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Adu FA, Poku CA, Adu AP, Owusu LB. The role of social support and self-management on glycemic control of type 2 diabetes mellitus with complications in Ghana: A cross-sectional study. Health Sci Rep 2024; 7:e2054. [PMID: 38650722 PMCID: PMC11033339 DOI: 10.1002/hsr2.2054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Diabetes mellitus (DM) can result in detrimental complications which are connected with long-term impairments and disabilities. Chronic complications are well-known consequences of type 2 diabetes mellitus (T2DM) progression, which reduce patient quality of life, place a burden on the healthcare system, and increase mortality. Measures to promote health outcomes for people with DM are scanty; the study therefore aimed at determining the effects of self-management and social support on glycemic control of T2DM with complications in Ghana. Methods A cross-sectional design using convenience sampling was conducted on 400 T2DM patients using Hensarling's Diabetes Family Support Scale and Summary of Diabetes Self‑Care Activities scale. Data analysis was conducted using descriptive, Pearson Moment Product Correlation and Binary Logistic Regression on self-management, social support, and glycemic control in T2DM patients. Results Social support among participants was high and there was a positive correlation or relationship between social support and T2DM self-management. There was a correlation between social support and self-management (r = 0.149, p < 0.05) and diet control (r = 0.221, p < 0.05). The results also showed a significant correlation between medication adherence and glycemic management (r = 0.116, p < 0.05) while female T2DM participants, individuals with at least primary education were less likely to have low self-management relative to T2DM. Conclusion Though the level of T2DM self-management was high it does not translate to good glycemic control. Focused health education programs should be incorporated into patients' care plans which will be particularly relevant for patients with T2DM and will contribute to positive physiological and psychological outcomes. Furthermore, a more robust monitoring and follow-up scheme should be scaled up or instituted for patients with T2DM.
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Affiliation(s)
- Frank Amankwah Adu
- Medical Technology in the Xiangya School of NursingCentral South UniversityChangshaChina
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Collins Atta Poku
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Amanda Parko Adu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Lydia Boampong Owusu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
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Kumar P, Puri O, Unnithan VB, Reddy AP, Aswath S, Pathania M. Preparedness of diabetic patients for receiving telemedical health care: A cross-sectional study. J Family Med Prim Care 2024; 13:1004-1011. [PMID: 38736819 PMCID: PMC11086785 DOI: 10.4103/jfmpc.jfmpc_1024_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/09/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction This study evaluates feasibility of telemedicine to deliver diabetic care among different regions of the country. Materials and Methods Medical interns affiliated with Rotaract Club of Medicrew (RCM) organized a Free Diabetes Screening Camp called "Diab-at-ease" at multiple sites across the country. Of all beneficiaries of the camp >18 years of age, patients previously diagnosed with diabetes and undiagnosed patients with a random blood sugar level of more than 200 mg/dL were interviewed regarding their knowledge, attitude, and practice regarding diabetes care and preparedness and vigilance to receiving care through telemedicine. Random blood sugar, height, weight, and waist circumference were also documented. Results About 51.1% (N = 223) of female patients aged 57.57 ± 13.84 years (>18 years) with body mass index (BMI) =26.11 ± 4.63 were the beneficiaries of the health camps. About 75.3% (n = 168) of them were on oral hypoglycemic agents (OHAs), 15.7% (n = 35) were on insulin preparations, and 59.6% (n = 156) and 88.5% (n = 31) of which were highly compliant with treatment, respectively. About 35% (n = 78) and 43.9% (n = 98) of them were unaware of their frequency of hypoglycemic and hyperglycemic episodes, respectively. About 64.6% (n = 144) of the patients were equipped for receiving teleconsultation. Glucometer was only possessed by 51.6% (115) of which only 46.95% (n = 54) can operate it independently. Only 80 patients (35.9%) were aware of the correct value of blood glucose levels. Conclusion While a majority of the population is compliant with treatment and aware about diabetes self-care, they lack adequate knowledge and resource equipment for the same leading to very limited utilization.
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Affiliation(s)
- Pratyush Kumar
- Intern, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi, India
| | - Oshin Puri
- Intern, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Vishnu B. Unnithan
- Department of Nuclear Medicine, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Asmitha P. Reddy
- Intern, Father Muller Medical College, Mangalore, Karnataka, India
| | - Shravya Aswath
- Intern, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
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Salad AM, Duale HA, Sheikh IM, Hassan GD, Farah AA, Gele A. Prevalence of diabetes foot ulcers and associated factors among adult diabetic patients in three referral hospitals in Mogadishu, Somalia. Front Public Health 2023; 11:1195483. [PMID: 37564428 PMCID: PMC10411730 DOI: 10.3389/fpubh.2023.1195483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/08/2023] [Indexed: 08/12/2023] Open
Abstract
Background Diabetes mellitus (DM) causes significant morbidity and mortality in sub-Saharan Africa (SSA), including Somalia. Among diabetic patients, diabetic foot ulcers (DFUs) constitute the largest proportion of admissions, amputations, and mortality. The aim of this study is to assess the prevalence of diabetic foot ulcers and subsequently determine factors associated with it among diabetic patients at three major hospitals in Somalia. Methods An institutional-based cross-sectional study was conducted among 193 diabetic patients between August and November 2022. All eligible diabetes patients who were attending De Martini Hospital, Madina General Hospital, and Deynile General Hospital during the study period were included in the study. Patients were interviewed using a structured questionnaire. We collected demographic, clinical, and behavioral variables from all participants. A bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. An odds ratio with a 95% confidence interval was computed to determine the level of significance. Result The mean age of the study's participants was 50.9 ± 13.6 years. The prevalence of diabetic foot ulcer was 15%. Patients who were either overweight or obese (OR 4.63, CI: 2.08-10.30), had a lack of family support in managing diabetes (OR 3.33, CI: 1.74-6.36), and did not check their feet regularly were more likely to develop DFU (OR 1.99, CI:1.08-3.66). Conclusion Increased body mass index, lack of family support, and not checking feet regularly were associated with DFUs. The high prevalence of DFUs and the plethora of needs of people with DFUs pose challenges for health care. A coordinated health care system is necessary to meet the needs of diabetic patients and prevent DFUs.
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Affiliation(s)
- Abdulwahab M. Salad
- School of Public Health and Research, Somali National University, Mogadishu, Somalia
| | - Hodan A. Duale
- Somali Institute for Health Research (SIHR), Garoowe, Somalia
| | - Ismael M. Sheikh
- School of Public Health and Research, Somali National University, Mogadishu, Somalia
| | - Gallad Dahir Hassan
- School of Public Health and Research, Somali National University, Mogadishu, Somalia
| | | | - Abdi Gele
- Somali Institute for Health Research (SIHR), Garoowe, Somalia
- Norwegian Institute of Public Health, Garoowe, Somalia
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Examining Between-Group Differences in Social Network Density and High-Sensitivity C-Reactive Protein in Older Adults: Implications for the Hispanic Mortality Paradox. Psychosom Med 2023; 85:165-174. [PMID: 36729601 PMCID: PMC9924960 DOI: 10.1097/psy.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hispanic/Latino(x) and African American/Black older adults experience disproportionate cardiometabolic disease burdens when compared with their non-Hispanic White counterparts. Sources of resilience such as social networks have been found to mitigate the risk of this disease and its end points like high-sensitivity C-reactive protein (hs-CRP). However, little is known about the social network infrastructure among these groups. Moreover, existing work has largely ignored the degree to which members of one's network are connected to one another (network density), which may be important for navigating structural barriers within interdependent groups. The objective of this study was to understand the association between network density and 5-year hs-CRP (blood spot) and whether this association was moderated by race-ethnicity. METHODS A subsample of Hispanic/Latino(x), African American/Black, and non-Hispanic White older adults ( N = 1431) from the National Social Life Health and Aging Project was used. Multivariable regression was used to estimate the association between network density and its interaction with race-ethnicity, with hs-CRP 5 years later. RESULTS Although no main effect of network density on 5-year hs-CRP was found, results revealed a significant network density by race-ethnicity interaction (Wald χ2 (2, 1242) = 3.31, p = .037). Simple slopes analyses revealed that Hispanic/Latino(x) older adults with high network density had significantly lower hs-CRP levels when compared with their same-ethnic counterparts with low network density ( b = -0.73, standard error = 0.31, 95% confidence interval = -1.33 to -0.13, p = .018). CONCLUSIONS Results demonstrate population-level differences in social network structure and differential associations of this infrastructure with health. Implications for the Hispanic Mortality Paradox are discussed.
