning was high, but worse control when functioning was low. The relationship between self-efficacy and A1C was moderated by negative symptom severity (B = 6.88, standard error = 3.34, p = .043). Higher self-efficacy was associated with poorer glycemic control only when negative symptom severity was high. Positive symptoms did not interact with self-efficacy to predict A1C. CONCLUSIONS These results suggest that adults with SMI and low cognitive function or high negative symptom severity may misperceive their ability to manage their diabetes. They may benefit from efforts, including care management and monitoring, cognitive remediation, and skill training, to identify and correct inaccurate diabetes self-efficacy.
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Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, Fisher EB, Hanson L, Kent D, Kolb L, McLaughlin S, Orzeck E, Piette JD, Rhinehart AS, Rothman R, Sklaroff S, Tomky D, Youssef G. National standards for diabetes self-management education and support. Diabetes Care 2014; 37 Suppl 1:S144-53. [PMID: 24357210 PMCID: PMC4181074 DOI: 10.2337/dc14-s144] [Citation(s) in RCA: 215] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Linda Haas
- VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, WA
| | | | - Joni Beck
- Pediatric Diabetes and Endocrinology, The University of Oklahoma Health Sciences Center College of Medicine, Edmond, OK
| | | | - Paulina Duker
- Diabetes Education/Clinical Programs, American Diabetes Association, Alexandria, VA
| | | | - Edwin B. Fisher
- Peers for Progress, American Academy of Family Physicians Foundation and Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lenita Hanson
- Ultracare Endocrine and Diabetes Consultants, Venice, FL
| | - Daniel Kent
- Group Health Central Specialty Clinic, Seattle, WA
| | - Leslie Kolb
- Diabetes Education Accreditation Program, American Association of Diabetes Educators, Chicago, IL
| | | | - Eric Orzeck
- Endocrinology Associates, Main Medical Plaza, Houston, TX
| | - John D. Piette
- VA Center for Clinical Management Research and the University of Michigan Health System, Ann Arbor, MI
| | | | - Russell Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN
| | | | - Donna Tomky
- Department of Endocrinology and Diabetes, ABQ Health Partners, Albuquerque, NM
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Reid AM, Balkhi AM, St. Amant J, McNamara JPH, Silverstein JH, Navia L, Geffken G. Relations Between Quality of Life, Family Factors, Adherence, and Glycemic Control in Pediatric Patients With Type 1 Diabetes Mellitus. CHILDRENS HEALTH CARE 2013. [DOI: 10.1080/02739615.2013.842455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Khunti K, Davies MJ, Kalra S. Self-titration of insulin in the management of people with type 2 diabetes: a practical solution to improve management in primary care. Diabetes Obes Metab 2013; 15:690-700. [PMID: 23253563 DOI: 10.1111/dom.12053] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 10/22/2012] [Accepted: 12/11/2012] [Indexed: 01/03/2023]
Abstract
Good glycaemic control in type 2 diabetes (T2DM) is associated with a reduced risk of diabetes complications; however, achieving and maintaining glycaemic control represents a major challenge to physicians, and despite the availability of a range of antidiabetic therapies, many patients with T2DM will eventually require insulin supplementation to reach target glycaemic levels. Insulin initiation, adjustment of the insulin dose and the need for frequent assessment of blood glucose levels are often complicated by patient and physician misconceptions and concerns regarding its use. For most patients requiring insulin therapy, dose titration is carried out by physicians; however, evidence suggests that this process may not provide optimal glycaemic management for patients. Self-monitoring of blood glucose and self-adjustment of insulin dose (insulin self-titration) is well established in type 1 diabetes, suggesting that similar therapeutic self-management may be beneficial when applied to patients with T2DM. This article reviews the rationale and clinical evidence for insulin self-titration in patients with T2DM with the aim of highlighting the importance of educating patients about insulin therapy and empowering them to manage their diabetes through self-titration of insulin.
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Affiliation(s)
- K Khunti
- Diabetes Research Unit, University of Leicester, Leicester, UK.
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17
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Bagnasco A, Di Giacomo P, Da Rin Della Mora R, Catania G, Turci C, Rocco G, Sasso L. Factors influencing self-management in patients with type 2 diabetes: a quantitative systematic review protocol. J Adv Nurs 2013; 70:187-200. [PMID: 23763567 DOI: 10.1111/jan.12178] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 12/11/2022]
Abstract
AIM To describe a protocol for a quantitative systematic review, to identify critique and summarize factors that influence self-management education. BACKGROUND Self-management education enables patients to manage their condition successfully and it is associated with better self-care, good control over lifestyle and leading the best possible quality of life, notwithstanding the presence of a chronic disease. Type II Diabetes is a chronic disease that requires lifestyle adjustments and disease management to keep glycaemia and long-term complications under control. Education has to be customized and based on an assessment that includes factors influencing self-management, such as personal characteristics that can optimize the educational intervention. DESIGN The protocol for the systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination, York (UK). METHOD The review question was defined in terms of population, interventions, comparators, outcomes and study designs. The protocol included decisions about the review question, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. DISCUSSION An initial summary will be made by tabulating the data; the review will be reported in a narrative style and be developed according to the PRISMA guidelines. The protocol for the systematic review will allow us to identify, among the factors influencing self-management in people with Type II diabetes, the personal characteristics most relevant to the factors of motivation and empowerment. In addition, the systematic review will also identify an appropriate self-management model.
