This study aimed to provide directions and implications for a future program by analyzing studies on diabetes programs from 2000 to 2020. Among the studies with control and experimental groups, the selected studies included ones that provided intervention to patients with diabetes and ones that contained descriptive statistics. Sixteen studies were selected to verify the effectiveness and homogeneity of the data coding meta-analysis. The overall effect size in the diabetes program combined estimate was 0.398 (95% CI: 0.268, 0.425, p=0.000). Among the dependent variables, fasting blood glucose (-0.616) and glycated hemoglobin (-0.442) showed median effect sizes, but the effect of fasting blood glucose was not statistically significant. In terms of the study design, non-randomized control trials (NRCTs) (-0.543) was more effective than randomized control trials (RCTs) (0.719). Among, the counseling and self-management program (-3.241) showed a very large effect size. Furthermore, the cognitive-behavioral (-0.828) and self-management (-0.482) programs were also found to have a positive effect on lowering fasting blood glucose. As the importance of diabetes management increases, further studies based on RCT should be actively performed, and differentiated and specialized diabetes intervention plans need to be established.
Purpose: The purpose of this study was to investigate the effects and characteristics of health care programs for pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: This study was conducted according to the Cochrane Collaboration's systematic literature review handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. We searched eight international and domestic electronic databases for relevant studies. Two reviewers independently selected the studies and extracted data. For each study, information on the research method, participants, characteristics of the program, and results were extracted using a previously established coding table. The National Evidence-based Healthcare Collaborating Agency's risk of bias assessment tool for non-randomized studies was used to assess the risk of bias of the included articles. A qualitative review of the selected studies was performed because the interventions differed considerably and the measured outcomes varied. Results: Out of 128 initially identified papers, seven were included in the final analysis. The risk of bias was evaluated as generally low. Health care programs for pregnant women with GDM showed positive effects on blood glucose control. Anxiety and depression were reduced, and self-management and self-care behavior, self-efficacy, and maternal identity improved. Conclusion: Our study provides clinical evidence for the effectiveness of health care programs for pregnant women with GDM, and its results can be used to support the development of health care programs for GDM. More well-designed research is needed on GDM, especially studies that deal with emotional stress and apply a family-oriented approach.
Objectives: Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia. Methods: The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients' registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies. Results: Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants' recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions. Conclusions: Patients' main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.
Minority populations in the United States have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and more persons die of the disease than white persons. This study was to review and compare risk factors and prevalence rates of NIDDM in African Americans, Hispanic s, Korean Americans and Native Americans in the United States. The risk factors of NIDDM, including family history of diabetes, obesity, physical inactivity, diet and age, were reviewed in the minority populations. Risk factors such as obesity, physical inactivity and family history of diabetes occurred to a greater extent in some minority populations than in the white population. Diabetes should be treated as a public health problem for minority populations. Due to the increase of older populations and the increased prevalence of obesity and sedentariness, NIDDM in minorities is nearing epidemic proportions. Good diet and regular exercise can reduce the incidence of NIDDM but an understanding of the cultural aspects of diabetes is imperative in order to provide adequate community health education programs because those programs involve diet and behavior changes, characteristics that are often culturally determined. In summary, it is important to plan a community health education program targeted on NIDDM in a culturally adapted manner that will be received with both comprehension and acceptability. In particular, the program for high-risk populations should be stressed so to prevent diabetes. Preventive approaches to diabetes should be considered because they can be both therapeutic and cost effective.
This research was a review and analysis of published articles and theses in Korea on Intervention Programs for patients with Diabetes Mellitus. A comprehensive search of databases was undertaken(Korean studies, Riss4u). using research terms such as"diabetes", "diabetes and education" "diabetes and exercise", "diabetes and intervention", "diabetes and education or exercise." 53 studies were analyzed focusing on type, application method, dependant variable and effect using descriptive statistics. 8 intervention type and 113 dependant variables were used. The most frequently used applied education and counseling and glycometabolism, self-care, self-efficacy the most frequently used dependant variable. The effects of dependant variables no effect or were different effects. Further reserarch in the digital convergence should requires the consideration of Structured content and exercise and the effect of the measurement variables, including the psychological variable effect.
Purpose: The purpose of this study was to identify predictors of eating disorders in adolescents with type 1 diabetes, with the goal of providing data in support of nursing interventions to improve their health. Methods: A total of 136 adolescents aged 13-18 years with type 1 diabetes completed the Diabetes Eating Problem Survey-Revised, Rosenberg Self-Esteem Scale, and the Beck Depression Inventory-II, using structured self-reported questionnaires. The collected data were analyzed using the t-test, $x^2$ test, and binominal logistic regression with SPSS version 23.0 for Windows. Results: The prevalence of eating disorders in adolescents with type 1 diabetes was 39%. Four significant predictors of eating disorders were identified; absence of body satisfaction (odds ratio [OR]=3.87, 95% confidence interval [CI]=1.55~9.65), depression (OR=2.87, 95% CI=1.13~7.28), female gender (OR=2.67, 95% CI=1.09~6.54), and glycosylated hemoglobin type A1c levels (OR=1.47, 95% CI=1.10~1.97). Conclusion: In order to prevent eating disorders among adolescents with type 1 diabetes, programs for managing adolescents' depression and improving their body satisfaction should be developed. Futhermore, more attention should be directed towards programs aiming to prevent eating disorders in female adolescents.
