ABSTRACT
The purpose of this study was to evaluate the effects of guided reflection on self-care behaviors, confidence scores, and diabetes knowledge among adults with diabetes. A randomized controlled trial with a pre/posttest design was used to generate data from a convenience sample of 62 adults with diabetes recruited from a single site. After viewing a 30-minute video on how to manage diabetes, participants were randomized to a control group (CG) (usual care) or an intervention group (IG). The IG further engaged in a reflection educational session. For 8 weeks, the IG isolated diabetes-related events weekly, critically analyzed them using Gibbs's reflective questions, and recorded their analysis in a journal. They also shared their perspective relative to using the journal in an audiotaped interview. Main measures included baseline and 8-week clinical outcomes (self-care maintenance, monitoring, management, and confidence scores and diabetes knowledge scores) and intervention acceptability. Compared to the CG, the IG had no statistically significant difference in self-care measures over time, although scores trended in the anticipated direction. Importantly, both groups had statistically significant improvement in self-care scores. Furthermore, there was statistically significant improvement in diabetes knowledge among IG participants. Informatively, IG critically analyzed 147 diabetes-related events concentrating on blood glucose, diet, exercise, monitoring, medication, sleep pattern, and health care visits. Participants found the guided reflection activity highly acceptable. Combined educational and reflection interventions are effective approaches for improving self-care outcomes and diabetes knowledge among adults with diabetes. Research concentrating on purposeful patient reflection is warranted in a larger sample paying careful attention to study limitations.
Subject(s)
Diabetes Mellitus/therapy , Imagery, Psychotherapy/methods , Patient Education as Topic/methods , Self Care/methods , Adult , Audiovisual Aids , Diabetes Mellitus/psychology , Female , Humans , Male , Middle Aged , Self Care/psychology , Treatment OutcomeABSTRACT
Diabetes mellitus is the seventh leading cause of death in America and affects 382 million people worldwide. Individuals with diabetes must manage the complexity of the disease, its treatment, and complications to avert deleterious consequences associated with the illness. However, not all patients with diabetes successfully gain mastery to positively impact self-management. A new middle-range theory is proposed that merges 2 extant theories, theory of mastery and organismic integration theory, to better understand this human response. The theories' philosophical, theoretical, and conceptual perspectives were examined and relational properties synthesized to provide a conceptual representation of the phenomenon of interest.
Subject(s)
Adaptation, Psychological , Attitude to Health , Diabetes Mellitus/psychology , Diabetes Mellitus/therapy , Disease Management , Motivation , Self Care/psychology , Female , Humans , MaleABSTRACT
PURPOSE/AIMS: The purpose of this study was to describe the healthcare experiences of lesbian, gay, and bisexual college students (ages 18-24 years) in the local college community. A specific aim of the study was to describe the factors (eg, healthcare system, patient, provider, clinical encounter) that influence this experience. DESIGN: This qualitative descriptive study used a community-based participatory research approach. SETTING: This study was conducted at a local college consortium in New England that consisted of 13 private and public colleges and universities. SAMPLE: A total of 19 college students who self-identified as lesbian (n = 7), gay (n = 7), and female bisexual (n = 4) were included. The mean (SD) age of the sample was 20.7 (1.2) years (range, 19-24 years), and the mean (SD) number of completed college years was 2.4 (1.2) (range, 1-5). METHODS: Three online synchronous focus groups were conducted. RESULTS: Qualitative content analysis revealed 1 overarching theme (not all the same), 1 main theme (comfort during the clinical encounter), and 3 subthemes (personalizing the clinical encounter, deciding to disclose and social stigma, and seeking support of self-identified sexual orientation). CONCLUSIONS: Participants provided recommendations that are helpful to clinical nurse specialists to promote positive clinical encounters. Implications for clinical nurse specialist practice and recommendations for further research are addressed.