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Affiliation(s)
| | | | | | | | - Carlo Turci
- Member of the Centre of Excellence for Nursing Scholarship, Rome, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, President Ipasvi Rome Nursing Board, Rome, Italy
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18
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Spencer MS, Hawkins J, Espitia NR, Sinco B, Jennings T, Lewis C, Palmisano G, Kieffer E. Influence of a Community Health Worker Intervention on Mental Health Outcomes among Low-Income Latino and African American Adults with Type 2 Diabetes. RACE AND SOCIAL PROBLEMS 2013; 5:137-146. [PMID: 26448789 PMCID: PMC4593061 DOI: 10.1007/s12552-013-9098-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study investigated the influence of a community health worker (CHW) diabetes lifestyle intervention on mental health outcomes. Our study was guided by the principles of community-based participatory research. Data were collected from 164 African American (N = 94) and Hispanic adults (N = 70) participating in a randomized, 6-month delayed intervention group design for improving glycemic control. The intervention time periods were baseline to 6 months for the treatment group and 6-12 months for the delayed group. Linear mixed models were used to conduct longitudinal analyses of the Problem Areas in Diabetes (PAID) and Patient Health Questionnaire (PHQ) scales. In the model adjusted for demographics, the PAID dropped significantly from pre-intervention to post-intervention within both the treatment and delayed groups (p < 0.05) with an average intervention effect of -6.4 (p < 0.01). The PAID dropped even further within the immediate group from 6 to 12 months. Although the PHQ did not change significantly, the PHQ-2 had an average intervention effect of -0.3 (p < 0.05) in the model adjusted for demographics. This study contributes to an understanding of how a CHW-led diabetes intervention can result in positive mental health outcomes for Latinos and African Americans with Type 2 diabetes. It also highlights the importance of further exploring what factors may contribute to racial/ethnic variation in mental health outcomes for African Americans and Latinos with diabetes and the role CHWs can play.
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Affiliation(s)
- Michael S. Spencer
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA
| | - Jaclynn Hawkins
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA
| | - Nicolas R. Espitia
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA. Community Health and Social Services Center, Detroit, MI, USA
| | - Brandy Sinco
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA
| | - Tezra Jennings
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA
| | - Carissa Lewis
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA. Community Health and Social Services Center, Detroit, MI, USA
| | - Gloria Palmisano
- REACH Detroit Partnership, Detroit, MI, USA. Community Health and Social Services Center, Detroit, MI, USA
| | - Edith Kieffer
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109-1106, USA. REACH Detroit Partnership, Detroit, MI, USA
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19
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Chesla CA, Chun KM, Kwan CML, Mullan JT, Kwong Y, Hsu L, Huang P, Strycker LA, Shum T, To D, Kao R, Waters CM. Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research. Res Nurs Health 2013; 36:359-72. [PMID: 23606271 DOI: 10.1002/nur.21543] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 11/08/2022]
Abstract
Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.
