Power and self-perceived health in blind diabetic and nondiabetic individuals

Health Literacy and self-care among visually impaired people with type 1 diabetes in Denmark

AIMS

The aim of this study was to investigate health literacy and self-care among visually impaired people with type 1 diabetes in Denmark.

METHODS

Survey data from 1425 Danes with type 1 diabetes were categorised in two groups according to visual status: visually impaired ( n = 38) and sighted ( n = 1387). Using the Health Literacy Questionnaire and the Summary of Diabetes Self-Care Activities Scale, health literacy and self-care activities were assessed. Visually impaired respondents were compared to sighted respondents using t-tests and chi-squared tests.

RESULTS

Visually impaired people were older, had higher diabetes duration and were more likely to live alone. Also they had a significant lower level of health literacy on two key dimensions of health literacy ('Ability to find good health information' and 'Understanding health information well enough to know what to do'), they monitored blood sugar less frequently than people that were sighted but had better self-care regarding feet examination.

CONCLUSIONS

Visually impaired people with type 1 diabetes are less able to find and understand health information than sighted people with type 1 diabetes. Our findings indicate need for interventions to promote better self-care and health literacy among visually impaired people with diabetes.

The Relation of Meditation to Power and Well-Being

The purpose of this research is to examine the relation of meditation to power and well-being in Korean adults. Using a quasi-experimental design, meditation was provided through a chakra meditation music program over a 4 week period. The Power as Knowing Participation in Change Tool and the Well-Being Picture Scale were used, after being translated into Korean. Statistically significant interaction effects of power and group (p < .001), and well-being and group (p < .05) were found. Meditation has a potential to facilitate power and well-being in the human and environmental field patterning process.

Quality of life, impaired vision and social role in people with diabetes: a multicenter observational study

Diabetic retinopathy may induce visual impairment. We evaluated vision-related quality of life in patients with visual acuity <5/10 in the better eye induced by retinopathy using the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25). The NEI VFQ-25 was self-administered to 196 patients in 3 Italian centres (A, B and C; n = 64, 61 and 71, respectively) dedicated to DR screening and treatment. Patients in the 3 centres did not differ by age, gender, occupation and diabetes duration. Multivariate analysis demonstrated that reduced visual acuity was associated with decreased scores for General Vision, Near Activities, Distance Activities, Visual-Specific Social Functioning, Mental Health, Role Difficulties and Dependency, Driving, Colour Vision and Peripheral Vision (p < 0.01, all). Treatment by photocoagulation was associated with reduced scores in General Health (-8.3; p = 0.002), General Vision (-7.2; p = 0.001), Visual-Specific Role Difficulties (-8.8; p = 0.015) and Driving (-13.7; p = 0.003). Centre affiliation was associated with different scores for General Health, Ocular pain, Distance Activities, Visual-Specific Social Functioning and Role Difficulties and Peripheral Vision. Women had higher scores for General Vision (p = 0.015), Near Activities (p = 0.005), Distance Activities (p = 0.006), Visual-Specific Social Functioning (p = 0.03), Visual-Specific Mental Health (p = 0.035) and Colour Vision (p = 0.012). Diabetic retinopathy and vision loss modify the way people perceive their own ability to function autonomously. More data should be collected to confirm this interpretation and to guide the development of more appropriate settings to improve approach and support to patients.

A reflective case for valuing nurse practitioners in ophthalmology clinics

Following recent publicity regarding the downgrading of specialist nurses and nurse practitioners (NPs) in an effort to balance the books, a reflective article has been compiled using Driscoll's reflective model in order to assess the value of using NPs in medical-retinal ophthalmology clinics. From reflection on a case study and review of the literature, it appears that nurses trained in this speciality with sufficient cognitive and practical knowledge and experience could positively affect both the smooth running of eye clinics and the psychological outcome for patients long-term. Strategies are currently being considered to restructure skill mix within the clinics to facilitate this change in traditional working practice.

Sense of coherence and power among people with blindness caused by diabetes

The aim of the present study was to analyze whether strong sense of coherence (SOC) or power or the combination of strong SOC and power was related to blind diabetic patients' self-perceived health, burden of diabetes, glycaemic control and self-care among blind people. In some variables we wanted to compare subjects with diabetes-related blindness with people who were blind for other reasons than diabetes. The present descriptive study included 39 blind subjects from three ophthalmic outpatient clinics who agreed to participate; 23 were blind due to diabetes and 16 were blind for other reasons. Power was explored during semi-structured interviews, SOC was measured with the SOC-scale and burden of diabetes with semantic differential in diabetes (SDD) questionnaires. A single Likert scale (EVGFP) was used to measure self-perceived health. Participants with the combination of strong SOC and power perceived better health, experienced less burden of diabetes and had better glycaemic control than those with the combination of weak SOC and non-power. Nearly all participants with diabetes experienced problems with self-care, especially with the insulin treatment. The results highlight the importance of education that increases SOC and power as well as developing visual aids that assist blind people with diabetes in different self-care situations.

A qualitative study of Iranian nurses' understanding and experiences of professional power

BACKGROUND: Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. Some researchers have emphasized that understanding the concept of power is an important prerequisite of any empowerment program. While many authors have tried to define the concept of power, there is no comprehensive definition. This paper is an attempt to clarify the concept of power in nursing. It also would present a model describing the factors affecting nurse empowerment. METHODS: We chose the grounded-theory approach for analysis of the participants' experiences and their viewpoints regarding the concept of professional power in nursing. Semi-structured interviews and participant observation methods were used to gather the data. Forty-four participants were interviewed and 12 sessions of observation were carried out. The constant comparative analysis method was used. RESULTS: Six main themes emerged from the data: "Application of knowledge and skills", "Having authority", "Being self-confident", "Unification and solidarity", "Being supported" and "Organizational culture and structure". According to the participants, nurses' power is influenced by these six variables. A theoretical model was designed to represent the interrelationships between these six variables. CONCLUSIONS: Nurses' power depends on gaining and applying professional knowledge and skills. Delegating authority and enhancing self-confidence of the nurses also help them to apply their knowledge in practice. Unification of the nurses and their mutual support play the key roles in development of their collective power and provide a base for better working conditions, professional independence and self-regulation.

Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing

AIM

This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed.

BACKGROUND

Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable.

DISCUSSION

The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. REVIEW LIMITATIONS: This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s).

CONCLUSION

Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples.