bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for Outpatient Screening and Initiation of Continuous Subcutaneous Insulin Infusion Therapy: Impact on Cost and Quality
Authors: Sanfield Jeffrey A. , Hegstad Marcia , Hanna Raouf S. 
Published: April 2008

PURPOSE the purpose of this study was to determine the effectiveness of a screening protocol in identifying subjects who would initiate continuous subcutaneous insulin infusion (CSII) and continue the therapy for at least 2 1A years. METHODS One hundred four subjects were recruited to participate in a screening protocol involving a mock trial of insulin pump use. Participants who initiated CSII were followed for 2½ years; those deemed ill suited for CSII used multiple insulin injections. Discontinuation rates, quality of life, and costs were evaluated for subjects using CSII. Baseline and quarterly hemoglobin Al C (Al C) were measured and compared. RESULTS The screening protocol identified 37 subjects (35.6%) who were unsuited for CSII. Subjects who initiated CSII reported enhanced quality of life and exhibited a low discontinuation rate (3.3%). No safety issues were encountered. Screening, CSII initiation, and follow-up were accomplished at lower costs per subject ($2431.50) than those reported in the Diabetes Control and Complications Trial (DCCT) ($8265.00). Al C was significantly lower over time for subjects receiving CSII compared with those receiving multiple injections. CONCLUSIONS A structured screening protocol with trial pump use was effective in identifying individuals who would initiate CSII and continue the therapy for at least 2½ years.
Impact of Diabetes Disclosure on Perceptions of Eating and Self-Care Behaviors
Authors: Berlin Kristoffer S. , Sass Daniel A. , Davies W. Hobart , Hains Anthony A. 
Published: April 2008

PURPOSE This study investigated whether disclosure of diabetes and gender influenced perceptions of eating and self-care behaviors. METHODS A vignette was developed in which a hypothetical friend engaged in diabetes self-care behaviors during a meal. Respondents (231 young adults) read vignettes that varied according to a 2 x 2 design (male vs female, preventative disclosure vs nondisclosure of diabetes). Participants answered 12 questions, which resulted in 2 factors: concern for friend and encourage professional help. RESULTS Significantly higher scores resulted on the concern for friend and encourage professional help factors when diabetes was not disclosed. Female characters also received significantly higher scores on the concern for friend factor. CONCLUSIONS Individuals with diabetes who choose to disclose their illness may prevent negative or incorrect perceptions related to self-care and eating behaviors, and may have a decreased likelihood that a true eating disorder would be identified by others.
Reliability and Validity of a Measure of Perceived Diabetes and Dietary Competence in African American Women With Type 2 Diabetes
Authors: Samuel-Hodge Carmen D. , DeVellis Robert F. , Ammerman Alice , Keyserling Thomas C. , Elasy Tom A. 
Published: April 2008

PURPOSE General measure of perceived diabetes and dietary competence (PDDC) was developed to assess a person's sense of confidence and perceived behavioral control in diabetes and dietary self-management. Internal structure, reliability, and construct validity were evaluated. METHODS There were 2 samples of African American women with type 2 diabetes; 226 patients in the development sample and 225 patients in the validation sample. Factor analysis, Cronbach's coefficient alpha, and correlation analysis were used to assess reliability and validity of the PDDC measure. RESULTS Three subscales were empirically determined by factor analysis: positive competence, negative dietary competence, and negative control. Cronbach's alphas for all subscales were good. Predicted relationships with measures of perceived health competence, self-efficacy, social support, and perceived dietary barriers were largely supported in construct validation. CONCLUSIONS This study provides initial support for the internal reliability and validity of a perceived diabetes and dietary competence measure. Further research is needed to determine its validity in other samples of African Americans with type 2 diabetes and its clinical utility in evaluating diabetes self-management training.
Perceived Adherence to Prescribed or Recommended Standards of Care Among Adults With Diabetes
Authors: Jorgensen Wendy A. , Pollvka Barbara J. , Lennie Terry A. 
Published: April 2008

PURPOSE Adults with diabetes were surveyed to determine the extent to which respondents perceived specific preventive regimens (diet, exercise, weight control, and education) had been prescribed or recommended, adhered to their prescribed regimens, and identified barriers to nonadherence. METHODS Surveys were mailed to 2 samples of adults diagnosed with diabetes. The clinic sample was from health department clinics (n=264); the agency sample was from a nonprofit agency serving people with diabetes (n=1 11). RESULTS Of the 4 preventive measures under investigation, diet plans and weight reduction were perceived as most commonly recommended by health professionals; exercise schedules were the least commonly recommended. Diabetes self-management education was reportedly recommended more often among the agency sample. In terms of adherence, approximately half of both samples were able to lose weight. A smaller portion of the clinic sample was able to get needed foods and exercise, and maintain weight loss. The most frequently cited reasons for nonadherence were cost, transportation, and other health conditions. CONCLUSIONS Improvement in the implementation of preventive behaviors is needed, particularly exercise schedules. Barriers to care, such as costs and transportation, may need special consideration.
Quality Improvement Initiative to Integrate Teaching Diabetes Standards Into Home Care Visits
Authors: Jonos Phyllis M. 
Published: April 2008