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Affiliation(s)
- Catherine A Chesla
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, USA
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20
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Aghili R, Khamseh M, Malek M, Banikarimi A, Baradaran H, Ebrahim Valojerdi A. Development and validation of diabetes empowerment questionnaire in Iranian people with type 2 diabetes. Int Nurs Rev 2013; 60:267-73. [DOI: 10.1111/inr.12007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- R. Aghili
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
| | - M.E. Khamseh
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
| | - M. Malek
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
| | - A.S. Banikarimi
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
| | - H.R. Baradaran
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
| | - A. Ebrahim Valojerdi
- Endocrine Research Center (Firouzgar); Institute of Endocrinology and Metabolism; Tehran University of Medical Sciences; Tehran; Iran
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21
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Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, Fisher EB, Hanson L, Kent D, Kolb L, McLaughlin S, Orzeck E, Piette JD, Rhinehart AS, Rothman R, Sklaroff S, Tomky D, Youssef G. National standards for diabetes self-management education and support. Diabetes Care 2013; 36 Suppl 1:S100-8. [PMID: 23264420 PMCID: PMC3537270 DOI: 10.2337/dc13-s100] [Citation(s) in RCA: 147] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Linda Haas
- From the VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, Washington; the
| | | | - Joni Beck
- Pediatric Diabetes and Endocrinology, The University of Oklahoma Health Sciences Center College of Medicine, Edmond, Oklahoma; the
| | | | - Paulina Duker
- Diabetes Education/Clinical Programs, American Diabetes Association, Alexandria, Virginia; the
| | - Laura Edwards
- Center for Healthy North Carolina, Apex, North Carolina
| | - Edwin B. Fisher
- Peers for Progress, American Academy of Family Physicians Foundation and Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lenita Hanson
- Ultracare Endocrine and Diabetes Consultants, Venice, Florida; the
| | - Daniel Kent
- Group Health Central Specialty Clinic, Seattle, Washington; the
| | - Leslie Kolb
- Diabetes Education Accreditation Program, American Association of Diabetes Educators, Chicago, Illinois
| | | | - Eric Orzeck
- Endocrinology Associates, Main Medical Plaza, Houston, Texas; the
| | - John D. Piette
- VA Center for Clinical Management Research and the University of Michigan Health System, Ann Arbor, Michigan
| | | | - Russell Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Donna Tomky
- Department of Endocrinology and Diabetes, ABQ Health Partners, Albuquerque, New Mexico; and
| | | | - on behalf of the 2012 Standards Revision Task Force
- From the VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, Washington; the
- Joslin Diabetes Center, Boston, Massachusetts
- Pediatric Diabetes and Endocrinology, The University of Oklahoma Health Sciences Center College of Medicine, Edmond, Oklahoma; the
- Western Montana Clinic, Missoula, Montana; the
- Diabetes Education/Clinical Programs, American Diabetes Association, Alexandria, Virginia; the
- Center for Healthy North Carolina, Apex, North Carolina
- Peers for Progress, American Academy of Family Physicians Foundation and Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Ultracare Endocrine and Diabetes Consultants, Venice, Florida; the
- Group Health Central Specialty Clinic, Seattle, Washington; the
- Diabetes Education Accreditation Program, American Association of Diabetes Educators, Chicago, Illinois
- On Site Health and Wellness, LLC, Omaha, Nebraska
- Endocrinology Associates, Main Medical Plaza, Houston, Texas; the
- VA Center for Clinical Management Research and the University of Michigan Health System, Ann Arbor, Michigan
- Johnston Memorial Diabetes Care Center, Abingdon, Virginia; the
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee
- Technical Writer, Washington, DC; the
- Department of Endocrinology and Diabetes, ABQ Health Partners, Albuquerque, New Mexico; and
- MedStar Diabetes Institute/MedStar Health, Washington, DC
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22
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Fleer J, Tovote KA, Keers JC, Links TP, Sanderman R, Coyne JC, Schroevers MJ. Screening for depression and diabetes-related distress in a diabetes outpatient clinic. Diabet Med 2013; 30:88-94. [PMID: 22924587 DOI: 10.1111/dme.12001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To investigate: (1) the willingness of patients with diabetes to participate in a screening programme; (2) the extent to which patients with diabetes who screen positive endorse need for psychosocial care; (3) the rate of referral to psychosocial care during screening vs. usual care. METHODS Four hundred and ninety-nine patients with diabetes were invited to complete the Center for Epidemiologic Studies Depression and the Problem Areas in Diabetes questionnaires. Patients screening positive on either instrument were invited for an interview. One year after screening was withdrawn, rates of referral to psychosocial care were assessed from physician reports of patient referrals. RESULTS In total, 349/499 (70%) patients with diabetes completed the questionnaire. Patients who did not take up the screening were younger, smoked more often and had higher HbA(1c) values. 'No-shows' for clinical appointments accounted for 74% of non-participation. Of the 104 (30% of 349) patients screening positive, 45 accepted an invitation for an interview. Finally, 36/104 (35%) would like a referral for psychological care. Seven per cent of patients were referred to psychological care during screening compared with 1% when screening was withdrawn. CONCLUSIONS Results raise questions as to whether screening is the most efficient way to identify patients with psychological problems. Many patients did not take up the screening, especially those with low adherence to diabetes care in general. Furthermore, few patients screening positive wanted to be referred. Screening should be evaluated in the context of consideration of alternative ways to identify at-risk patients, including providing resources to deal with patients with already known adjustment and adherence problems.