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Higa C, Davidson EJ, Loos JR. Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management. J Am Med Inform Assoc 2021; 28:261-275. [PMID: 33164074 DOI: 10.1093/jamia/ocaa223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/01/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Diabetes self-management (DSM) education, social support, and information technology interventions can improve patient engagement and health. A major challenge is animating, integrating, and accessing resources in under-resourced, rural communities. Set in an island community in Hawai'i, this study piloted a program that integrated friend-and-family support, community health services, telehealth-enabled DSM education, and mobile technologies by activating the community's social capital to support the program. MATERIALS AND METHODS An action research approach informed the design and implementation of a community-based DSM program that included: friends and family support, telehealth classes, personalized consultations, Bluetooth-enabled blood glucose monitors, and text messaging support. Outcomes were evaluated using biometric data, surveys, interviews, and participant observations. RESULTS The study spanned 9 months with 7 dyads, each with 1 individual with type 2 diabetes and a friend or family member. Six of the 7 participants with diabetes experienced reduced hemoglobin A1c percentages, with 3 reducing by more than 1%. The seventh participant maintained a hemoglobin A1c level within American Diabetes Association recommended ranges. DSM knowledge and self-care behaviors improved overall. Interviews and participant observations highlighted program strengths and social challenges associated with the interpersonal relationships between the members of the dyads. CONCLUSIONS A community-centric diabetes program can enhance understanding of diabetes etiology, DSM activities, and communication skills for effective disease management support in under-resourced rural communities. Social capital among community members, leveraged with health information technology, can catalyze and integrate limited health system resources for DSM and social support as a cost-effective strategy to develop community-centric chronic healthcare management initiatives.
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Affiliation(s)
- Christina Higa
- Social Science Research Institute, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Elizabeth J Davidson
- Shidler School of Business, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Joanne R Loos
- School of Nursing and Dental Hygiene, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
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Baig AA, Stutz MR, Fernandez Piñeros P, Benitez A, Gao Y, Quinn MT, Solomon MC, Sanchez-Johnsen L, Burnet DL, Chin MH. Using photovoice to promote diabetes self-management in Latino patients. Transl Behav Med 2019; 9:1151-1156. [PMID: 31162592 DOI: 10.1093/tbm/ibz082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Innovative, patient-centered interventions that employ novel educational methods are needed to address the burden of diabetes in the growing Latino population. Objective of this study was to assess the acceptability, feasibility, and perceived utility of photovoice in a diabetes self-management intervention for Latinos. Thirty-seven adults with diabetes attended a church-based self-management education program that included a photovoice exercise where participants were asked to take photographs to illustrate their successes and challenges in diabetes management. Participants discussed their photographs in the group classes and evaluated the exercise in an exit survey. Photographs and discussion notes were analyzed for prevalent themes. We measured participant participation in the photovoice activity, content of photographs, themes of the discussions that were prompted by the photographs in class, and participants' satisfaction with the photovoice exercise. Of the 37 participants, 70% took photos and 65% shared them in class. Photos depicted family, social gatherings, diet, exercise, the neighborhood, diabetes supplies and medications, and home life. Almost all the group discussions involved aspects of social support, including giving advice, empathizing, or providing motivation for self-care to one another. Eighty-six percent reported learning how to better manage their diabetes from others' photos; 93% noted sharing photos made them feel connected to the group. In a diabetes self-management education program, photovoice was well received by Latino adults and provided a vehicle to receive and provide social support in self-care. This trial was registered at clinicaltrials.gov with identifier NCT01288300.
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Affiliation(s)
- Arshiya A Baig
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Matthew R Stutz
- Department of Medicine, University of California, Los Angeles, CA, USA
| | | | | | - Yue Gao
- NORC at the University of Chicago, Bethesda, MD, USA
| | - Michael T Quinn
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Marla C Solomon
- Department of Pediatric Endocrinology, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.,Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Marshall H Chin
- Department of Medicine, University of Chicago, Chicago, IL, USA
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8
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Vissenberg C, Nierkens V, Uitewaal PJM, Middelkoop BJC, Nijpels G, Stronks K. Development of the Social Network-Based Intervention " Powerful Together with Diabetes" Using Intervention Mapping. Front Public Health 2017; 5:334. [PMID: 29326916 PMCID: PMC5741616 DOI: 10.3389/fpubh.2017.00334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/23/2017] [Indexed: 11/15/2022] Open
Abstract
This article describes the development of the social network-based intervention Powerful Together with Diabetes which aims to improve diabetes self-management (DSM) among patients with type 2 diabetes living in socioeconomically deprived neighborhoods by stimulating social support for DSM and diminishing social influences hindering DSM (e.g., peer pressure and social norms). The intervention was specifically developed for patients with Dutch, Turkish, Moroccan, and Surinamese backgrounds. The intervention was developed according to Intervention Mapping. This article describes the first four steps of Intervention Mapping: (1) the needs assessment; (2) development of performance and change objectives; (3) selection of theory-based methods and strategies; and (4) the translation of these into an organized program. These four steps resulted in Powerful Together with Diabetes, a 10-month group-based intervention consisting of 24 meetings, 6 meetings for significant others, and 2 meetings for participants and their spouses. The IM method resulted in a tailored approach with a specific focus on the social networks of its participants. This article concludes that the IM method helped our planning team to tailor the intervention to the needs of our target population and facilitated our evaluation design. However, in hindsight, the intervention could have been improved by investing more in participatory planning and community involvement.
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Affiliation(s)
| | - Vera Nierkens
- Academic Medical Center (AMC), Amsterdam, Netherlands
| | | | | | - Giel Nijpels
- VU University Medical Center, Amsterdam, Netherlands
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Reyes J, Tripp-Reimer T, Parker E, Muller B, Laroche H. Factors Influencing Diabetes Self-Management Among Medically Underserved Patients With Type II Diabetes. Glob Qual Nurs Res 2017; 4:2333393617713097. [PMID: 28660239 PMCID: PMC5476324 DOI: 10.1177/2333393617713097] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 04/24/2017] [Accepted: 05/01/2017] [Indexed: 11/26/2022] Open
Abstract
In this study, researchers compare and contrast issues regarding diabetes self-management between persons in good versus poor glycemic control. The sample comprises low-income racially diverse adults with diabetes from four mid-western community health centers; 44 patients participated in eight focus groups divided by control status (HbA1c of > 9 [uncontrolled] or < 7 [controlled]). Themes common to both groups included the impact of dietary restrictions on social interactions, food cravings, the impact of mental health on self-management, and the importance of formal and informal (friends and family) support. Those in the uncontrolled groups described fear about being able to control their diabetes, confusion about self-management, and difficulty managing their diabetes while caring for family members. Although those in the controlled groups acknowledged difficulties, they discussed resisting cravings, making improvements with small changes, positive feelings about their ability to control their diabetes, and enjoying new foods and exercise. Interventions should include mental health support, incorporate formal and informal patient support structures, and address literacy issues. Health care providers and intervention personnel should be very concrete about how to do self-management tasks and guide patients on how to alter their diabetes regimens for social and other important life events.
