The experience of weight management in normal weight adults.

BACKGROUND: No prior research has been done with normal weight persons specific to their experience of weight management. PURPOSE: The purpose of this research was to discover the experience of weight management in normal weight individuals. METHOD: Glaserian grounded theory was used. Qualitative data (focus group) and quantitative data (food diary, study questionnaire, and anthropometric measures) were collected. DISCUSSION: Weight management was an ongoing process of trying to focus on living (family, work, and social), while maintaining their normal weight targets through five consciously and unconsciously used strategies. Despite maintaining normal weights, the nutritional composition of foods eaten was grossly inadequate. CONCLUSIONS: These five strategies can be used to develop new weight management strategies that could be integrated into existing weight management programs, or could be developed into novel weight management interventions. Surprisingly, normal weight individuals require dietary assessment and nutrition education to prevent future negative health consequences.

Weighing in on the body knowledge questionnaire: initial development and pilot testing.

PURPOSE: The purpose of this research was to develop and pilot test the Body Knowledge Questionnaire (BKQ), an instrument that measures weight management integration, and to determine its reliability and validity. METHODS: The 27 items of the BKQ were developed through review of the literature on integration and weight management/obesity. The resulting BKQ was pilot tested with 4 groups of individuals with and without type 2 diabetes. Exploratory factor analysis was used to assess the construct validity of the BKQ, and discriminant function analysis and logistic regression were used to establish criterion-related validity. Scale reliability analysis was used to determine the internal consistency of the BKQ and its subscales. RESULTS: Exploratory factor analysis yielded a 2-factor solution, with factor loadings that were fair to excellent (.45-.81). Discriminant function analysis determined that the BKQ subscales could accurately predict the classification of participants into normal- and obese-weight groups. Results of the logistic regression showed that the BKQ could reliably distinguish between normal- and obese-weight participants. Internal consistency of the overall BKQ was .87, .89, and .73 for the subscales, Food Centricity and Psychosomatic Awareness. CONCLUSIONS: This research provided preliminary evidence of the validity (content, construct, and criterion) and reliability (internal consistency) of the BKQ. With additional psychometric testing, the BKQ instrument has great potential for use in weight management practice areas, such as diabetes education, dietetics, nursing, and psychology, for use in individual or group weight management programs and program evaluation; or in the development of novel weight management interventions.

Integration: a phenomenon to explore in chronic nonmalignant pain (CNP).

The concept of integration has been identified as an ongoing process occurring between a diagnosis of illness and subsequent physical and emotional healing. Integration has been explored in a variety of illness populations, such as Crohn disease, diabetes, and cardiac rehabilitation. It has also been posited as a useful concept to investigate in other chronic conditions, such as mental illness and weight management. However, integration has not been explored in the field of chronic pain. The purpose of this paper was to provide an overview of the strategies taken to examine the utility of integration as a concept in the field of chronic nonmalignant pain (CNP). Various comparisons were conducted between published qualitative studies examining the lived experiences of individuals with CNP and the theory of integration. These comparisons affirmed the significance of integration as a concept to be explored in the field of CNP. The resulting recommendation is for the continued investigation of the integration process, including development of a valid and reliable tool to measure CNP integration.

Getting grounded: using Glaserian grounded theory to conduct nursing research.

Glaserian grounded theory is a powerful research methodology for understanding client behaviour in a particular area. It is therefore especially relevant for nurse researchers. Nurse researchers use grounded theory more frequently than other qualitative analysis research methods because of its ability to provide insight into clients' experiences and to make a positive impact. However, there is much confusion about the use of grounded theory.The author delineates key components of grounded theory methodology, areas of concern, and the resulting implications for nursing knowledge development. Knowledge gained from Glaserian grounded theory research can be used to institute measures for enhancing client-nurse relationships, improving quality of care, and ultimately improving client quality of life. In addition, it can serve to expand disciplinary knowledge in nursing because the resulting substantive theory is a middle-range theory that can be subjected to later quantitative testing.

Student articulation of a nursing philosophical statement: an assignment to enhance critical thinking skills and promote learning.