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Affiliation(s)
- J Fleer
- Department of Health Sciences, Section Health Psychology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
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23
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Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, Fisher E, Hanson L, Kent D, Kolb L, McLaughlin S, Orzeck E, Piette JD, Rhinehart AS, Rothman R, Sklaroff S, Tomky D, Youssef G. National standards for diabetes self-management education and support. DIABETES EDUCATOR 2012; 38:619-29. [PMID: 22996411 DOI: 10.1177/0145721712455997] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Linda Haas
- VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, Washington, USA
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24
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Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, Fisher EB, Hanson L, Kent D, Kolb L, McLaughlin S, Orzeck E, Piette JD, Rhinehart AS, Rothman R, Sklaroff S, Tomky D, Youssef G. National standards for diabetes self-management education and support. Diabetes Care 2012; 35:2393-401. [PMID: 22995096 PMCID: PMC3476915 DOI: 10.2337/dc12-1707] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Linda Haas
- From the VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, Washington; the
| | | | - Joni Beck
- Pediatric Diabetes and Endocrinology, The University of Oklahoma Health Sciences Center College of Medicine, Edmond, Oklahoma; the
| | | | - Paulina Duker
- Diabetes Education/Clinical Programs, American Diabetes Association, Alexandria, Virginia; the
| | - Laura Edwards
- Center for Healthy North Carolina, Apex, North Carolina
| | - Edwin B. Fisher
- Peers for Progress, American Academy of Family Physicians Foundation and Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lenita Hanson
- Ultracare Endocrine and Diabetes Consultants, Venice, Florida; the
| | - Daniel Kent
- Group Health Central Specialty Clinic, Seattle, Washington; the
| | - Leslie Kolb
- Diabetes Education Accreditation Program, American Association of Diabetes Educators, Chicago, Illinois
| | | | - Eric Orzeck
- Endocrinology Associates, Main Medical Plaza, Houston, Texas; the
| | - John D. Piette
- VA Center for Clinical Management Research and the University of Michigan Health System, Ann Arbor, Michigan
| | | | - Russell Rothman
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Donna Tomky
- Department of Endocrinology and Diabetes, ABQ Health Partners, Albuquerque, New Mexico; and
| | | | - on behalf of the 2012 Standards Revision Task Force
- From the VA Puget Sound Health Care System Hospital and Specialty Medicine, Seattle, Washington; the
- Joslin Diabetes Center, Boston, Massachusetts
- Pediatric Diabetes and Endocrinology, The University of Oklahoma Health Sciences Center College of Medicine, Edmond, Oklahoma; the
- Western Montana Clinic, Missoula, Montana; the
- Diabetes Education/Clinical Programs, American Diabetes Association, Alexandria, Virginia; the
- Center for Healthy North Carolina, Apex, North Carolina
- Peers for Progress, American Academy of Family Physicians Foundation and Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Ultracare Endocrine and Diabetes Consultants, Venice, Florida; the
- Group Health Central Specialty Clinic, Seattle, Washington; the
- Diabetes Education Accreditation Program, American Association of Diabetes Educators, Chicago, Illinois
- On Site Health and Wellness, LLC, Omaha, Nebraska
- Endocrinology Associates, Main Medical Plaza, Houston, Texas; the
- VA Center for Clinical Management Research and the University of Michigan Health System, Ann Arbor, Michigan
- Johnston Memorial Diabetes Care Center, Abingdon, Virginia; the
- Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee
- Technical Writer, Washington, DC; the
- Department of Endocrinology and Diabetes, ABQ Health Partners, Albuquerque, New Mexico; and
- MedStar Diabetes Institute/MedStar Health, Washington, DC
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25
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Carpenter DM, Fisher EB, Greene SB. Shortcomings in public and private insurance coverage of diabetes self-management education and support. Popul Health Manag 2012; 15:144-8. [PMID: 22313442 DOI: 10.1089/pop.2011.0042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of this study is to present preliminary data to characterize public and private insurance coverage for diabetes self-management education (DSM Education) and diabetes self-management support (DSM Support). Representatives from Medicaid and 2 private insurance providers in 10 states provided coverage information for their insurance plans. Two states (the most populous state from the East and West coasts) were sampled purposively and 8 additional states from 4 geographic regions (northeast, southeast, northwest, southwest) were sampled at random. Representatives from each private insurer described both a premium and basic coverage plan. Thus, 10 Medicaid programs and 40 private insurance plans were represented. Information about Medicare coverage was accessed from publicly available documents. Restricted by physician certification of patient eligibility, Medicare coverage included 10 hours of DSM Education plus 3 hours of medical nutrition therapy (MNT) within a continuous 12-month period, and 4 hours of follow-up (2 hours DSM Education and 2 hours MNT) for each subsequent year. Only 22 of 40 sampled private insurance and 5 of 10 Medicaid plans covered DSM Education, which ranged from 7 to 20 hours of education per year. Medicaid and private plans often limited the amount of DSM Education or required patients to obtain a physician certification of eligibility. Other than on-demand access features, coverage of DSM Support was minimal. Public and private insurance coverage of DSM Education was neither widespread nor uniform, while coverage of DSM Support was scarce.
