Year of Publication

2013

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Karen Stefaniak

Clinical Mentor

Dr. Sharon Denham

Committee Member

Dr. Leslie Scott

Abstract

Purpose: The purpose of this study was to see if education and counseling of the Appalachian individual with diabetes and a family member/friend would improve knowledge of the disease and self-efficacy of the patient in regard to their diabetes care.

Setting: The setting was one of eight primary care offices of Our Lady of Bellefonte Hospital, Bon Secours, located in the Ashland, Kentucky.

Design: A pilot study of descriptive, comparative design was used.

Subjects: Data were collected from a convenience sample of patients with type 2 diabetes (n=15) that were established at the primary care office and their family members/friends (n=15).

Measurements: The Diabetes Knowledge Tests (DKT), the Diabetes Empowerment Tests (DES-SF) and the Thai Family Function Tests were used to assess the subjective variables of interest. A chart review of the standard office visit was reviewed and objective metabolic outcomes, such as weight, blood pressure (systolic and diastolic), lipids (total cholesterol and triglycerides), pulse, and glycohemoglobin were extracted and recorded. All measurements were evaluated pre-education and post-education. Demographic and clinical characteristics were obtained from all participants.

Results: Thirty participants, consisting of patients with type 2 diabetes (n=15) and family members/friends (n=15), completed the study with pre-education and three month post-education results. Increases in diabetes knowledge, improvement in self-efficacy and increased family function were noted; however, there was no indication that a higher family function score would relate to a higher level of diabetes knowledge, a greater improvement of self-efficacy or improvement in metabolic outcomes. Although the test regarding self-efficacy (p=0.188) was not statistically significant p-value >0.05, it was clinically significant as evidenced by the results of the metabolic testing. The family function score (p=0.016) and diabetes knowledge (p=0.035) were statistically significant p-value

Conclusions: Results of the pilot study indicated positive changes in diabetes knowledge, self-efficacy and family function, as well as the majority of metabolic outcomes. Families with higher family functioning scores did not appear to have higher scores measuring diabetes knowledge or self-efficacy at the initiation of the study. Those families with higher family functioning scores showed no greater improvement in diabetes knowledge or self-efficacy scores than those families with lower family functioning scores at the conclusion of the study. This pilot study did not support inclusion of family in the educational process or disease management, but will support the use of a structured diabetes educational plan in the family practice setting to promote patient collaboration and outcomes. This study offers patients and their family members/friends education on maintenance and preventive measures, encouraging them to lead a healthy lifestyle, maintain their current health and prevent expensive complications, therefore reducing healthcare costs.

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