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Affiliation(s)
- Jimmy Reyes
- Iowa Board of Nursing, Des Moines, Iowa, USA
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Plasencia J, Hoerr S, Carolan M, Weatherspoon L. Acculturation and Self-Management Perceptions Among Mexican American Adults With Type 2 Diabetes. FAMILY & COMMUNITY HEALTH 2017; 40:121-131. [PMID: 28207675 DOI: 10.1097/fch.0000000000000139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Because type 2 diabetes (T2DM) is disproportionately high among Mexican Americans in the United States, this study examined how acculturation influences T2DM self-management, a critical component for disease outcome. Qualitative interviews of 24 low-income Mexican American patients with T2DM were matched to their biomedical and dietary data and degree of acculturation. Greater acculturation to the United States was associated with less favorable diabetes control, fiber density, leisure-time physical activity, and more physical disability. Health care professionals can improve their cultural competence by learning culturally appropriate foods and fostering a warm, caring manner with Mexican Americans to enhance their sense of well-being and compliance with T2DM recommendations.
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Affiliation(s)
- Julie Plasencia
- Department of Food Science and Human Nutrition (Ms Plasencia, and Drs Hoerr, and Weatherspoon) and Human Development and Family Studies (Dr Carolan), Michigan State University, East Lansing
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Cherrington A, Ayala GX, Sleath B, Corbie-Smith G. Examining Knowledge, Attitudes, and Beliefs About Depression Among Latino Adults With Type 2 Diabetes. DIABETES EDUCATOR 2016; 32:603-13. [PMID: 16873598 DOI: 10.1177/0145721706290836] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to explore knowledge, attitudes, and beliefs about depression among Latinos with type 2 diabetes. METHODS Eight 90-minute focus groups were conducted, each moderated by a bilingual, bicultural woman. Participants included 45 self-identified Latino adults with diabetes. Discussion topics included diabetes management, perceived control, emotional barriers, conceptualization of depression, and help-seeking behavior. Themes pertinent to depression and emotional health were identified using a combined deductive/inductive approach and an iterative process of consensus coding. RESULTS Participants' mean age was 40 years, 44% were male, and most were born in Mexico. The mean time with diabetes was 6.5 years. The primary theme identified was the bidirectional relationship between emotional health and diabetes. Diagnosis of diabetes led to feelings of hopelessness and upset, while difficulty with diabetes management led to feelings of anxiety and depression. Participants felt that being "stressed out" or sad directly affected their blood sugar. Participants described factors that influence the relationship between emotions and diabetes, including family and societal stressors, and they reported little discussion of depression with providers. Depression and emotional health are closely associated with diabetes in the minds of these Latino adults. It is important to ask patients with diabetes about their emotional health, to screen for depression, and to elicit preferences about treatment when indicated.
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Affiliation(s)
- Andrea Cherrington
- The School of Medicine, University of North Carolina at Chapel Hill (Dr Cherrington, Dr Corbie-Smith)
| | - Guadalupe X Ayala
- The Graduate School of Public Health, San Diego State University, San Diego, California (Dr Ayala)
| | - Betsy Sleath
- The School of Pharmacy, University of North Carolina at Chapel Hill (Dr Sleath)
| | - Giselle Corbie-Smith
- The School of Medicine, University of North Carolina at Chapel Hill (Dr Cherrington, Dr Corbie-Smith)
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Ingram M, Torres E, Redondo F, Bradford G, Wang C, O'Toole ML. The Impact of Promotoras on Social Support and Glycemic Control Among Members of a Farmworker Community on the US-Mexico Border. DIABETES EDUCATOR 2016; 33 Suppl 6:172S-178S. [PMID: 17620398 DOI: 10.1177/0145721707304170] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to describe the effect of a promotora-driven intervention to build social support as a means to affect self-management behaviors and clinical outcomes in a farmworker community on the US-Mexico border. METHODS Promotoras implemented a community-based intervention that included support groups, home/hospital visits, telephone support, and advocacy to people with diabetes. A 12-month pre/post study design was used to investigate the relationship between promotora contact, perceived support, and clinical outcomes. Clinical data were gathered from 70 participants during routine physician visits. A pre/post questionnaire was used to measure perceived support and self-management practices. RESULTS Glycosylated hemoglobin (HbA1c) levels decreased 1% among high-risk participants. Improved HbA1c level was associated with promotora advocacy and participation in promotora-led support groups. Participants reported increased support from family and friends and more comfort speaking about diabetes (la enfermedad) with family and friends. CONCLUSIONS These findings document improvement in both clinical and social health indicators for Mexican Americans in a farmworker community when a promotora model is used to provide and facilitate culturally relevant support for diabetes self-management practices.
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Affiliation(s)
- Maia Ingram
- The Mel and End Zuckerman College of Public Health, University of Arizona, Tucson (Ms Ingram, Ms Bradford)
| | - Emma Torres
- Campesinos Sin Fronteras, Somerton, Arizona (Ms Torres, Ms Redondo)
| | - Flor Redondo
- Campesinos Sin Fronteras, Somerton, Arizona (Ms Torres, Ms Redondo)
| | - Gail Bradford
- The Mel and End Zuckerman College of Public Health, University of Arizona, Tucson (Ms Ingram, Ms Bradford)
| | - Chin Wang
- Sunset Community Health Center, Somerton, Arizona (Dr Wang)
| | - Mary L O'Toole
- The Robert Wood Johnson Foundation Diabetes Initiative, National Program Office, St Louis, Missouri (Dr O’Toole)
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Seley JJ, Weinger K. The State of the Science on Nursing Best Practices for Diabetes Self-Management. DIABETES EDUCATOR 2016; 33:616-8, 620, 622 passim. [PMID: 17684163 DOI: 10.1177/0145721707305121] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Jane Jeffrie Seley is a diabetes nurse practitioner at New York Presbyterian—Weill Cornell Medical Center, New York City. She is a contributing editor and the column coordinator for Diabetes Under Control in the American Journal of Nursing. Katie Weinger is an investigator in behavioral and mental health research, director of the Center of Innovation in Diabetes Education and of the Office of Research Fellow Affairs at Joslin Diabetes Center, and an assistant professor of psychiatry at Harvard Medical School, all in Boston. She has received a grant from the National Institutes of Health (NIDDK60115) to study breaking down barriers to diabetes self-care. Contact author: Jane Jeffrie Seley, diabetesnp@gmail.com. Seley serves on the advisory boards of Abbott Diabetes Care, Amylin Pharmaceuticals, Sanofi-Aventis Pharmaceuticals, Pfizer Pharmaceuticals, Roche Diagnostics, Bayer Diabetes Care, Novo Nordisk Pharmaceuticals, and GlaxoSmithKline Pharmaceuticals, several of which provided funding for the project discussed in this article. The authors have no other significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.
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Affiliation(s)
- Jane Jeffrie Seley
- Jane Jeffrie Seley is a diabetes nurse practitioner at New York Presbyterian–Weill Cornell Medical Center, New York City. She is a contributing editor and the column coordinator for Diabetes Under Control in the American Journal of Nursing. Seley serves on the advisory boards of Abbott Diabetes Care, Amylin Pharmaceuticals, Sanofi-Aventis Pharmaceuticals, Pfizer Pharmaceuticals, Roche Diagnostics, Bayer Diabetes Care, Novo Nordisk Pharmaceuticals, and GlaxoSmithKline Pharmaceuticals, several of which provided funding for the project discussed in this article
| | - Katie Weinger
- Katie Weinger is an investigator in behavioral and mental health research, director of the Center of Innovation in Diabetes Education and of the Office of Research Fellow Affairs at Joslin Diabetes Center, and an assistant professor of psychiatry at Harvard Medical School, all in Boston. She has received a grant from the National Institutes of Health (NIDDK60115) to study breaking down barriers to diabetes self-care
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Sussman T, Mccusker J, Yaffe M, Belzile E, Sewitch M, Cole M, Strumpf E. Family members' or friends' involvement in self-care for patients with depressive symptoms and co-morbid chronic conditions. Chronic Illn 2016; 12:182-98. [PMID: 26935233 DOI: 10.1177/1742395316633510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/30/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F. METHODS One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided. RESULTS 30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient use of self-care materials when examined alongside all F/F support variables (Proportional Odds Ratio = 1.21; 95% C.I. = 1.01, 1.45). F/F perceived less involvement in the self-care intervention than patients. DISCUSSION Patients engaged in a self-care intervention for depressive symptoms use more self-care materials when they perceive F/F involvement in the intervention. Patients and F/F may perceive involvement differently and benefit from discussions about potential F/F roles.
