2.50
Hdl Handle:
http://hdl.handle.net/10755/211511
Type:
Research Study
Title:
NURSE TELEHEALTH COACHING FOR RURAL DIABETICS: INNOVATION in CARE
Abstract:
Purpose: This study tested the benefit of nurse telehealth coaching for persons with diabetes living at home in rural communities.  This model employed a person centered approach that emphasized self-management, the techniques of motivational interviewing, and telehealth technology and compared outcomes of those receiving the telehealth intervention to those receiving usual care. Background: The incidence of diabetes in the U.S. is escalating at alarming rates.  In California, the cost of health care for individuals with diabetes is estimated to be approximately $12 billion a year which includes an estimated $3.4 billion for over 300,000 diabetes-related hospitalizations. The chronic care model emphasizes self-management and encourages persons with diabetes to take an active role in improving their health. Diabetes educators and self-management programs are scarce in rural communities, where the need is often the greatest. Methods: This study used a randomized experimental design to compare the control group receiving usual care and the intervention group receiving nurse health coaching in six rural communities. The intervention included a 2 hour orientation at the clinic, followed by a series of five phone or video contacts with participants, approximately 2 weeks apart. English- and Spanish-speaking nurses provided the coaching in the language of the participant’s choice. Self-efficacy/empowerment and satisfaction with overall care (Diabetes Empowerment Scale- Short Form and Diabetes History Form from the Michigan Diabetes Research and Training Center) were assessed at baseline and post-enrollment at 16 weeks and 9-months. A multilevel modeling approach was used for all statistical analyses.  Generalized linear mixed models were employed to estimate intervention effects while allowing appropriate control of explainable within-site correlations. Findings: The sample (n=121), included 44% women, with an average age of 59 years (SD=11.47years) and the following  ethnic background: 38% Hispanic, 62% Caucasian, 1.6% Native American, 1% Asian, and 3.3% other.  Forty-one percent had high school or less education with 43% having a college degree. From baseline to 9-months post enrollment, the intervention was associated with gains in five of eight indicators of self-efficacy (p<.05), relative to the control group.  The intervention group had increased levels of satisfaction with their diabetes care from baseline to 16 weeks and baseline to 9 months (p<.05), relative to the control group. Conclusion: Significant improvement in participant self-efficacy indicates a treatment effect with nurse health coaching. The increase in levels of satisfaction with care validates acceptability of coaching through home-based telehealth technology. This approach holds promise as an innovative way to improve health in rural communities by empowering individuals to work on goals to self-manage their diabetes. 
Keywords:
Nurse telehealth coaching; Diabetes; Rural communities
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5339
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleNURSE TELEHEALTH COACHING FOR RURAL DIABETICS: INNOVATION in CAREen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211511-
dc.description.abstractPurpose: This study tested the benefit of nurse telehealth coaching for persons with diabetes living at home in rural communities.  This model employed a person centered approach that emphasized self-management, the techniques of motivational interviewing, and telehealth technology and compared outcomes of those receiving the telehealth intervention to those receiving usual care. Background: The incidence of diabetes in the U.S. is escalating at alarming rates.  In California, the cost of health care for individuals with diabetes is estimated to be approximately $12 billion a year which includes an estimated $3.4 billion for over 300,000 diabetes-related hospitalizations. The chronic care model emphasizes self-management and encourages persons with diabetes to take an active role in improving their health. Diabetes educators and self-management programs are scarce in rural communities, where the need is often the greatest. Methods: This study used a randomized experimental design to compare the control group receiving usual care and the intervention group receiving nurse health coaching in six rural communities. The intervention included a 2 hour orientation at the clinic, followed by a series of five phone or video contacts with participants, approximately 2 weeks apart. English- and Spanish-speaking nurses provided the coaching in the language of the participant’s choice. Self-efficacy/empowerment and satisfaction with overall care (Diabetes Empowerment Scale- Short Form and Diabetes History Form from the Michigan Diabetes Research and Training Center) were assessed at baseline and post-enrollment at 16 weeks and 9-months. A multilevel modeling approach was used for all statistical analyses.  Generalized linear mixed models were employed to estimate intervention effects while allowing appropriate control of explainable within-site correlations. Findings: The sample (n=121), included 44% women, with an average age of 59 years (SD=11.47years) and the following  ethnic background: 38% Hispanic, 62% Caucasian, 1.6% Native American, 1% Asian, and 3.3% other.  Forty-one percent had high school or less education with 43% having a college degree. From baseline to 9-months post enrollment, the intervention was associated with gains in five of eight indicators of self-efficacy (p<.05), relative to the control group.  The intervention group had increased levels of satisfaction with their diabetes care from baseline to 16 weeks and baseline to 9 months (p<.05), relative to the control group. Conclusion: Significant improvement in participant self-efficacy indicates a treatment effect with nurse health coaching. The increase in levels of satisfaction with care validates acceptability of coaching through home-based telehealth technology. This approach holds promise as an innovative way to improve health in rural communities by empowering individuals to work on goals to self-manage their diabetes. en_GB
dc.subjectNurse telehealth coachingen_GB
dc.subjectDiabetesen_GB
dc.subjectRural communitiesen_GB
dc.date.available2012-02-20T11:59:25Z-
dc.date.issued2012-02-20T11:59:25Z-
dc.date.accessioned2012-02-20T11:59:25Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.