Diabetes self-management education program (DSME) among adolescents with type 1 diabetes mellitus

@#<p style="text-align: justify;">The DSME program is aimed to educate adolescents about diabetes mellitus: disease process, survival skills, exercise management, drug management, diet management, prevent acute and chronic complications and optimize quality of life. This study utilized the quasi experimental pre and post-test design involving 15 adolescent patients with Type 1 Diabetes Mellitus. The DSME materials were composed of five modules that included topics in diabetes awareness, survival skills, exercise, drug and diet management. Knowledge, Fasting Blood Sugar (FBS), Random Blood Sugar (RBS) and waist and hip ratio (WHR) were tested. The Intervention phase was implemented in three months where each module was completed by patients in two weeks. Pre and post-test examinations were done after each module. Participants have very satisfactory knowledge in diabetes awareness, survival skills, exercise, drug management before and after the DSME program. However, participants knowledge in diet management were unsatisfactory before and after the DSME program. FBS were high but RBS levels and WHR were in normal levels before, during and after the DSME program. Knowledge scores were significantly different before and after the implementation of all the modules (Module 1 to Module 5) to the participants. RBS results were significantly different after the implementation of the Module 1- DM awareness and Module 5- diet management. However, no significant differences were obtained in the RBS results of the participants after the implementation of Module 2, 3, 4, and 5. No significant differences were also obtained in the WHR parameters of the participants in each of the implementation of DSME. No significant differences in the FBS results were obtained after the implementation of the DSME modules. The module type DSME is effective in increasing knowledge of the adolescent patients in diabetes and its management. The content of the diet management module needs to be strengthened and be tested again for its effectiveness in increasing knowledge of adolescent patients.</p>

Assessment of health care needs of older persons with type 2 diabetes mellitus

The global prevalence of diabetes by 2030 estimated an increase in number of people with diabetes. People who are 64 years of age will be 82 million in developing countries and 48 million in developed countries. The study aimed to assess the health care needs of older persons' physical, cognitive, functional and self-care abilities and determine relationship of these to their profiles. These assessments are the bases in designing modules for Diabetes Self-Management Education training module for Diabetes Educators. A descriptive correlational design was utilized to assess the health care needs of 100 young older persons. The Filipino Activities of Daily Living (Fil-ADL) and the Filipino Instrumental Activities of Daily living were utilized to assess the functional status of the older persons. The Montreal Cognitive Assessment (MOCA-P) and cognitive function exams were used to assess cognitive status while Mini- Nutritional Assessment (MNA) was used to assess nutritional status of the older persons. The Self-Care Inventory Revised (Sci-R) was used to assess self-care behaviors of older persons to diabetes management. Frequency and percentage were used to describe the health care needs of older persons, while mean and standard deviation were used in assessing knowledge and self-care abilities. Chisquare test for Association was utilized to determine relationship of the health care needs and the profile of the respondents. Study shows that most of the older persons are female, 66-70 years old, married and had primary education. The older persons' knowledge in diabetes is satisfactory, had a normal nutritional status, was functional in daily living activities (ADL), was functional in their instrumental activities of daily living (IADL), was normal of their cognitive status, and sometimes perform self-care abilities to diabetes management. There is significant relationship between knowledge, civil status and history of diabetes. Nutrition and cognitive status had significant relationship to their civil status, education and history of diabetes. The functional status of the older persons has significant relationship with history of diabetes. It is necessary to include the culture-based health care needs of older persons and to consider demography such as education and history of diabetes in designing the training module for diabetes educators.

Pressure ulcer prevention in acute care using the pressure ulcer bundle of care

@#<p style="text-align: justify;">A study was conducted to determine the effectiveness of the pressure ulcer bundle of care (PUB) in preventing pressure ulcers among patients in acute care. The pre and post-test quasi-experimental design was utilized to predict a model of preventing pressure ulcer in acute care setting. Thirty acute care patients with moderate risk for pressure ulcers were randomly selected to receive the following five PUB interventions: assessment of pressure ulcer risk, repositioning, head elevation, heel elevation, and frequent diet monitoring. Pressure ulcer risk was assessed using the Braden risk assessment scale before and after PUB interventions. This scale assesses important aspects of ulcer formation according to six subscales: sensory perception, moisture, mobility, physical activity, nutrition, and friction/shear. Profile of the patients according to age, sex, and length of hospital stay was described using frequency and percentage distribution. Bundle compliance, as measured by performance of the five interventions was described using mean scores and standard deviations. The t-test was used to determine the differences in pressure ulcer risk or occurrence between pre- and post-intervention phases. Multiple linear regression analysis was used to determine the relationship of Pressure Ulcer Risk Assessment  Scores (PURAS) to the PUB, and to identify the predictor(s)  of PURAS among the four interventions in the PUB. Statistical significance was considered at the .05 level. Pressure ulcer risk scores of patients improved significantly from "mild risk" to "not a risk" post-PUB (p=<0.001). Head elevation, heel elevation, and diet monitoring were found to be predictors of pressure ulcer risk scores after PUB interventions. Repositioning was not significantly associated with pressure ulcer risk scores of patients after PUB interventions. The three predictor model revealed the PUB interventions were able to account for 52% of the variance in pressure ulcer risk scores, which indicates a strong significant relationship between patients receiving PUB and their improvement in pressure ulcer risk. In conclusion, the pressure ulcer bundle of care intervention is effective in prevention of pressure ulcers in patients at risk. Nurses should adopt the provision of bundle of care intervention(s) to enhance patient safety and quality of care.</p>

Level of awareness and compliance in diabetes mellitus management among adolescents diagnosed with type-1 diabetes

@#<p style="text-align: justify;">The study aimed to determine the level of awareness and to assess compliance to Diabetes management of adolescents diagnosed with Type-1 Diabetes. A descriptive correlational type of research was utilized to gather information on the level of awareness and compliance of adolescents patients to diet, exercise and drug management suffering from Type-1 diabetes mellitus. The patients (n=20) were recruited from Institute for Studies on Diabetes Foundation Incorporated, Philippines. A purposive sampling was utilized to select twenty adolescents. A researcher-made questionnaire was utilized as the main instrument in gathering data. Focus group discussion was also done to further assess patient's level of awareness and compliance to diabetes management. Results showed that patients have a moderate level of awareness and some extent of compliance to diabetes. Patients have extreme awareness in diet management and moderate awareness in exercise and drug management. In terms of compliance, patients are compliant to some extent only, while drug management has the highest highest level of compliance, followed by exercise and diet. There is a low correlation between level of awareness and compliance in diabetes management (r=.32 p=0.15), indicating that the moderate level of awareness of patients to DM management is not related to their compliance. The results are limited only to the participants of the study. Further study using a larger population and different setting is recommended. Nurses taking care of adolescent patients with diabetes mellitus must understand the importance of health education. Health educations are valuable to increase level of awareness and extent of compliance of adolescents patients with Type-1 diabetes.</p>