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Affiliation(s)
- Tamara Sussman
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Jane Mccusker
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University St Mary's Research Centre, Montreal, QC, Canada
| | - Mark Yaffe
- Department of Family Medicine, McGill University, Montreal, QC, Canada Department of Family Medicine, St. Mary's Hospital Centre, St. Mary's Hospital Centre, Montreal, QC, Canada
| | | | - Maida Sewitch
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Department of Medicine, McGill University, Montreal, QC, Canada Divisions of Gastroenterology and Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada
| | - Martin Cole
- St Mary's Research Centre, Montreal, QC, Canada Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Erin Strumpf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Department of Economics, McGill University, Montreal, QC, Canada
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Rotberg B, Junqueira Y, Gosdin L, Mejia R, Umpierrez GE. The Importance of Social Support on Glycemic Control in Low-income Latinos With Type 2 Diabetes. AMERICAN JOURNAL OF HEALTH EDUCATION 2016. [DOI: 10.1080/19325037.2016.1203838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Lucas Gosdin
- Emory University School of Medicine
- Emory University, Rollins School of Public Health
| | - Roberto Mejia
- Emory University School of Medicine
- Emory University, Rollins School of Public Health
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Abstract
Purpose: The purpose of this article is to explore how kin and nonkin social support networks influence health behaviors among older Samoan women. Method: Using a cross-sectional survey design, 290 Samoan women who were age 50 years and older were interviewed. Using separate logistic regressions, each health behavior was regressed on age and kin and nonkin social support networks after controlling for background characteristics and health status. Results: In multivariate analyses, higher scores on kin increased the likelihood of never salting food, getting screened for diabetes in the past year, and having had a mammogram in the past 2 years, whereas higher scores on nonkin increased the likelihood of exercising at all and ever trying to lose weight. Discussion: Kin networks positively affect mostly chronic disease-related health behaviors, whereas nonkin networks positively affect mostly lifestyle-related health behaviors.
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Affiliation(s)
- Lené Levy-Storms
- University of California, Los Angeles, and Jewish Home for the Aging of Greater Los Angeles, USA
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Marquez B, Anderson A, Wing RR, West DS, Newton RL, Meacham M, Hazuda HP, Peters A, Montez MG, Broyles ST, Walker M, Evans-Hudsnall G. The relationship of social support with treatment adherence and weight loss in Latinos with type 2 diabetes. Obesity (Silver Spring) 2016; 24:568-75. [PMID: 26833676 PMCID: PMC4769665 DOI: 10.1002/oby.21382] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/23/2015] [Accepted: 10/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Little is known about the effects of social support on weight loss in Latinos. This study determined whether sex moderated and treatment adherence mediated the association between social support and weight loss. METHODS Data from 278 Latino males and females with type 2 diabetes in the Intensive Lifestyle Intervention of the Look AHEAD trial were analyzed. Multivariable modeling tested for moderation and parallel multiple mediator modeling simultaneously tested the mediating effects of adherence to physical activity, diet, and session attendance on the relationship between baseline social support and percent weight loss at 1 year. RESULTS Social support for physical activity (having family and friends join in physical activity) was related to weight loss. Adherence to physical activity was related to both social support for physical activity and weight loss. Sex did not moderate these relationships. Adherence to physical activity completely mediated the relationship between social support for physical activity and weight loss. CONCLUSIONS Increasing companionship for physical activity may be an effective intervention strategy to promote behaviors important for weight loss among Latinos.
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Affiliation(s)
- Becky Marquez
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA
| | - Andrea Anderson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown University, Providence, RI
| | - Delia S. West
- Department of Exercise Science, University of South Carolina, Columbia, SC
| | - Robert L. Newton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Maria Meacham
- Southwestern American Indian Center, Phoenix, Arizona and Shiprock, New Mexico
| | - Helen P. Hazuda
- Department of Medicine, Division of Nephrology, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Anne Peters
- Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Maria G. Montez
- Department of Medicine, Division of Nephrology, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Stephanie T. Broyles
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Martha Walker
- Keck School of Medicine of the University of Southern California, Los Angeles, CA
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19
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Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci 2015; 1353:89-112. [PMID: 26250784 DOI: 10.1111/nyas.12844] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Diabetes self-care is a critical aspect of disease management for adults with diabetes. Since family members can play a vital role in a patient's disease management, involving them in self-care interventions may positively influence patients' diabetes outcomes. We systematically reviewed family-based interventions for adults with diabetes published from 1994 to 2014 and assessed their impact on patients' diabetes outcomes and the extent of family involvement. We found 26 studies describing family-based diabetes interventions for adults. Interventions were conducted across a range of patient populations and settings. The degree of family involvement varied across studies. We found evidence for improvement in patients' self-efficacy, perceived social support, diabetes knowledge, and diabetes self-care across the studies. Owing to the heterogeneity of the study designs, types of interventions, reporting of outcomes, and family involvement, it is difficult to determine how family participation in diabetes interventions may affect patients' clinical outcomes. Future studies should clearly describe the role of family in the intervention, assess quality and extent of family participation, and compare patient outcomes with and without family involvement.
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Affiliation(s)
- Arshiya A Baig
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amanda Benitez
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Michael T Quinn
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Deborah L Burnet
- Department of Medicine, University of Chicago, Chicago, Illinois
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Soto SC, Louie SY, Cherrington AL, Parada H, Horton LA, Ayala GX. An Ecological Perspective on Diabetes Self-care Support, Self-management Behaviors, and Hemoglobin A1C Among Latinos. THE DIABETES EDUCATOR 2015; 41:214-223. [DOI: 10.1177/0145721715569078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Purpose The purpose of this study was to examine the role of self, interpersonal (ie, family/friend), and organizational (ie, health care) support in performing diabetes-related self-management behaviors and hemoglobin A1C (A1C) levels among rural Latinos with type 2 diabetes. Methods Cross-sectional data from baseline interviews and medical records were used from a randomized controlled trial conducted in rural Southern California involving a clinic sample of Latinos with type 2 diabetes (N = 317). Self-management behaviors included fruit and vegetable intake, fat intake, physical activity, glucose monitoring, daily examination of feet, and medication adherence. Multivariate linear and logistic regression models were used to assess the relationships of sources of support with self-management behaviors and A1C. Results Higher levels of self-support were significantly associated with eating fruits and vegetables most days/week, eating high-fat foods few days/week, engaging in physical activity most days/week, daily feet examinations, and self-reported medication adherence. Self-support was also related to A1C. Family/friend support was significantly associated with eating fruits and vegetables and engaging in physical activity most days/week. Health care support was significantly associated with consuming fats most days/week. Conclusions Health care practitioners and future interventions should focus on improving individuals’ diabetes management behaviors, with the ultimate goal of promoting glycemic control. Eliciting family/friend support should be encouraged to promote fruit and vegetable consumption and physical activity.
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Affiliation(s)
- Sandra C. Soto
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
| | - Sabrina Y. Louie
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
| | - Andrea L. Cherrington
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
| | - Humberto Parada
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
| | - Lucy A. Horton
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
| | - Guadalupe X. Ayala
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Health Behavior) and the Institute for Behavioral and Community Health, San Diego, California (Ms Soto)
- Cedars-Sinai Medical Center, Los Angeles, California (Ms Louie)
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama (Dr Cherrington)
- University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina (Mr Parada)
- Institute for Behavioral and Community Health, San Diego, California (Ms Horton)
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Sussman T, Yaffe M, Mccusker J, Burns V, Strumpf E, Sewitch M, Belzile E. A mixed methods exploration of family members'/friends' roles in a self-care intervention for depressive symptoms. Chronic Illn 2014; 10:93-106. [PMID: 23986084 DOI: 10.1177/1742395313500359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aims of this exploratory study were to examine the: (1) family and friend (F/F) support patients reported receiving and F/F reported providing to patients while participating in a self-care intervention (SCI) for depressive symptoms and (2) associations between different types of F/F support and patients' use of the self-care tools in the SCI. METHODS Fifty-seven patients aged 40 + participating in an uncontrolled feasibility study of an SCI, completed structured telephone interviews about the support they received from F/F while participating in the SCI. Eighteen F/F completed questionnaires on the support they provided to patients during the SCI. Seven F/F participated in a post-study qualitative interview on their involvement in the SCI. RESULTS About 35% of patients reported receiving F/F support with the SCI. Patients' use of the behavioral tools was positively associated with patients' report of F/F support, and with F/F's report of instrumental support provided. F/F reported uncertainty about the type of support they should offer to patients in the SCI. DISCUSSION F/F involvement in SCIs for depressive symptoms may be helpful to patients and may foster adherence to these interventions. More research is warranted on the nature of such involvement from the perspective of patients and F/F.