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Affiliation(s)
- Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
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26
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2012; 35 Suppl 1:S101-8. [PMID: 22187467 PMCID: PMC3632167 DOI: 10.2337/dc12-s101] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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27
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Wu SFV, Liang SY, Wang TJ, Chen MH, Jian YM, Cheng KC. A self-management intervention to improve quality of life and psychosocial impact for people with type 2 diabetes. J Clin Nurs 2011; 20:2655-65. [DOI: 10.1111/j.1365-2702.2010.03694.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National Standards for diabetes self-management education. Diabetes Care 2011; 34 Suppl 1:S89-96. [PMID: 21193633 PMCID: PMC3006053 DOI: 10.2337/dc11-s089] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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29
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Maldonato A, Piana N, Bloise D, Baldelli A. Research in therapeutic patient education: current challenges. ACTA ACUST UNITED AC 2010. [DOI: 10.1051/tpe/2009022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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30
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2010; 33 Suppl 1:S89-96. [PMID: 20042780 PMCID: PMC2797385 DOI: 10.2337/dc10-s089] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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31
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Abstract
Good diabetic control minimizes the risk of complications. Stress affects control directly through the release of hormones and indirectly by disrupting self-management activities. This review examines the impact of stress management interventions on glycaemic control. Qualifying studies since 1980 were identified using searches of Medline and PsycInfo databases. Ten were identified in adult populations, and four in adolescent populations. The general trend suggested that stress management interventions may be useful in management of diabetes. Further research will provide greater understanding of the particular benefits of various components of stress management training in relation to specific subgroups of the diabetic population.
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Affiliation(s)
| | - Sarah Lam
- Royal North Shore Hospital, Australia
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32
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Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, Philippides G, Rocchini A. Exercise Training for Type 2 Diabetes Mellitus. Circulation 2009; 119:3244-62. [DOI: 10.1161/circulationaha.109.192521] [Citation(s) in RCA: 261] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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33
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Julien E, Senécal C, Guay F. Longitudinal relations among perceived autonomy support from health care practitioners, motivation, coping strategies and dietary compliance in a sample of adults with type 2 diabetes. J Health Psychol 2009; 14:457-70. [PMID: 19293307 DOI: 10.1177/1359105309102202] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to test the causal ordering among perceived autonomy support from health care practitioners, motivation, coping strategies and compliance to dietary self-care activities. Using a cross-lagged panel model, we investigate how these variables relate to one another over a one-year period. A total of 365 adults with Type 2 diabetes participated in the study. Results suggest that autonomous motivation and active planning are reciprocally related over time, and that prior autonomous motivation is related to the extent participants subsequently comply with their diet. Results are discussed in light of Self-determination Theory and the coping perspective.
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34
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Sousa VD, Hartman SW, Miller EH, Carroll MA. New measures of diabetes self-care agency, diabetes self-efficacy, and diabetes self-management for insulin-treated individuals with type 2 diabetes. J Clin Nurs 2009; 18:1305-12. [DOI: 10.1111/j.1365-2702.2008.02729.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Peyrot M, Rubin RR, Funnell MM, Siminerio LM. Access to diabetes self-management education: results of national surveys of patients, educators, and physicians. DIABETES EDUCATOR 2009; 35:246-8, 252-6, 258-63. [PMID: 19208816 DOI: 10.1177/0145721708329546] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine factors related to access to diabetes self-management education (DSME), including services delivered and sought; patient, physician, and program barriers to access; educator outreach and expansion efforts; and perceptions of alternative DSME delivery strategies. METHODS Internet surveys were completed by 1169 adults with diabetes (661 with prior DSME, 508 with no prior DSME) from a national community survey panel, 1871 educators who were AADE members, and 629 physicians (212 diabetes specialists, 417 primary care practitioners) from a national physician survey panel. RESULTS Physicians want patients to receive more self-management support, but some report that patients are told to do things with which the physician does not agree. Provider (physician and educator)-delivered DSME is more highly regarded among those who have received it than among those who have not received it. Physicians generally have positive perceptions of provider-delivered DSME, and educators see physicians as key to encouraging DSME use in patients. Some physicians are concerned about losing patients sent to DSME, and 11% of patients report changing physicians as a result of DSME. Most DSME programs have grown recently as a result of recruiting efforts and adding new programs/services; most programs plan more such efforts. Patients prefer traditional DSME sources/settings and are moderately accepting of media sources. CONCLUSIONS Additional efforts are required to guarantee that all people with diabetes receive the DSME they need. This will require increased referral by physicians, increased follow-through by patients, and increased availability of DSME in forms that make it appealing to patients and physicians.
