Effect of Orem's self-care model on the quality of life in adolescents with diabetes type 1: A randomized clinical trial (original) (raw)
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2018
and consistent encouragement made this dissertation possible. Dr. Milligan always treated me with care and compassion and was always eager to offer support and encouragement. Dr. Jacobsen's expertise in systematic reviews made me sharpen the focus of my research. Her expeditious responses to my continuous inquiries and detailed comments on my research have contributed to my expanded understating of research. Dr. Jacobsen was always prompt in suggesting various research options whenever I was stuck. Her mentoring and encouragement made it possible for me to submit my papers for publication. Dr. Rodan's knowledge on interventional studies was invaluable during the systematic review phase of my dissertation. Her command of statistics and interventions among adolescents helped me to look at my topic with deeper understanding. Dr. Conn, an expert in field of systematic reviews and meta-analysis, taught me how to conduct a systematic review. The summer course I took with her in 2012 was instrumental in this dissertation. Her support and willingness to be a consultant on my committee is highly appreciated. v
Impact of the self-care education program on quality of life in patients with type II diabetes
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2017
Impact of the self-care education program on quality of life in patients with type II diabetes Abstract Introduction: Diabetes is an irreversible disease requiring lifetime self-care and rehabilitation. Patient education to improve their ability in administering self-care is also effective, lowering the risks of developing complications and promoting the
… journal of general …, 2011
Objective:To assess quality of life (QoL) and glycemic control in adolescents with type 1 diabetes and to investigate the impact of an educational program.Methods:A quasiexperimental study with nonrandomized experimental and control groups was conducted in which a total of 503 adolescents with type 1 diabetes completed a questionnaire using the Diabetes Quality of Life Instrument for Youth. Adolescents were then assigned to experimental and control groups. The experimental group was subjected to four 120-minute sessions of an educational program over a period of 4 months. Extracted medical chart data included the duration of diabetes, insulin dosage, and most recent hemoglobin A1c levels. Analysis of covariance was used to detect the impact of intervention.Results:The overall mean QoL score (%) was 76.51 ± 9.79, with good QoL in 38% of all adolescents. Poorer QoL was significantly associated with older age (P < 0.001), more hospital admissions in the last 6 months (P = 0.006), higher levels of depression (P < 0.001), poor self-esteem (P < 0.001), and poor self-efficacy (P < 0.001). There was significant deterioration in all domains of QoL in the experimental group after intervention. However, this deterioration was significantly less severe than in the control group. Between-group effects on total knowledge, adherence to exercise, glucose monitoring, treatment, self-efficacy, family contribution to management, glycemic control, and satisfaction with life were significantly in favor of the experimental group.Conclusion:Education intervention for adolescents with type 1 diabetes could be a safeguard against possible deterioration in QoL and glycemic control over time.
Evaluating Self-Care Practices of Children with Type 1 Diabetes Mellitus in Northern West Bank: A controlled Randomized Study Utilizing Orem- Self Care Theory, 2014
Abstract Background: Diabetes mellitus, a non-communicable disease and a major public health problem. It is a chronic disorder of metabolism characterized by partial or complete deficiency of the insulin hormone. Diabetes, which historically has been a phenomenon in older people, has now crept into the lives of young children. Self– cared diabetes involves a complex set of tasks and the key to successful management of diabetes is adherence to these tasks. Diabetes self-care education is a critical element of care for all people with diabetes and necessary to improve patient outcomes. Design: Quasi-experimental design utilized in the current study. Sample, include176 patients attending diabetic clinics of primary health care centers in Northern West Bank districts (Nablus, Tulkarem, Jenin, Tubas, Salfit, and Qalqellia). Research instrument: Two tools developed by the researchers, a structured questionnaire for participants and an observational performance checklist. First tool: A structured questionnaire developed to assess participants’ knowledge and self-care practices. Second Tool: An Observational self-care practices checklist developed by the researchers to observe self-care practices of diabetic children. Aim of the study: to assess specific knowledge of diabetes mellitus and self-care practices accompanied with observational self-care practices checklist by researchers among children with type 1 diabetes mellitus, based on Orem self-care theory a health education program was developed and administered in the targeted clinics. Procedure: the study was conducted in two phases; phase I pre-test for both the intervention and control groups. The intervention group attended health education program and the control group received routine care. After 3 months from intervention program, phase II post-test with the same tool applied for both the intervention and control groups. Results: The mean scores of diabetic knowledge in the intervention group at post-test was higher than pre-test 1.94&1.619respectively. For self-care practices was 3.53 in post-test and 2.73 in pre-test. For observational self- care practices checklist in insulin injection technique was 3.45 in post-test and 2.56 in pre-test. For blood glucose test was 3.68 in post-test and 2.84 in pre- test. For urine test for glucose and ⁄or ketones was 3.39 in post-test and 2.07 in pre-test. In addition, for hygiene care was 1.89 in post- test and 1.54 in pre-test at P. value 0.05.Conclusions: The current study indicate that the intervention program utilizing Orem's self care theory is effective in transferring diabetic children from wholly or partly compensatory to educative ⁄ supportive system to accomplish self care practices. Keywords: Type1 diabetes mellitus, Self-care practices, Children.