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Affiliation(s)
- Tamara Sussman
- 1School of Social Work, McGill University, Montreal, Canada
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22
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Rankin D, Barnard K, Elliott J, Cooke D, Heller S, Gianfrancesco C, Taylor C, Lawton J. Type 1 diabetes patients' experiences of, and need for, social support after attending a structured education programme: a qualitative longitudinal investigation. J Clin Nurs 2014; 23:2919-27. [PMID: 24443789 DOI: 10.1111/jocn.12539] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore patients' experiences of, views about and need for, social support after attending a structured education programme for type 1 diabetes. BACKGROUND Patients who attend structured education programmes attain short-term improvements in biomedical and quality-of-life measures but require support to sustain self-management principles over the longer term. Social support can influence patients' self-management practices; however, little is known about how programme graduates use other people's help. DESIGN This study was informed by the principles of grounded theory and involved concurrent data collection and analysis. Data were analysed using an inductive, thematic approach. METHODS In-depth interviews were undertaken postcourse, six and 12 months later, with 30 adult patients with type 1 diabetes recruited from Dose Adjustment for Normal Eating courses in the United Kingdom. RESULTS Patients' preferences for social support from other people ranged from wanting minimal involvement, to benefiting from auxiliary forms of assistance, to regular monitoring and policing. New self-management skills learnt on their courses prompted and facilitated patients to seek and obtain more social support. Support received/expected from parents varied according to when patients were diagnosed, but parents' use of outdated knowledge could act as a barrier to effective support. Support sought from others, including friends/colleagues, was informed by patients' domestic/employment circumstances. CONCLUSION This study responds to calls for deeper understanding of the social context in which chronic illness self-management occurs. It highlights how patients can solicit and receive more social support from family members and friends after implementing self-care practices taught on education programmes. RELEVANCE TO CLINICAL PRACTICE Health professionals including diabetes specialist nurses and dietitians should explore: patients' access to and preferences for social support; how patients might be encouraged to capitalise on social support postcourse; and new ways to inform/educate people within patients' social networks.
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Affiliation(s)
- David Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Naranjo D, Mulvaney S, McGrath M, Garnero T, Hood K. Predictors of self-management in pediatric type 1 diabetes: individual, family, systemic, and technologic influences. Curr Diab Rep 2014; 14:544. [PMID: 25200590 DOI: 10.1007/s11892-014-0544-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Type 1 diabetes (T1D) is a complex chronic disease that has many facets for successful management. The burden of this management falls largely on the individual and their family members. Self-management has a major influence on T1D health outcomes, and with successful management, children and adolescents with T1D can lead long and healthy lives. We discuss how various individual, family, and systemic/technologic factors influence T1D self-management, providing research that supports interventions targeting each of these factors. With this information, health care practitioners and researchers can better understand the role of T1D self-management and bolster this important aspect of T1D care.
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Affiliation(s)
- Diana Naranjo
- University of California, 3333 California St. Suite 245, Box 0503, San Francisco, CA, 94118, USA,
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24
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Ezenwaka C, Onuoha P, Sandy D, Isreal-Richardson D. Diabetes self-management education in a high-income developing country: survey of the opinion of nurses and dietitians. Int J Diabetes Dev Ctries 2013. [DOI: 10.1007/s13410-013-0174-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Dingley C, Roux G. The role of inner strength in quality of life and self-management in women survivors of cancer. Res Nurs Health 2013; 37:32-41. [PMID: 24357538 DOI: 10.1002/nur.21579] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2013] [Indexed: 11/06/2022]
Abstract
The role of inner strength in quality of life (QOL) and self-management, primary variables in the Theory of Inner Strength, were examined with demographic and clinical characteristics in 107 women with cancer. The strongest predictors of QOL were depressive symptoms, inner strength, and time since diagnosis, respectively, accounting for 82% of the variance in QOL. When depressive symptoms were excluded due to multicollinearity, 64% of variance in QOL was explained by inner strength, time since diagnosis, and comorbidities, with inner strength the strongest predictor. The strongest predictors of self-management were depressive symptoms and inner strength, accounting for 17% of the variance. Results contribute to theory development and suggest the value of supporting inner strength to enhance QOL in cancer survivors.
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Factors that influence diabetes self-management in Hispanics living in low socioeconomic neighborhoods in San Bernardino, California. J Immigr Minor Health 2013; 14:1090-6. [PMID: 22427108 DOI: 10.1007/s10903-012-9601-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The growing incidence of diabetes among Hispanics is a serious public health concern. To identify factors that influence diabetes self-management in Hispanics, qualitative data gathered through five focus group interviews was examined using grounded theory methods. Four major themes emerged which were perceived by participants as enhancing or limiting factors: (1) access to resources, (2) struggle with diet, (3) self-efficacy, and (4) social support. The family's role as a determinant of diabetes self-management emerged as the underlying sub-theme to all four themes and underscores its importance among Hispanics living with diabetes. Results suggest that for the family to be an enhancing factor, health care providers need to educate, empower, and include the family in diabetes management and prevention. Programs which aim to improve the practice of self-management should incorporate the sociocultural and socioeconomic context in which Hispanics with diabetes live.
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Paterson C, Jones M, Rattray J, Lauder W. Exploring the relationship between coping, social support and health-related quality of life for prostate cancer survivors: A review of the literature. Eur J Oncol Nurs 2013; 17:750-9. [DOI: 10.1016/j.ejon.2013.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 02/01/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
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Abstract
Diabetes is one of the fastest growing chronic diseases globally and in the United States. Although preventable, type 2 diabetes accounts for 90 % of all cases of diabetes worldwide and continues to be a source of increased disability, lost productivity, mortality, and amplified health-care costs. Proper disease management is crucial for achieving better diabetes-related outcomes. Evidence suggests that higher levels of social support are associated with improved clinical outcomes, reduced psychosocial symptomatology, and the adaptation of beneficial lifestyle activities; however, the role of social support in diabetes management is not well understood. The purpose of this systematic review is to examine the impact of social support on outcomes in adults with type 2 diabetes.
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Affiliation(s)
- Joni L Strom
- Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280E, PO Box 250593, Charleston, SC 29425, USA.
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Naranjo D, Hessler DM, Deol R, Chesla CA. Health and psychosocial outcomes in U.S. adult patients with diabetes from diverse ethnicities. Curr Diab Rep 2012; 12:729-38. [PMID: 22961116 DOI: 10.1007/s11892-012-0319-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Within the United States, diabetes is a serious public health concern and patients with diabetes are more likely to experience clinical depression, psychological distress, and depressive symptoms than those without. Negative psychosocial factors are associated with poorer diabetes management and glycemic control. Overall, both the rates of diabetes and related psychological distress are greater for persons of diverse ethnicities than for non-Latino whites, and have reached epidemic proportions in certain groups. The following article will provide an overview across ethnicities of the rates of diabetes, health outcomes, psychosocial outcomes, and unique cultural and linguistic challenges that contribute to disparities within US diabetes patients of diverse ethnicities. Using this information, our hope is that health care practitioners and researchers alike can better respond to the psychosocial needs of ethnically diverse patients.