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Affiliation(s)
- Mark Peyrot
- Loyola College, Department of Sociology, and Johns Hopkins University, Department of Medicine, Baltimore, Maryland (Dr Peyrot)
| | - Richard R Rubin
- Johns Hopkins University, Departments of Medicine and Pediatrics, Baltimore, Maryland (Dr Rubin)
| | - Martha M Funnell
- Department of Medical Education, University of Michigan, and the Diabetes Research and Training Center, Ann Arbor, Michigan (Ms Funnell)
| | - Linda M Siminerio
- The Department of Medicine and Diabetes Institute, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio)
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2009; 32 Suppl 1:S87-94. [PMID: 19118294 PMCID: PMC2613581 DOI: 10.2337/dc09-s087] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- 1Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ, Safren SA. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 2008; 31:2398-403. [PMID: 19033420 PMCID: PMC2584202 DOI: 10.2337/dc08-1341] [Citation(s) in RCA: 644] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in patients with diabetes and is associated with worse treatment outcomes. Its relationship to treatment adherence, however, has not been systematically reviewed. We used meta-analysis to examine the relationship between depression and treatment nonadherence in patients with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS We searched MEDLINE and PsycINFO databases for all studies published by June 2007 and reviewed references of published articles. Meta-analytic procedures were used to estimate the effect size r in a random effects model. Significance values, weighted effect sizes, 95% CIs, and tests of homogeneity of variance were calculated. RESULTS Results from 47 independent samples showed that depression was significantly associated with nonadherence to the diabetes treatment regimen (z = 9.97, P < 0.0001). The weighted effect size was near the medium range (r = 0.21, 95% CI 0.17-0.25). Moderator analyses showed that the effect was significantly larger in studies that measured self-care as a continuous versus categorical variable (P = 0.001). Effect sizes were largest for missed medical appointments and composite measures of self-care (r values = 0.31, 0.29). Moderation analyses suggest that effects for most other types of self-care are also near the medium range, especially in studies with stronger methodologies. CONCLUSIONS These findings demonstrate a significant association between depression and treatment nonadherence in patients with diabetes. Studies that used stronger methodologies had larger effects. Treatment nonadherence may represent an important pathway between depression and worse diabetes clinical outcomes.
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Affiliation(s)
- Jeffrey S Gonzalez
- Behavioral Medicine, Department of Psychiatry, Massachusetts General Hospital Boston, Boston, Massachusetts, USA.
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Abstract
PURPOSE The purpose of this study is to explore issues related to access to diabetes self-management education (DSME), including supply and demand, educator outreach and expansion efforts, patient and physician barriers to access, and acceptability of alternative DSME delivery strategies. METHODS Telephone focus groups were conducted with 17 diabetes educators, 18 primary care physicians who treat adults with diabetes, and 14 adults with type 1 or type 2 diabetes (8 in a group for those who had received diabetes education and 6 in a group for those who had not). RESULTS DSME programs develop new services to attract additional patients but do little outreach, and budget struggles are common. Some physicians establish good relationships with DSME programs, but others are critical of the available programs and experience conflicts over the role of educators vis-à-vis that of the physician. Physicians do not refer all patients to DSME and are perceived by educators and patients as not providing enough encouragement to attend DSME. Patients generally have positive experiences with DSME but do not discuss these experiences with their physicians. Patients are receptive to alternative strategies for DSME delivery (community settings, electronic media), but physicians are concerned about meeting standards, and educators want to make sure that they are available to support alternative education strategies. CONCLUSIONS Future advocacy efforts should seek implementation of policies to guarantee that all people with diabetes can receive the DSME they need.
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Affiliation(s)
- Mark Peyrot
- The Department of Sociology, Loyola College, and the Department of Medicine, Johns Hopkins University, Baltimore, Maryland (Dr Peyrot)
| | - Richard R Rubin
- The Departments of Medicine and Pediatrics, Johns Hopkins University, Baltimore, Maryland (Dr Rubin)
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Sigurdardottir AK, Benediktsson R. Reliability and validity of the Icelandic version of the problem area in diabetes (PAID) scale. Int J Nurs Stud 2008; 45:526-33. [PMID: 17161401 DOI: 10.1016/j.ijnurstu.2006.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 10/20/2006] [Accepted: 10/27/2006] [Indexed: 11/15/2022]
Abstract
BACKGROUND Diabetes is a burdensome disease that increases distress among people with diabetes. OBJECTIVES To test the validity and reliability of an Icelandic version of the problem area in diabetes scale (PAID) and to assess the hitherto unknown distress level of Icelandic people with insulin requiring diabetes. DESIGN Methodological research design. SETTING Diabetes clinics. PARTICIPANTS People with insulin-dependent diabetes, between 18 and 61 years. METHODS All instruments were translated using a back-translation technique. Participants answered three consecutive questionnaires in succession, the PAID scale, the diabetes empowerment scale (DES) and the diabetes knowledge test (DKT). Principical component analysis with varimax rotation was conducted on the PAID scale to identify latent factors. RESULTS Factor analysis revealed two factors: (a) distress in relation to life with diabetes, with Cronbach alpha coefficient of 0.93 and (b) distress in relation to management of diabetes, with Cronbach alpha coefficient of 0.88, for PAID overall Cronbach alpha coefficient was 0.94. PAID showed neither floor nor ceilings effects. Propositions set to indicate validity were generally met. However, PAID's factor structure and predictive validity needs to be tested further. CONCLUSIONS The Icelandic version of PAID is sufficiently psychometrically robust. PAID is simple to administer and by using the scale clinicians can identify people at risk for developing diabetes-related distress. The results are comparable to results from studies in other countries using the PAID scale.