The development of a personal philosophical statement about nursing is a useful assignment for both undergraduate and graduate nursing students. Students are asked to write a paper describing their philosophical views about nursing related to the metaparadigm concepts and include in-depth examples from their clinical practice to illustrate these views. This article includes information regarding important preparatory activities and handouts to facilitate the writing and evaluation of this assignment. There are many potential benefits of this complex assignment. It promotes students' reflection on their personal clinical practice experiences and engages students in mental and verbal dialogue that elicits their philosophical ideas about the metaparadigm concepts. These activities promote critical thinking and reflective clinical practice, act as a foundation for building theoretical understanding, and promote confidence in learning about nursing and other theories.

Evaluation of a self-awareness intervention for adults with type 1 diabetes and hypoglycemia unawareness.

The purpose of this prospective before-and-after study was to determine whether there are psychosocial and physical benefits of a self-awareness intervention for adults with type 1 diabetes and hypoglycemia unawareness (HU). A total of 29 adults participated in the self-awareness intervention of 8 sessions, each lasting 3 hours. Psychosocial (integration, diabetes quality of life) and physical (number of body cues, HU-related events, HbA1c) measures were taken at baseline and at 6, 12, and 18 months post-intervention. Post-intervention the participants detected more cues of euglycemia and hypoglycemia and experienced significant increases in integration and metabolic control (HbA1c). The number of HU-related events was not decreased and diabetes quality-of-life results were unstable. A self-awareness intervention can have physical and psychosocial benefits and has implications for diabetes education. This intervention needs to be tested in a multi-centre randomized control trial.

Choosing and using citation and bibliographic database software (BDS).

The diabetes educator/researcher is faced with a proliferation of diabetes articles in various journals, both online and in print. Keeping track of cited references and remembering how to cite the references in text and the bibliography can be a daunting task for the new researcher and a tedious task for the experienced researcher. The challenge is to find and use a technology, such as bibliographic database software (BDS), which can help to manage this information overload. This article focuses on the use of BDS for the diabetes educator who is undertaking research. BDS can help researchers access and organize literature and make literature searches more efficient and less time consuming. Moreover, the use of such programs tends to reduce errors associated with the complexity of bibliographic citations and can increase the productivity of scholarly publications. The purpose of this article is to provide an overview of BDS currently available, describe how it can be used to aid researchers in their work, and highlight the features of different programs. It is important for diabetes educators and researchers to explore the many benefits of such BDS programs and consider their use to enhance the accuracy and efficiency of accessing and citing references of their research work and publications. Armed with this knowledge, researchers will be able to make informed decisions about selecting BDS which will meet their usage requirements.

Choosing and using theories in diabetes education research.

Diabetes educators use theories all the time, even if they are not aware of it. To teach, one must have some assumptions about how people learn and what constitutes effective teaching. The purpose of this article is to help diabetes educators interested in research and evaluation choose appropriate theories. The article will review the 4 purposes of theories, that is, description, explanation, prediction, and control, as well as the degree to which a theory has been articulated and elaborated. The importance of a theory's personal resonance, its explanatory power, and its utility will also be examined. The article will also review how to use 1 or more theories at each stage of a research or evaluation project.

Evaluation of a self-awareness education session for youth education with type 1 diabetes.

This research sought to determine if a one-hour education session about self-awareness had any short-or long-term impact on young participants with Type 1 diabetes. The study was conducted within Hernandez' (1991) theory of integration. Twenty-nine adolescents and young adults participated in the intervention, which was operationalized through the collaborative alliance educational method. The intervention consisted of viewing a videotape on self-awareness and participating in discussion of cues of low, high, and normal blood glucose as well as the situations that cause these. Questionnaires were completed pre-education, immediately following education, and 12 months later. The number of cues identified for all levels of blood glucose was significantly increased by the intervention. Many of the body cues identified by participants were different than those typically presented in diabetes education materials and programs. Participants identified issues regarding changes in body cues over time, frequency of classic signs of hypoglycemia, and the frequency of severe lows. Findings have implications for the content, delivery method, and educational materials of diabetes education programs.

Six-month evaluation of a diabetes self-awareness intervention.

The purpose of this pilot study was to evaluate the effectiveness of a self-awareness intervention in promoting increased awareness of body cues associated with various levels of glycemia and in enhancing well-being in persons with Type I diabetes and hypoglycemia unawareness. Study results indicated that participants could identify more cues of normal blood glucose; experienced fewer blood glucose levels below 3.5 mmol/L, fewer hypoglycemia unawareness-related events, and improved glycemia; but reported lower diabetes quality of life. The self-awareness intervention represents an innovative theory-based approach for helping clients with Type I diabetes and hypoglycemia unawareness to achieve positive health outcomes.