PURPOSE This quality improvement project was initiated to determine the quality of diabetes care for clients of a home health agency and to integrate the teaching of diabetes standards of care into home care nursing visits. METHODS A descriptive study design was used to evaluate the effectiveness of teaching materials and the Standards of Care Teaching Program. Performance indicators and outcome measures from the American Diabetes Association Provider Recognition Program (ADA PRP) were used to determine the baseline status of diabetes care and for comparing performance measures from 50 home care clients. RESULTS The educational materials and care plan interventions helped nurses learn the standards and facilitated tracking interventions and performance measures. These results showed statistical significance in performance measures for eye, foot, lipid tests, and diabetes self-management education, but not for hemoglobin Al C, urine protein, and medical nutrition therapy. CONCLUSIONS The Standards of Care Teaching Program was a useful way to integrate the standards into a diabetes program and home care visits. Comparing clients' diabetes performance measures with national standards helped identify specific areas for quality improvement.
Diabetes Self-Management in African Americans: An Exploration of the Role of Fatalism
Authors: Egede Leonard E. , Bonadonna Ramita J. 
Published: April 2008

PURPOSE This study was conducted to explore the concept of fatalism in relation to diabetes self-management behavior in African Americans with type 2 diabetes. METHODS Participants (n=39) were recruited from a clinic sample of African Americans with type 2 diabetes. Seven focus groups were conducted; the sessions were recorded, transcribed, and analyzed to identify themes related to fatalism and diabetes self-management. The ISAS paradigm (individual, symbols, audience, situation), a social psychology theory, provided the theoretical framework for the study. RESULTS Four dimensions of fatalism were identified: the meaning of diabetes, the illness experience, the individual's coping response, and the individual's religious and spiritual beliefs. For the participants in this study, fatalism seemed to characterize the nature of the interaction between the individual with diabetes and others, the meanings they attached to such interactions, and the decision to adopt an effective or ineffective diabetes self-management behavior. CONCLUSIONS Fatalism was associated with diabetes self-management in African Americans with diabetes and was multidimensional in this population; the construct appeared to differ conceptually from the perspective of current measures.
Insights From Older Adults With Type 2 Diabetes: Making Dietary and Exercise Changes
Authors: Dye Cheryl J. , Haley-Zitlin Vivian , Willoughby Deborah 
Published: April 2008

PURPOSE The purpose of this research was to identify factors that affect the nutrition and exercise behaviors of persons over the age of 55 with type 2 diabetes. METHODS Focus groups were conducted using a validated focus group interview guide to determine primary health concerns and health behaviors, favored learning modalities, barriers to learning, food preferences, and exercise preferences. RESULTS The following major themes and subthemes were identified: some risk factors for diabetes and heart disease seem more salient than others; perceived susceptibility for serious outcomes of diabetes can occur through vicarious learning; willpower, often obtained through a belief in God, is necessary for successful behavior change; effective modification of behavior and building self-efficacy starts with small steps; and intrinsic reinforcement is necessary for behavior change. CONCLUSIONS These data were used to identify strategies and messages to enhance adherence to nutrition and activity recommendations for persons with type 2 diabetes and accompanying cardiovascular risk factors.
Stage of Change Advancement for Diabetes Self-Management Behaviors and Glucose Control
Authors: Parchman Michael L. , Arambula-Solomon Teshia G. , Noël Polly Hitchcock , Larme Anne C. , Pugh Jacqueline A. 
Published: April 2008

PURPOSE This study was conducted to evaluate whether patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-management behaviors and to determine if movement was related to glucose control. METHODS A cohort of 428 patients with type 2 diabetes participated in a traditional diabetes education program in a large urban center in the Southwest. The sample was predominantly female with less than a high school education, a mean age of 52 years, and a mean duration of diabetes of 7 years. Two interviews were conducted approximately 9 months apart, at 1 to 4 weeks before the educational program and at 6 months after completing it. Blood specimens were collected at each interview to measure hemoglobin A1C (A1C) levels. RESULTS Most of the patients advanced 1 or more stages of change for at least 1 self-management behavior. Those with diabetes for less than 2 years were significantly more likely to advance at least 1 stage of change for diet and exercise than those with diabetes for more than 2 years. Such advancement was significantly associated with a decline in A1C. CONCLUSIONS Patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-care behaviors. The intervention was more effective for those with a shorter duration of diabetes.
Condom Use, Pregnancy, and STDs in Adolescent Females With and Without Type 1 Diabetes
Authors: Falsetti Donna , Charron-Prochownik Denise , Sereika Susan , Kitutu Julius , Peterson Karen , Becker Dorothy , Jacober Scott , Mansfield Joan , White Neil H. 
Published: April 2008