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Affiliation(s)
- A K Sigurdardottir
- Faculty of Health, University of Akureyri, Sólborg, 600 Akureyri, Iceland.
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Sigurdardottir AK, Jonsdottir H. Empowerment in diabetes care: towards measuring empowerment. Scand J Caring Sci 2008; 22:284-91. [PMID: 18298619 DOI: 10.1111/j.1471-6712.2007.00506.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to measure validity and reliability of the Icelandic version of the Diabetes Empowerment Scale (DES) among people with diabetes and to develop knowledge about Icelandic people with diabetes. For this purpose, DES was distributed along with the Diabetes Knowledge Test and the Problem Area in Diabetes scale in four diabetes clinics in Iceland after the study received ethical approval from the National Bioethical Committee. Of the 101 allocated questionnaires, 92 were returned and 90 questionnaires were useable, resulting in 89% response rate. The Cronbach's alpha coefficient for DES was 0.84, and for the three subscales: Managing the Psychosocial Aspects of Diabetes (alpha = 0.76), Assessing Dissatisfaction and Readiness to Change (alpha = 0.63) and Setting and Achieving Diabetes Goals (alpha = 0.79). There was a criterion validity between level of education and DES. Mean value for DES was 3.68 +/- 0.52 on a scale of 1-5 where a higher score indicates increased empowerment. Range was from 2.43 to 4.68, indicating that the instrument demonstrates neither floor nor ceiling effects. This study indicates that the DES, the only available instrument to measure the concept of empowerment in diabetes care, is a sufficiently reliable and valid instrument in the Icelandic culture. However, it needs further testing. Empowerment is highly valued within the clinical arena, as well as when health professionals study patients' capacity to deal with health problems.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2008; 31 Suppl 1:S97-104. [PMID: 18165344 PMCID: PMC2797381 DOI: 10.2337/dc08-s097] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. DIABETES EDUCATOR 2007; 33:599-600, 602-4, 606 passim. [PMID: 17684162 DOI: 10.1177/0145721707305880] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2007; 30:1630-7. [PMID: 17526822 DOI: 10.2337/dc07-9923] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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Mensing C, Boucher J, Cypress M, Weinger K, Mulcahy K, Barta P, Hosey G, Kopher W, Lasichak A, Lamb B, Mangan M, Norman J, Tanja J, Yauk L, Wisdom K, Adams C. National standards for diabetes self-management education. Diabetes Care 2007; 30 Suppl 1:S96-S103. [PMID: 17192388 DOI: 10.2337/dc07-s096] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
This article synthesizes the research on behavioral interventions aimed at diabetes self-management, describes current trends in diabetes self-management, and proposes future directions for diabetes self-management care and research. Interventions that are multifaceted, tailored to the individual, and provided six months or longer demonstrate modest effects in improving diabetes-related outcomes. Improving access to behavioral interventions, maintaining the effects of behavioral interventions, and addressing the more complex social and environmental factors that contribute to behavior change are current challenges in diabetes self-management that warrant further attention and research.
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Affiliation(s)
- Robin Whittemore
- Yale University School of Nursing, New Haven, CT 06536-0740, USA.
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Peyrot M, Rubin RR, Siminerio LM. Physician and nurse use of psychosocial strategies in diabetes care: results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study. Diabetes Care 2006; 29:1256-62. [PMID: 16732005 DOI: 10.2337/dc05-2444] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the use of psychosocial strategies by health care providers in treating patients with diabetes and the factors associated with use of these strategies. RESEARCH DESIGN AND METHODS Cross-sectional survey of national samples of generalist and diabetes specialist physicians (n = 2,705) and nurses (n = 1,122) from the multinational study of Diabetes Attitudes, Wishes and Needs. Respondents were from 13 countries in Asia, Australia, Europe, and North America. Two psychosocial strategies were examined: provider psychosocial care, which provides psychosocial support by diabetes care providers to their own patients, and psychosocial specialist care, which refers diabetic patients to psychosocial specialists. RESULTS Compared with physicians, nurses perceived significantly higher prevalence and severity of psychosocial problems and used psychosocial strategies significantly more frequently, even though they rated their own psychosocial skills lower. Among both physicians and nurses, diabetes specialists were significantly more likely than generalists to utilize psychosocial strategies. Physicians and nurses used psychosocial strategies significantly more when they believed that more patients have psychosocial problems and that problems interfere more with diabetes control. Referral to psychosocial specialists was significantly more likely when physicians and nurses perceived that professional psychological resources were more available. There were substantial country differences in all factors studied. Compared with other countries, U.S. providers provided more psychosocial care themselves but were less likely to refer to psychosocial specialists. CONCLUSIONS Psychosocial strategies are important parts of the diabetes care provider repertoire; understanding their determinants may facilitate efforts to increase their use.