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Affiliation(s)
- Diana Naranjo
- Department of Pediatrics, University of California San Francisco, 400 Parnassus Avenue, 4th Floor, UCSF, MailBox 0318, San Francisco, CA 94143-0318, USA.
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30
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Gunn KL, Seers K, Posner N, Coates V. 'Somebody there to watch over you': the role of the family in everyday and emergency diabetes care. HEALTH & SOCIAL CARE IN THE COMMUNITY 2012; 20:591-598. [PMID: 22758654 DOI: 10.1111/j.1365-2524.2012.01073.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper reports on the role of family members in everyday diabetes self-care and in diabetic crises. It is based on qualitative data drawn from 45 semi-structured interviews with a wide range of people with an established diagnosis of Type 1 or Type 2 diabetes, who were admitted to hospital for urgent or emergency treatment in connection with their diabetes. The interviews were carried out in two contrasting sites in the United Kingdom in 2009-2010, transcribed and analysed thematically with particular reference to framework analysis methods. We found that family involvement in self-care was common, and the role of family and friends was especially important when the person with diabetes needed urgent help. We comment on the diversity of family members who assisted regularly or dealt with crises, the importance of taking account of the complexities of family life, including reciprocal care, and the particular problems faced by people without family support. Finally, we make recommendations for further research and for improvements in existing services.
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Affiliation(s)
- Kathleen L Gunn
- Royal College of Nursing Research Institute, School of Health and Social Studies, University of Warwick, Coventry, UK.
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31
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Song Y, Song HJ, Han HR, Park SY, Nam S, Kim MT. Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes. DIABETES EDUCATOR 2012; 38:77-85. [PMID: 22222514 DOI: 10.1177/0145721711432456] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was (1) to characterize the primary sources of social support and the extent of unmet needs for support (defined as the gap between social support needs and the receipt of social support) in a sample of Korean Americans (KAs) with type 2 diabetes and (2) to examine the effect of unmet needs for support on their self-care activities. METHODS Baseline data obtained from a community-based intervention trial were used for this study of 83 middle-aged KAs with type 2 diabetes. Study design and data analysis were guided by social cognitive theory. The key variables were dictated the order of the variables in multivariate regression analysis. RESULTS Our findings indicated that for diabetic KAs, the primary source of social support differed according to gender. Unmet needs for support were significantly associated with self-care activities, but the amount of support needs and of social support received were not. Multivariate analysis also confirmed that unmet needs for social support are a significant strong predictor of inadequate type 2 diabetes self-care activities, after controlling for other covariates. The hierarchical regression model explained about 30% of total variance in self-care activities. CONCLUSIONS The findings highlight the importance of considering unmet needs for social support when addressing self-care activities in type 2 diabetes patients. Future interventions should focus on filling gaps in social support and tailoring approaches according to key determinants, such as gender or education level, to improve self-care activities in the context of type 2 diabetes care.
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Affiliation(s)
| | - Hee-Jung Song
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Hae-Ra Han
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - So-Youn Park
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Soohyun Nam
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
| | - Miyong T Kim
- The Johns Hopkins University, Baltimore, USA (Dr Song, Dr Han, Dr Park, Dr Nam, Dr Kim)
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Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: patient and provider factors. Diabetes Res Clin Pract 2011; 93:1-9. [PMID: 21382643 DOI: 10.1016/j.diabres.2011.02.002] [Citation(s) in RCA: 382] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 01/08/2011] [Accepted: 02/03/2011] [Indexed: 12/12/2022]
Abstract
Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. Patients' adherence, attitude, beliefs, and knowledge about diabetes may affect diabetes self-management. Culture and language capabilities influence the patient's health beliefs, attitudes, health literacy, thereby affecting diabetes self-management. Other influential factors include the patient's financial resources, co-morbidities, and social support. Clinician's attitude, beliefs and knowledge about diabetes also influence diabetes management. Clinicians may further influence the patient's perception through effective communication skills and by having a well-integrated health care system. Identifying barriers to diabetes management is necessary to improve the quality of diabetes care, including the improvement of metabolic control, and diabetes self-management. Further research that considers these barriers is necessary for developing interventions for individuals with type 2 diabetes.
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Affiliation(s)
- Soohyun Nam
- Johns Hopkins University, School of Nursing, Department of Health Systems and Outcomes, 525 North Wolfe Street, Baltimore, MD 21205-2110, United States.
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Rosland AM, Heisler M, Piette JD. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med 2011; 35:221-39. [PMID: 21691845 DOI: 10.1007/s10865-011-9354-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 05/16/2011] [Indexed: 01/12/2023]
Abstract
In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts); however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient's autonomous motivation.
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Affiliation(s)
- Ann-Marie Rosland
- Department of Veterans Affairs, Ann Arbor VA Center for Clinical Management Research, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105, USA.
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Ko IS, Lee TH, Kim GS, Kang SW, Kim MJ. Effects of visiting nurses' individually tailored education for low-income adult diabetic patients in Korea. Public Health Nurs 2011; 28:429-37. [PMID: 22092426 DOI: 10.1111/j.1525-1446.2011.00941.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the effects of individually tailored education by visiting nurses for low-income adult diabetic patients. DESIGN AND SAMPLE This one-group pretest-posttest study included 96 newly registered low-income adult diabetic patients in a public health center in DJ-gu (similar to a county in the United States) in 2006; the patients met the selection criteria. MEASURES Diabetes knowledge, self-management, and blood glucose levels were compared before and after education. INTERVENTION 15 visiting nurses delivered individually tailored education for 60-90 min/month for 7 months. RESULTS After education, diabetes knowledge (p<.001) and self-management in all categories of lifestyle (p<.001), diet (p<.001), exercise (p<.001), foot care (p<.001), medication (p=.004), and insulin therapy (p=.022) significantly improved. The mean fasting blood glucose (FBG) level decreased by 14.53 mg/dl; this decrease was insignificant (p=.117). However, the relationship between education and FBG levels was significant (χ(2)=40.11, p=.005). CONCLUSIONS Tailored education effectively improved the patients' knowledge of diabetes and self-management. Therefore, regular, individually tailored education on a long-term basis by visiting nurses can provide essential education to low-income adult diabetic patients for maintaining self-management.
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Affiliation(s)
- Il Sun Ko
- College of Nursing, Nursing Policy Research Institute, Yonsei University, Seoul, Korea
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McEwen MM, Pasvogel A, Gallegos G, Barrera L. Type 2 diabetes self-management social support intervention at the U.S.-Mexico border. Public Health Nurs 2011; 27:310-9. [PMID: 20626831 DOI: 10.1111/j.1525-1446.2010.00860.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To pilot test the efficacy of a culturally tailored diabetes self-management social support intervention for Mexican American adults with Type 2 diabetes (T2DM) living in the U.S.-Mexico border region and to test the feasibility of recruiting and training promotoras to participate in intervention delivery. DESIGN AND SAMPLE This study used a single-group pretest and posttest design. The convenience sample consisted of 21 Mexican American adults with T2DM. The setting for the study was a community in the Arizona-Sonora, Mexico border region. INTERVENTIONS A bilingual, bicultural certified diabetes educator (CDE) and a nurse researcher developed the intervention to improve T2DM self-management activities for Mexican Americans. Data were collected using self-report questionnaires, glycosolated hemoglobin (HbA(1c)), and anthropometric measures. RESULTS Intervention efficacy was demonstrated by an increase in participants' diabetes self-management activities and diabetes knowledge and a decrease in diabetes-related distress and sedentary behaviors. There were no significant changes in physiologic outcomes. Feasibility of recruitment and training of 2 promotoras who participated in intervention delivery was established. CONCLUSIONS Promotoras, in collaboration with a CDE, successfully delivered a culturally tailored diabetes self-management social support intervention for Mexican American adults with T2DM. This intervention positively affected diabetes self-management behaviors.
