[ Diabetes Type 2 ]


Background. Although self care can be managed by most diabetes patients, there are many variables that may make diabetes self-management difficult. 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). Katherine Pereira, DNP, Beth Phillips, MSN, Constance Johnson, PhD, and Allison Vorderstrasse DNSc, Duke University School of Nursing (Durham, NC), review various methods of delivering diabetes education via the Internet and compare their effectiveness in improving diabetes-related outcomes. Methods. The translation of efficacy trials (1,2) that improve metabolic control for adults with type 2 diabetes to communities is of major interest, given the variable adherence to established diabetes clinical practice guidelines (3,4). Implications for healthcare professionals are discussed and further research proposes whether the model could be applicable to other chronic illnesses.

A total of 17·6% of youth reported high depressive symptoms, and depressive symptoms were correlated with family annual revenue, school attendance, peer relationship and parent–child relationship. Half the participants were initially uncomfortable with text messaging. The proposed Type 2 diabetes mellitus Self-management Behaviour Support framework incorporates Modified Social Learning Theory and instrumental health value as the theoretical basis for development and could provide clinical nurses and doctors with a tool that will allow for in-depth assessment and planning of Type 2 diabetes mellitus patients’ self-management behaviours. Avatars interact with other avatars or bots through voice or text chat via a headset with a microphone, and navigate by walking, running, swimming, flying, or teleporting from one location to another. Preventing Chronic Disease, 10:120112. J. (2005).

PDSME program was effective in improving self-management cognitive and clinical outcomes. CAM is a widely used component of health self-management among rural among older adults with diabetes. Clark. They had made a plan with their doctors to take more or less medication, depending on the results. 2014; 11(7):6727-6742. Management of chronic disease by patients. In the last two decades, extensive scientific research on self-management has been performed and a wide range of self-management programs have been developed for various target populations.

Coleman, M.T., & Newton, K.S. (2005). Supporting self-management patients with chronic illness. American Family Physician, 72(8), 1503-1510. Handley, M., MacGregor, K., Schillinger, D., Sharifi, C., Wong, S., & Bodenheimer, T. (2006). Using action plans to help primary care patients adopt healthy behaviors: A descriptive study.

Journal of the American Board of Family Medicine, 19(3), 224-231. Lindner, H., Menzies, D., Kelly, J., Taylor, S., & Shearer, M. (2003). Coaching for behavior change in chronic disease: A review of the literature and implications for coaching as a self-management intervention. Australian Journal of Primary Care, 9(2&3), 1-9. Lorig, K., & Holman H. (2003).

Self-management education: History, definition, outcomes and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7. MacGregor, K., Handley, M., Wong, S., Sharifi, C., Gjeltema, K., Schillinger, D., & Bodenheimer, T. (2006). All health care professionals involved in the study were sent questionnaires asking how they spent their time. Mann, E.G., LeFort, S., & VanDenKerkhof, E.G. (2013).

Self-management interventions for chronic pain. Pain Manage., 3(3), 211-222. National Health Service, Scotland. (2009). Long-term conditions collaborative: Improving self-management support. Retrieved from NHS Scotland website. Newman, S., Steed, L., & Mulligan, K.

(2004). Self-management interventions for chronic illness. 13. Norris, S.L., Lau, J., Smith, S.J., Schmid, C.H., & Engelgau, M.M. Nwaokoro, J. Self-management education for adults with type 2 diabetes: A meta-analysis of the effect on glycemic control. Diabetes Care, 25(7), 1159-1171.

Pearson, M.L., Mattke, S., Shaw, R., Ridgely, M.S., Wiseman, S.H. (2007). Patient self-management support programs: An evaluation (AHRQ Publication No. 08-0011). Retrieved from the Agency for Healthcare Research and Quality website. And consider attending a diabetes support group regularly to get the support you need. (2008).

Supporting self-management. In E. Nolte & M. McKee (Eds.), Caring for people with chronic conditions: A health system perspective (pp. 116-142). Berkshire: Open University Press. Smeulders, E.S.T.F., van Haastregt, J.C.M., Ambergen, T., Stoffers, H.E.J.H., Janssen-Boyne, J.J.J., Uszko-Lencer, N.H.K.M., … Kempen, G.I.J.M.

(2010). Heart failure patients with a lower educational level and better cognitive status benefit most from a self-management group programme. Patient Education & Counseling,81(2), 214-221. Task Force on Community Preventive Services. (2002). Recommendations for health-care system and self-management education interventions to reduce mortality and morbidity from diabetes. American Journal of Preventive Medicine, 22(4S), 10 to 14.

Wagner, E., Davis, C., Schaefer, J., Von Korff, M., & Austin, B. (2002). A survey of leading chronic disease management programs: Are they consistent with the literature? Journal of Nursing Care Quality, 16(2), 67-80. Wagner, E.H., Glasgow, R.E., Davis, C., Bonomi, A.E., Provost, L., McCulloch, D., … Sixta, C. (2001). Quality improvement in chronic illness care: A collaborative approach.

Journal on Quality Improvement, 27(2), 63-80. Zwar, N., Harris, M., Griffiths, R., Roland, M., Dennis, S., Powell Davies, G., & Hasan, I. (2006). A systematic review of chronic disease management. Research Centre for Primary Health Care & Equity. School of Public Health & Community Medicine, UNSW. Retrieved from Australian National University.

McGowan, P. (2010). Patient education and self-management support. In A.R. Jadad, A. Cabrera, F. Martos, R.

Smith, & R.F. Lyons (Eds.), When people live with multiple chronic diseases: A collaborative approach to an emerging global challenge (pp. 115-138.). Granada: Andalusian School of Public Health. Newman, S., Steed, L., & Mulligan, K. (Eds.). (2009).

Chronic physical illness: Self-management and behavioural interventions. New York: McGraw Hill. Redman, B.K. (2004). Patient self-management of chronic disease: The health care provider’s challenge. Sudbury, MA: Jones and Bartlett Publishers, Inc.

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[ Diabetes Type 2 ]


The Pomperaug District Department of Health is offering an evidence-based program for persons with diabetes or pre-diabetes. These six-week workshops are taught in groups and offered in community settings throughout the state, including senior centers, churches, libraries and hospitals. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required. Our Diabetes Self-Management Program offers individualized assessments and nutrition planning with a registered dietician. All intervention components were consistently implemented by staff, but participant website usage decreased over time. A joint statement from the American Diabetes Association, the American Association of Diabetes Educators (AADE), and the Academy of Nutrition and Dietetics in 2015 found the numbers of patients who get training “disappointingly small,” and the organizations developed an algorithm to extend DSME more patients with type 2 diabetes (T2D), especially those newly diagnosed. The Internet-based intervention produced significantly greater improvements than the enhanced usual care condition on three of four behavioral outcomes (effect sizes [d] for healthy eating = 0.32; fat intake = 0.28; physical activity= 0.19) in both intent-to-treat and complete-cases analyses.

Previous studies indicate these reductions may cause reduced overall healthcare costs. Each participant (one per household) will receive a complimentary book, Living a Healthy Life with Chronic Conditions at workshop session two. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. The number of participant visits to the website over 4 months ranged from 1 to 119 (mean 28 visits, median 18). In the year following the educational and support interventions, the study will evaluate whether churches continue the programs using the tools and training provided, and which factors are key for successful uptake and sustainability. A physician referral is not required, and friends and family are welcome. A very warm thank you to the leaders for all their efforts and patience.

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