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Affiliation(s)
- Mark Peyrot
- Department of Sociology, Loyola College, 4501 North Charles St., Baltimore, MD 21210-2699, USA.
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Fisher EB, Brownson CA, O'Toole ML, Shetty G, Anwuri VV, Glasgow RE. Ecological approaches to self-management: the case of diabetes. Am J Public Health 2005; 95:1523-35. [PMID: 16051929 PMCID: PMC1449392 DOI: 10.2105/ajph.2005.066084] [Citation(s) in RCA: 206] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In the Diabetes Initiative of The Robert Wood Johnson Foundation, an ecological perspective helped identify the following key resources and supports for self-management (RSSM): individualized assessment, collaborative goal setting, skills enhancement, follow-up and support, access to resources, and continuity of quality clinical care. These RSSM reflect the grounding of diabetes self-management in the context of social and environmental influences. Research supports the value of each of these key resources and supports. Differences among self-management interventions may be seen as complementary, rather than conflicting, ways of providing RSSM. This way of understanding differences among interventions may aid development of varied programs to reach diverse audiences. In contrast to the "5 A's" model of key provider services (Assess, Advise, Agree, Assist, and Arrange), RSSM articulate self-management from the perspective of individuals' needs. Both approaches emphasize identification of goals, teaching of skills, and facilitation and reinforcement of the use of those skills.
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Affiliation(s)
- Edwin B Fisher
- Washington University, Division of Health Behavior Research, 4444 Forest Park Ave, St Louis, MO 63108, USA.
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Goldenberg D, Andrusyszyn MA, Iwasiw C. The Effect of Classroom Simulation on Nursing Students' Self-Efficacy Related to Health Teaching. J Nurs Educ 2005; 44:310-4. [PMID: 16094789 DOI: 10.3928/01484834-20050701-04] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this descriptive study was to investigate the effect of classroom simulation on third-year baccalaureate nursing students' self-efficacy in health teaching. Bandura's self-efficacy model provided the conceptual framework. A nonprobability, convenience sample of 22 students completed the self-efficacy questionnaire before and after the simulation workshop sessions. Students' overall self-efficacy scores increased significantly (p = 0.001) following the two sessions of role-playing case studies, suggesting more perceived confidence in performing health teaching. Recommendations include continuing the use of simulation as a teaching-learning method, applying simulation as a strategy to enhance other learner behaviors, and cultivating faculty's use of simulation in their teaching.
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Affiliation(s)
- Dolly Goldenberg
- University of Western Ontario, School of Nursing, London, Ontario, Canada.
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Skelly AH, Arcury TA, Snively BM, Bell RA, Smith SL, Wetmore LK, Quandt SA. Self-monitoring of blood glucose in a multiethnic population of rural older adults with diabetes. DIABETES EDUCATOR 2005; 31:84-90. [PMID: 15779249 PMCID: PMC1630682 DOI: 10.1177/0145721704273229] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of the study was to describe self-monitoring of blood glucose (SMBG) practices of 698 older adults with type 2 diabetes in the rural Southeast, to identify characteristics differentiating testers from nontesters, and to identify personal and support-related predictors of monitoring frequency. METHODS The ELDER (Evaluating Long-term Diabetes Self-management Among Elderly Rural Adults) study was a population-based, cross-sectional survey of African American, Native American, and white Medicare recipients > or =65 years with diagnosed diabetes. Data were obtained through in-home interviews. Multiple logistic regression models were used to identify factors associated with SMBG and frequency of monitoring. RESULTS Seventy-seven percent of respondents practiced SMBG in the previous week; 40% tested every day in that week. No ethnic differences were seen. Significant independent predictors of any SMBG were medication regimen (taking oral agents or insulin with or without oral agents) and health care provider (HCP) recommendation to test. Among those monitoring, significant independent predictors of SMBG frequency were medication regimen, HCP recommendation to test, duration of diabetes, and receiving help with testing, which was negatively associated with monitoring frequency. CONCLUSIONS Among rural older persons with diabetes, HCP recommendation significantly affected practicing SMBG and SMBG frequency. These findings suggest points of intervention by diabetes educators with this vulnerable population. Further research is needed to determine how older adults use SMBG data in their self-care regimen.
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Affiliation(s)
- Anne H Skelly
- The School of Nursing, University of North Carolina at Chapel Hill (Dr Skelly)
| | - Thomas A Arcury
- The Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Arcury)
| | - Beverly M Snively
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
| | - Ronny A Bell
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
| | - Shannon L Smith
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
| | - Lindsay K Wetmore
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
| | - Sara A Quandt
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Dr Snively, Dr Bell, Ms Smith, Ms Wetmore, and Dr Quandt)
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