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Aggarwal B, Liao M, Allegrante JP, Mosca L. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2010; 42:380-8. [PMID: 20696617 PMCID: PMC2978807 DOI: 10.1016/j.jneb.2009.08.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 08/11/2009] [Accepted: 08/18/2009] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Evaluate the relationship between low social support (SS) and adherence to diet in a cardiovascular disease (CVD) lifestyle intervention trial. DESIGN Prospective substudy. SETTING AND PARTICIPANTS Blood relatives/cohabitants of hospitalized cardiac patients in a randomized controlled trial (n=458; 66% female, 35% nonwhite, mean age 50 years). MAIN OUTCOME MEASURES Non-adherence to diet using MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, and Snacks) tool; SS using the Enhancing Recovery in Coronary Heart Disease Patients Social Support Instrument. ANALYSIS Logistic regression models adjusted for confounders. RESULTS Significant predictors (P<.05) of non-adherence to diet recommendations at 1 year included low SS, increased body mass index and waist size, lower physical activity, depression, pre-action stages of change, control group assignment, and being male. Those with low SS at baseline 2.7 greater odds of being non-adherent to diet at 1 year vs those with higher SS (95% confidence interval=1.1-6.4); there was no interaction by group assignment. CONCLUSION AND IMPLICATIONS Low SS at baseline was independently associated with non-adherence to diet at 1 year, suggesting that family members with low SS may be at heightened CVD risk as a result of poor dietary adherence.
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Affiliation(s)
| | - Ming Liao
- Columbia University Medical Center, New York, NY
| | | | - Lori Mosca
- Columbia University Medical Center, New York, NY
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Oftedal B, Karlsen B, Bru E. Perceived support from healthcare practitioners among adults with type 2 diabetes. J Adv Nurs 2010; 66:1500-9. [PMID: 20497269 DOI: 10.1111/j.1365-2648.2010.05329.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is a report of a study of how adults with type 2 diabetes perceive different attributes of support provided by healthcare practitioners and how various attributes of support can influence people's motivation to self-manage their disease. BACKGROUND Motivational problems seem to be a major reason for poor diabetes management. According to well-known theories of motivation, expectations of being able to perform certain behaviours are a key element. Different attributes of support from healthcare practitioners are likely to influence such expectations. To date, no researchers have specifically examined how people with type 2 diabetes perceive different attributes of support from healthcare practitioners and how these may influence their motivation to manage their disease themselves. METHODS A descriptive/explorative qualitative design and focus groups were used to collect data. The sample consisted of 19 adults with type 2 diabetes, and the data were collected in 2007 and analysed using qualitative content analysis. FINDINGS Five themes were identified, reflecting perceived attributes of support from healthcare practitioners: (1) an empathetic approach, (2) practical advice and information, (3) involvement in decision-making, (4) accurate and individualized information and (5) ongoing group-based support. CONCLUSION Healthcare practitioners may strengthen the self-management motivation among adults with type 2 diabetes by enhancing expectations of being able to perform the necessary diabetes care, and through the provision of empathetic, individualized, practical and ongoing group-based support.
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Affiliation(s)
- Bjørg Oftedal
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway.
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Rees CA, Karter AJ, Young BA. Race/ethnicity, social support, and associations with diabetes self-care and clinical outcomes in NHANES. DIABETES EDUCATOR 2010; 36:435-45. [PMID: 20332281 DOI: 10.1177/0145721710364419] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to evaluate how social support and race/ethnicity were associated with diabetes self-care behaviors and clinical outcomes. METHODS Using the cross-sectional 2005-2006 National Health and Nutrition Examination Survey (NHANES), the authors examined white, black, and Latino respondents who self-reported a diabetes diagnosis (n = 450), estimating the associations of social support on diabetes outcomes. The primary exposure was a social support index (0-5), which assessed the number of sources of support in one's life. Outcomes were self-care behaviors (controlling weight, exercising, controlling fat/caloric intake, checking feet, and self-monitoring blood glucose) and intermediate clinical outcomes (hemoglobin A1C, diastolic blood pressure, and low-density lipoprotein [LDL]). RESULTS There were no differences in social support by race/ethnicity. The authors observed several significant race/ethnicity by social support interactions in adjusted models, controlling for age, gender, education, self-reported health, depression, functional disability, insurance status, and insulin use. Among blacks, social support was associated with controlling weight (odds ratio [OR] = 1.55, P = .03), exercising (OR = 1.38, P = .03), controlling fat/calories (OR = 1.84, P = .03), and lower diastolic blood pressure (beta = -3.07, P = .02). Among whites, social support was associated with lower LDL (beta = -9.45, P = .01). No significant effects were noted for Latinos. CONCLUSIONS The relationship of social support with diabetes management differed by race/ethnicity, with the strongest findings among blacks. Social support may be influential for maintaining self-care behaviors among blacks and controlling lipid levels among whites.
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Affiliation(s)
- Courtney A Rees
- The University of Washington, Department of Health Services, Seattle, WA (Ms Rees)
| | - Andrew J Karter
- Kaiser Permanente Northern California, Division of Research, Oakland, CA (Dr Karter)
| | - Bessie A Young
- Veterans Administration Puget Sound Health Care System, Seattle, WA (Dr Young)
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Piette JD, Rosland AM, Silveira M, Kabeto M, Langa KM. The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses. Chronic Illn 2010; 6:34-45. [PMID: 20308349 PMCID: PMC2864454 DOI: 10.1177/1742395309347804] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study sought to (1) identify barriers to spousal support for chronic illness self-care among community-dwelling older adults; and (2) describe the potential availability of self-care support from adult children living outside of the household. METHODS Nationally representative US sample of chronically ill adults aged 51+ were interviewed as part of the Health and Retirement Study (N = 14,862). Both participants and their spouses (when available) reported information about their health and functioning. Participants also reported information about their contact with adult children and the quality of those relationships. RESULTS More than one-third (38%) of chronically ill older adults in the US are unmarried; and when spouses are available, the majority of them have multiple chronic diseases and functional limitations. However, the vast majority of chronically ill older adults (93%, representing roughly 60 million Americans) have adult children, with half having children living over 10 miles away. Most respondents with children (78%) reported at least weekly telephone contact and that these relationships were positive. Roughly 19 million older chronically ill Americans have adult children living at a distance but none nearby; these children are in frequent telephone contact and respondents (including those with multiple chronic diseases) report that the relationships are positive. DISCUSSION As the gap between available health services for disease management and the need among community-dwelling patients continues to grow, adult children-including those living at a distance-represent an important resource for improving self-care support for people with chronic diseases.
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Affiliation(s)
- John D Piette
- VA Center for Clinical Management Research, 300 North Ingalls, Ann Arbor, MI, USA.
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Abstract
OBJECTIVES We identify recent models for programmes aiming to increase effective family support for chronic illness management and self-care among adult patients without significant physical or cognitive disabilities. We then summarize evidence regarding the efficacy for each model identified. METHODS Structured review of studies published in medical and psychology databases from 1990 to the present, reference review, general Web searches and conversations with family intervention experts. Review was limited to studies on conditions that require ongoing self-management, such as diabetes, chronic heart disease and rheumatologic disease. RESULTS Programmes with three separate foci were identified: (1) Programmes that guide family members in setting goals for supporting patient self-care behaviours have led to improved implementation of family support roles, but have mixed success improving patient outcomes. (2) Programmes that train family in supportive communication techniques, such as prompting patient coping techniques or use of autonomy supportive statements, have successfully improved patient symptom management and health behaviours. (3) Programmes that give families tools and infrastructure to assist in monitoring clinical symptoms and medications are being conducted, with no evidence to date on their impact on patient outcomes. DISCUSSION The next generation of programmes to improve family support for chronic disease management incorporate a variety of strategies. Future research can define optimal clinical situations for family support programmes, the most effective combinations of support strategies, and how best to integrate family support programmes into comprehensive models of chronic disease care.
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Affiliation(s)
- Ann-Marie Rosland
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, USA.