Interventions for self-management in adolescents with Type 1 Diabetes: a scoping review protocol
Pensar Enfermagem - Revista Científica | Journal of Nursing
Introduction: Adolescent development involves building autonomy and progressive independence from parental supervision. Challenges that are more complex when they have a diagnosis of type 1 diabetes and have to take responsibility for managing their condition. At this age, it is crucial to implement interventions to promote self-management skills in adolescents with type 1 diabetes. Objective: The aim of this scoping review is to identify and map interventions that promote self-management skills in adolescents with type 1 diabetes. Methods: The methodology will follow the Joanna Briggs Institute recommendations for scoping reviews. Studies published in English, Portuguese and Spanish between 2009-2021 will be considered, with no geographical or cultural limitations. The process of data analysis, extraction, and synthesis will be performed by two independent reviewers, based on the inclusion criteria. The results of the study selection will be presented in a Preferred Reporting Items...
Journal of Diabetes Research
Background. Type 2 diabetes mellitus (T2DM) accounts for approximately 95% of all diabetes cases, making the disease a global public health concern. The increasing prevalence of T2DM has highlighted the importance of evidence-based guidelines for effective prevention, management, and treatment. Diabetes self-management education (DSME) can produce positive effects on patient behaviors and health status. Study objective. We synthesized findings from the existing studies to find out whether or not the impact of DSME on patient health behaviors and outcomes differ by the different models of diabetes care. That is, we determined whether there are differences in DSME outcomes when patient’s care provider is a general practitioner, a specialist, a nurse, or a combination of these health professionals. Methods. Searches were made of six electronic databases to identify relevant English language publications on DSME from 2000 through 2019. Titles and abstracts of the search results were scr...
A New Self-Report Measure of Self-Management of Type 1 Diabetes for Adolescents
Nursing Research, 2009
Background-The development of instruments to measure self-management in youth with type 1 diabetes has not kept up with current understanding of the concept. Objective-To report the development and testing of a new self-report measure to assess selfmanagement of type 1 diabetes in adolescence (SMOD-A). Methods-Following a qualitative study, items were identified and reviewed by experts for content validity.
Testing Components of a Self-management Theory in Adolescents with Type 1 Diabetes Mellitus
2014
Advances in treatment technology and the importance of obtaining normoglycemia in order to prevent or delay complications associated with Type 1 Diabetes Mellitus (T1DM) has shifted much of the emphasis of diabetes self-management (SM) onto the adolescent and his or her family. The primary responsibility for managing T1DM in childhood is with the parent whereas during adolescence, increasing levels of responsibility for SM are transferred to the adolescent. This study examined the relationships of key context and process variables on proximal (self-management behaviors [SMB]) and distal outcomes (metabolic control and diabetes-specific healthrelated quality of life [DQOL]) from the Individual and Family Self-management Theory (IFSMT) in a cohort of adolescents with T1DM. The aims in this correlational, crosssectional study included testing components of the IFMST by examining relationships among select context, process, and outcome variables thought to contribute to effective SMB in adolescents with T1DM and determining whether SMB mediated the relationship iii of IFSMT process variables on metabolic control and DQOL. Families were recruited from an ambulatory diabetes clinic in a Midwestern children's hospital. Participants included 103 adolescent-parent dyads (adolescents aged 12-17 years with T1DM) from an outpatient diabetes clinic. The dyads each completed a self-report survey including instruments intended to measure study variables from the IFSMT. Using hierarchical multiple regression, context (depressive symptoms) and process (communication) variables explained 37% of the variance in SMB. Regimen complexity and depressive symptoms explained 11% of the variance in metabolic control. Only regimen complexity was significant at Step 1. Neither of the regression steps adding process variables or SMB were significant. For DQOL, context (depressive symptoms) variables explained 26% of the variance at Step 1, 36% of the variance when process (self-efficacy and communication) variables were added at Step 2 and 52% of the total variance was explained when SM behaviors were added at Step 3. In the final model, three variables were significant: depressive symptoms, self-efficacy, and SMB. The criteria for mediation of SMB by the process variables were not met. IFSMT served as a cogent model for understanding key concepts, processes, and outcomes essential to SM in adolescents and families dealing with the complex disease, T1DM.
Trials, 2014
Providing care for adolescents with type 1 diabetes is complex, demanding, and often unsuccessful. Guided self-determination (GSD) is a life skills approach that has been proven effective in caring for adults with type 1 diabetes. To improve care, GSD was revised for adolescents, their parents, and interdisciplinary healthcare providers (HCP) to create GSD-Youth (GSD-Y). We evaluated the impact of GSD-Y after it was integrated into pediatric outpatient visits versus treatment-as-usual, focusing on glycemic control and the development of life skills in adolescents with type 1 diabetes. Seventy-one adolescents (mean age: 15 years, mean duration of diabetes: 5.7 years, mean HbA1c: 77 mmol/mol (9.1%), upon entering the study) from two pediatric departments were randomized into a GSD-Y group (n = 37, GSD-Y was provided during individual outpatient sessions) versus a treatment-as-usual group (n = 34). The primary outcome was the HbA1c measurement. The secondary outcomes were life skills d...
Factors Associated with Self-Management in Adolescents with Type 1 Diabetes
Advances in Nursing & Midwifery, 2018
Introduction: Diabetes is one of the most common chronic diseases that is also highly prevalent among adolescents. The present study was conducted to determine the relationship between demographic characteristics and self-management in adolescents with type 1 diabetes. Methods: This descriptive-analytical study was conducted on 426 adolescents with type 1 diabetes aged 13 to 18, and diagnosed for at least one year. The research tools included a demographic information form covering the patients’ personal, family, and health details, and the Self-Management of type 1 Diabetes in Adolescence (SMOD-A) with five subscales of collaboration with parents, diabetes care activities, diabetes problem-solving, diabetes communication, and diabetes goals. The content validity of the measure was then evaluated by a group of experts and found to be acceptable (SCVI = 98%). In the assessment of the measure›s reliability, the intraclass correlation showed an overall Cronbach’s alpha of 0.88. The tes...