Characteristics Of Readiness To Change In Poorly Controlled Type 1 Diabetes Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/163713
Category:
Abstract
Type:
Presentation
Title:
Characteristics Of Readiness To Change In Poorly Controlled Type 1 Diabetes Patients
Author(s):
Weinger, Katie
Author Details:
Katie Weinger, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA, email: katie.weinger@joslin.harvard.edu
Abstract:
Individuals with type 1 diabetes who are in poor glycemic control are at risk for severe microvascular complications of retinopathy, neuropathy and nephropathy. In order to characterize individuals in poor glycemic control who enroll in a formal diabetes education program, we compared psychological assessments of 63 type 1 patients who entered a program geared towards improving glycemic control with 46 type 1 patient volunteers who attended the Joslin Clinic for a regularly scheduled appointment (mean age= 31(8 years vs. 32(10 years; mean diabetes duration=11(5 years vs.10(5 years; 65% vs. 47% college grad; 65% vs. 65% female; all p's=ns). All poorly controlled patients (HbA1c levels ( 8.0%) without severe complications completed the Problem Areas in Diabetes (PAID), Self-Management Problems (SMP), Hypoglycemia Fear Survey (HFS), Rosenberg Self-Esteem (RSE), modified Self-Care Inventory (SCI), Confidence in Diabetes Self-Care Scale (CIDS) and rated their understanding of self-care behaviors. Although all patients were in poor control, those who joined an educational program had higher HbA1c levels than those who did not (HbA1c=10(2%, range=8%-16% vs. 9(1%, range=8%-11%; p=0.0003.) Interestingly, using multivariate logistic regression, the final model suggests that patients enrolled in a diabetes education program to improve their glycemic control were more likely to have higher HbA1c levels and to perceive that they did not understand or adhere to their treatment plan than those not enrolling in a formal program (table 1). In addition, controlling for level of adherence, understanding, and HbA1c, those with higher diabetes related self-efficacy were more likely to join a program than those with lower self-efficacy. In conclusion, patient's motivation for improving control appear to be based on their perceptions of their self-care behaviors and interpretation of HbA1c levels. Patients in poor control are unlikely to enroll in patient education programs if they 1) misperceive treatment recommendations, 2) overestimate their understanding of their treatment plan, or 3) overestimate their ability to perform self-care behaviors. Clarification of treatment recommendations and associated self-care behaviors may be a useful starting point for nurses to help motivate patients to improve their control.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
ENRS 13th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Atlantic City, New Jersey, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleCharacteristics Of Readiness To Change In Poorly Controlled Type 1 Diabetes Patientsen_GB
dc.contributor.authorWeinger, Katieen_US
dc.author.detailsKatie Weinger, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA, email: katie.weinger@joslin.harvard.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163713-
dc.description.abstractIndividuals with type 1 diabetes who are in poor glycemic control are at risk for severe microvascular complications of retinopathy, neuropathy and nephropathy. In order to characterize individuals in poor glycemic control who enroll in a formal diabetes education program, we compared psychological assessments of 63 type 1 patients who entered a program geared towards improving glycemic control with 46 type 1 patient volunteers who attended the Joslin Clinic for a regularly scheduled appointment (mean age= 31(8 years vs. 32(10 years; mean diabetes duration=11(5 years vs.10(5 years; 65% vs. 47% college grad; 65% vs. 65% female; all p's=ns). All poorly controlled patients (HbA1c levels ( 8.0%) without severe complications completed the Problem Areas in Diabetes (PAID), Self-Management Problems (SMP), Hypoglycemia Fear Survey (HFS), Rosenberg Self-Esteem (RSE), modified Self-Care Inventory (SCI), Confidence in Diabetes Self-Care Scale (CIDS) and rated their understanding of self-care behaviors. Although all patients were in poor control, those who joined an educational program had higher HbA1c levels than those who did not (HbA1c=10(2%, range=8%-16% vs. 9(1%, range=8%-11%; p=0.0003.) Interestingly, using multivariate logistic regression, the final model suggests that patients enrolled in a diabetes education program to improve their glycemic control were more likely to have higher HbA1c levels and to perceive that they did not understand or adhere to their treatment plan than those not enrolling in a formal program (table 1). In addition, controlling for level of adherence, understanding, and HbA1c, those with higher diabetes related self-efficacy were more likely to join a program than those with lower self-efficacy. In conclusion, patient's motivation for improving control appear to be based on their perceptions of their self-care behaviors and interpretation of HbA1c levels. Patients in poor control are unlikely to enroll in patient education programs if they 1) misperceive treatment recommendations, 2) overestimate their understanding of their treatment plan, or 3) overestimate their ability to perform self-care behaviors. Clarification of treatment recommendations and associated self-care behaviors may be a useful starting point for nurses to help motivate patients to improve their control.en_GB
dc.date.available2011-10-27T11:12:31Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:12:31Z-
dc.conference.date2001en_US
dc.conference.nameENRS 13th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationAtlantic City, New Jersey, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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