In Korea, diabetes mellitus, which causes micro and macrovascular complications, has been rapidly increasing during recent decades and has become a leading cause of disability-adjusted life years. The prevalence of diabetes mellitus was 12.4% in 2011 and that of prediabetes, a condition of high risk for developing diabetes mellitus, is 1.5- to 3-fold greater than that of diabetes. The diabetes prevention programs in other countries were shown to reduce or delay progression from prediabetes to diabetes mellitus. However, these results are not applicable to Korean people because of genetic and environmental differences. Therefore, we need to plan and perform a diabetes prevention study in Korean. Based on these results, we should design intervention tools for a Korean diabetes prevention program. We can consider several preventive interventions with lifestyle modification suitable for Korean people and pharmacologic treatments such as metformin or alpha-glucosidase inhibitor.
Purpose: This descriptive study investigated the effects of self-efficacy and self-stigma on self-care in people with diabetes. Methods: The study included a total of 377 patients with diabetes enrolled in university hospitals in D city and public health centers in S city. Data were collected from 1 July to 31 August, 2017, and were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Diabetes self-care was positively correlated with diabetes self-efficacy, whereas it was negatively correlated with diabetes self-stigma. Participants' education level, marital status, perceived health status, type of medication, self-efficacy, and self-stigma explained 42.4% of the variance in diabetes self-care. Conclusion: The findings indicate that diabetes self-efficacy and self-stigma are important factors for improving self-care in patients with diabetes. Therefore, systematic programs for enhancing self-efficacy and reducing self-stigma of these individuals should be developed.
Purpose: This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.
The Journal of Korean Academic Society of Nursing Education
/
v.8
no.1
/
pp.95-107
/
2002
The purpose of this study is to determine the clinical nurses' knowledge of DM and diabetes patient education aptitude so as to provide a basis for clinical nurse training with respect to diabetes patient education program. The data has been collected through the questionnaires of 42 items from the Knowledge on DM and each 16 item from the Importance on the elements of diabetes patient and the Recognition for clinical nurses, respectfully. 166 nurses from a general hospital who had participated in clinical nurse training in Sep. 28 and Oct. 4, 2001 were subject to respond the questionnaires. Analysis has been done by using statistical method such as percentage, average, standard deviation, t-test, ANOVA, Duncan test and Pearson correlation coefficients. The findings are as follows: 1. Clinical nurses' knowledge levels of diabetes 1) The average level of nurses' knowledge about diabetes is 29.37 (right answer- finding rate: 70%), which is intermediate. 2) Amongst the nurses classified by their knowledge levels about diabetes, the group with less than one year career and that with more than 5 year careers are found to have higher knowledge levels. The item with the highest right answer-finding rate was 'Please find the wrong out of the following examples about foot care'. Meanwhile, the item with highest incorrect answer-finding rate was 'what does blood sugar control aims for amongst gestational diabetes?'. 2. Clinical nurses' importance and perception levels of educational training about diabetes 1) There were no differences amongst nurses' importance level about diabetes. 2) Nurses usually had high scores(4.30) in terms of the items related to the importances about educational training. 3) There were quite high recognitions of general characteristics and symptoms about diabetes, amongst the nurse cohorts working more than one year and less than 5 years, and over 5 years, the group belonging to the internal department, that having the previous experiences of dealing with diabetes, and that having their diabetic relatives and other close people. Meanwhile, strangely, the group who identified themselves as 'not good at treating diabetes' had a high recognition level of educational training about diabetes. 3. Relationship between knowledge levels and importance & perception levels of diabetes 1) The higher knowledge about diabetes nurses had, the more importance they recognized. 2) It is found that there was no relationship between knowledge and perception of diabetes. 3) The more importance about diabetes nurses had, the higher perception they obtained. In conclusion, there is an urgent need for systematic educational programs about diabetes including technical aspects, in order to upgrade and improve nurses knowledge levels. In addition, re-educational training should be provided at regular intervals. Further, we believe the nurses with high knowledge about diabetes and interests in the provision of educations for patients can be far more confident, and in return, patients can have better self-management about diabetes obtained through educations. Based on the above-mentioned findings, we would like to make the suggestion: re-evaluation about nurses' knowledge and cognition levels should be carried out after job training programs about diabetes.
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