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Choi SE. Diet-specific family support and glucose control among Korean immigrants with type 2 diabetes. DIABETES EDUCATOR 2010; 35:978-85. [PMID: 19934457 DOI: 10.1177/0145721709349220] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the influence of diet family support on glucose outcome in Korean immigrants with type 2 diabetes, taking into consideration patient gender. METHODS A total of 143 Korean immigrants with type 2 diabetes were recruited from a West Coast Koreatown. On completing questionnaires (demographic, health history, and the Diabetes Family Behavior Checklist-II [DFBC]), a participant was given a finger stick blood test for glycosylated hemoglobin (A1C). Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated after measurements were taken. Analyses assessed the independent associations of diet family support, gender, and diet family support by gender interactions with glucose outcome. RESULTS A higher level of diet family support was significantly associated with lower A1C, indicating the beneficial effect of diet family support on glucose control. Although the main effect of gender on A1C was not significant, the effect of the product term of family support and gender was, indicating that the significant beneficial impact of diet family support on A1C depends on gender. The impact is much more pronounced in men (B = -.516) than women (B = -.038). CONCLUSIONS Family support, specific to diet, is significantly associated with glucose outcomes in Korean immigrants with type 2 diabetes. That is, more perceived family support was associated with better glucose control. The positive impact of family support on glucose outcome was significantly stronger in men than in women, even after other factors were taken into consideration.
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Affiliation(s)
- Sarah E Choi
- Program in Nursing Science, College of Health Sciences, University of California, Irvine, 214 Irvine Hall, Irvine, CA 92697-3959, USA.
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Gamarra CJ, Paz EPA, Griep RH. Social support and cervical and breast cancer screening in Argentinean women from a rural population. Public Health Nurs 2009; 26:269-76. [PMID: 19386062 DOI: 10.1111/j.1525-1446.2009.00779.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine whether emotional social support influences the use of 3 cancer screening tests in females. DESIGN Cross-sectional study. SAMPLE Data were collected via a household survey of a random sample of 200 Argentinean women. MEASUREMENTS The questionnaire included self-reported data about the cancer screening tests (Papanicolaou [Pap] test for cervical cancer, breast self-examination, and clinical examination for breast cancer), and socioeconomic background information. Social support was measured by the Duke-UNC-11 questionnaire. ANALYSIS Logistic models were used to investigate the association between social support and cancer screening tests. RESULTS Emotional social support was associated with having participated in Pap screening within 3 years before this study, but a link between social support and self or clinical breast examination was not supported. CONCLUSION Emotional social support may play a role in early cervical cancer detection among Argentinean females, specifically by encouraging performance of the Pap test. The educational practices accomplished by nurses should include actions that involve the family and community; therefore, emphasizing the importance of social ties on health and promoting interactions between target women and existent social groups in the community.
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Affiliation(s)
- Carmen Justina Gamarra
- Department of Community Health, Institute of Social Medicine, The State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Abstract
Despite the rising incidence of type 2 diabetes in Korean immigrants, little is known about glucose control in these individuals. This descriptive study examined factors influencing glucose control in Korean immigrants with type 2 diabetes. Participants were 143 Korean immigrants with type 2 diabetes who completed questionnaires, a finger stick blood test for glycosylated hemoglobin (HbA1c), and anthropometric measures. The mean HbA1c level was 7.6 % (SD = 1.5; range = 5.6 to 12.5). Less than half of the participants (41.3%) met the American Diabetes Association's goal of less than 7%. After adjusting for demographic and health variables, family diet support, waist-to-hip ratio (WHR), the duration of diabetes, the number of diabetic medications, and age significantly influenced glucose control. Findings support the positive role of family involvement in diabetes management. Patients with long-standing diabetes, higher WHR, and more diabetic medications deserve special attention because they tend to have higher HbA1c levels.
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When is social support important? The association of family support and professional support with specific diabetes self-management behaviors. J Gen Intern Med 2008; 23:1992-9. [PMID: 18855075 PMCID: PMC2596525 DOI: 10.1007/s11606-008-0814-7] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 06/25/2008] [Accepted: 09/10/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Social support is associated with better diabetes self-management behavior (SMB), yet interventions to increase family and friend support (FF support) have had inconsistent effects on SMB. OBJECTIVE To test whether FF support differentially affects specific SMBs and compare the influence of support from health professionals and psychological factors on specific SMBs to that of FF support. DESIGN Cross-sectional survey of people with diabetes recruited for a self-management intervention PARTICIPANTS AND SETTING One hundred sixty-four African-American and Latino adults with diabetes living in inner-city Detroit MEASUREMENTS AND MAIN RESULTS For every unit increase in FF support for glucose monitoring, the adjusted odds ratio (AOR) of completing testing as recommended was 1.77 (95% CI 1.21-2.58). FF support was not associated with four other SMBs (taking medicines, following a meal plan, physical activity, checking feet). Support from non-physician health professionals was associated with checking feet [AOR 1.72 (1.07-2.78)] and meal plan adherence [AOR = 1.61 (1.11-2.34)]. Diabetes self-efficacy was associated with testing sugar, meal plan adherence, and checking feet. Additional analyses suggested that self-efficacy was mediating the effect of FF support on diet and checking feet, but not the FF support effect on glucose monitoring. CONCLUSIONS The association between FF support and SMB performance was stronger for glucose monitoring than for other SMBs. Professional support and diabetes self-efficacy were each independently associated with performance of different SMBs. SMB interventions may need to differentially emphasize FF support, self-efficacy, or professional support depending on the SMB targeted for improvement.
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Abstract
Although social support has been found to promote health and decrease depression in individuals with diabetes, little research has examined the kinds and sources of support. This descriptive correlational study examined the effects of diabetes-related tangible social support and depression on diabetes self-efficacy in Hispanic older adults. Participants were predominantly Puerto Rican, and many were depressed. Primary support needs included transportation and communication; family was the primary source of support. Variables associated with diabetes self-efficacy included tangible support and education. Understanding the relationship between diabetes tangible support, depression, and diabetes self-efficacy will help nurses adapt their care.
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Affiliation(s)
- Maren J Coffman
- School of Nursing, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, NC 28223-0001, USA.
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Seley JJ, Weinger K. Executive summary. The State of the Science on Nursing Best Practices for Diabetes Self-Management. Am J Nurs 2007; 107:6-11. [PMID: 17563424 DOI: 10.1097/01.naj.0000277816.84979.6f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The State of the Science on Nursing Best Practices for Diabetes Self-Management.
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Affiliation(s)
- Katie Weinger
- Center of Innovation in Diabetes Education, Joslin Diabetes Center, Boston, MA, USA.
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Abstract
This review of the literature on vulnerable populations with diabetes identifies trends, summarizes major findings, and recommends strategies to fill gaps in the state of the science. For the purposes of this article "vulnerable populations" refers to members of diverse racial and ethnic groups, people of low-income, and those who live in rural and medically underserved areas.
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Affiliation(s)
- Alexandra A García
- School of Nursing, The University of Texas at Austin, TX 78701-1499, USA.
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Abstract
OBJECTIVE To elucidate the social meanings and interpretations that immigrant women attach to the diagnosis of type 2 diabetes, and the social support and professional advice that they receive following this diagnosis. METHODS In-depth interviews were conducted with 16 immigrant women living in Melbourne, Australia, from communities with a higher than average incidence of type 2 diabetes. Women were recruited purposively through general practitioners and community organizations. The women's initial reaction to the diagnosis of diabetes, understandings of the behavioural changes required to control symptoms and prevent complications and the nature of the social and professional supports were discussed. Interviews were audio-taped, transcribed, coded and analysed thematically by both authors. RESULTS Some women were critical of their doctors but also manipulated their encounters to avoid receiving unwelcome information about the progress of the disease and consequent required changes in management. Social interactions influenced women's adjustments to diagnosis and informed their communication and adaptation of their lives. Choice of support varied by cultural background, but many respondents reflected on the thin line between support and interference. All women found most understanding from others living with diabetes. DISCUSSION The social context of people with type 2 diabetes is important in facilitating or inhibiting the management of the condition. Variations in attitudes to family and professionals influenced adherence to advice and emphasized the need for appropriate support to women to sustain behavioural change.
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Affiliation(s)
- Renata Kokanovic
- Primary Care Research Unit, Department of General Practice, School of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia.
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