PURPOSE The purpose of this secondary analysis was to describe and compare adolescent females with and without diabetes in terms of use of condoms, pregnancy outcomes, and sexually transmitted disease (STD) outcomes. METHODS Data from a multisite, case-controlled, telephone survey study were used in a secondary analysis to evaluate the parameters stated in the purpose. RESULTS The 87 females with type 1 diabetes and 45 nondiabetic females who participated were 16 to 22 years old. Most were Caucasian, in high school, and lived with their parents. No demographic differences were noted between the groups. Of those sexually active, for both groups, the most common contraceptive method was male condoms. Four females with diabetes and 2 without diabetes reported an unplanned pregnancy. Three females with diabetes reported an STD infection (chlamydia or trichomonas). Five females with diabetes and 4 nondiabetic females had abnormal pap tests. CONCLUSIONS Adolescent females with and without diabetes engaged in less than optimally protected sexual activity, which increased their risk for unplanned pregnancies and STD infections. Further research is needed of the incidence, treatment, and short-term and long-term complications of STDs in adolescent females with diabetes.
A Survey of the Perceptions, Knowledge, and Use of A1C Values by Home Care Patients and Nurses
Authors: Setter Stephen M. , Corbett Cynthia F. , Campbell R K , Cook Dave , Gates Brian J. 
Published: April 2008

PURPOSE The purpose of this study was to provide baseline information on the perceptions, use, and knowledge of hemoglobin A1C (A1C) values among home healthcare nurses and patients. METHODS A convenience sample (44 patients, 26 nurses) from a Medicare-certified home care agency was surveyed using an investigator-developed demographic and knowledge questionnaire. Data collected from telephone interviews (patients), written questionnaires (nurses), and medicA1 record reviews were analyzed using descriptive methods. RESULTS Most of the home care nurses correctly identified the American Diabetes Association's recommendation for target A1C values; however, nurses rarely contact the physician to obtain A1C results. Nurses do not routinely teach patients about A1C values and inconsistently use A1C values to plan care for their patients with diabetes. Most patients said that they had never had an A1C test performed, and most did not recall the nurse providing any teaching about A1C. CONCLUSIONS Education related to target A1C values is needed. Methods to increase the availability of A1C results in the home care setting should be explored. The importance and clinicA1 utility of A1C values need to be more effectively conveyed to both nurses and patients in the home care setting.
Adolescents' Behavioral Autonomy Related to Diabetes Management and Adolescent Activities/Rules
Authors: Hanna Kathleen M. , Guthrie Diana 
Published: April 2008

PURPOSE the purpose of this preliminary study was to describe and explore the behavioral autonomy (both independent functioning and decision making) of adolescents with type 1 diabetes. METHODS A sample of 34 adolescents with type 1 diabetes completed checklists on independent functioning and decision making for daily and nondaily diabetes management as well as typical adolescent activities/rules. RESULTS Independent functioning in daily diabetes management was greater for older adolescents. Independent functioning and decision making for daily diabetes management, nondaily diabetes management, and typical adolescent activities/rules were strongly correlated. Independent decision making, but not independent functioning for daily diabetes management, was significantly correlated to metabolic control. CONCLUSIONS The strong relationship between independent decision making and functioning suggests that both aspects are important parts of behavioral autonomy to be assessed by healthcare professionals working with adolescents with type 1 diabetes. Healthcare professionals should encourage parental involvement that facilitates adolescents' independent decision making, which was related to better metabolic control in this study.
A Systematic Review of Diabetes Self-Care Interventions for Older, African American, or Latino Adults
Authors: Sarkisian Catherine A. , Brown Arieen F. , Norris Keith C. , Wintz Ruth L. , Managione Carol M. 
Published: April 2008

PURPOSE this study system dente and exained published self-care ntetion desgd to *nrv glycenu control or quality of life (QoL) among ole, African Americn or Latino adults. METHODS Six electronic databases were searchecl Eligible publicato were thoe that described an intervnin to change knowledge, belie, or behavior among adults with diabetes who were either older than 55 years, African American, or Latino, and that measured the outcomes ofglyeic control or QoL. RESULTS Twelve studies met the inclusion criteria, of which 8 were rdomized conrlld trials (RCTs). Of the 8 RCTs, i7provd glycemic control was reported in the intervention arm of S RCTs comparedwith the control arm Of the 4 RCTs theat amined QoL, inprd QoL was reported in the idention ann of 1 study Charaaristics of sssid inter dio s ed poor glcmvic control at baseline (AlC>1 1%), adtural or agetaioring the inevto use of group counseling or support, and inzdmt of spouses and adult children. CONCLUSIONS Large-scale cinial trials designed according to aural and age cieria speciic for older Ltins and African Americas uh diabetes are needed to determine hbow best to adess this growing publc heath problem.
Meta-Analysis of Randomized Educational and Behavioral Interventions in Type 2 Diabetes
Authors: Gary Tiffany L. , Genkinger Jeanine M. , Guallar Eliseo , Peyrot Mark , Brancati Frederick L. 
Published: April 2008

PURPOSE this meta-analysis was conducted to assess the effect of educational and behavioral interventions on body weight and glycemic control in type 2 diabetes. MEHODS Studies selected for analysis were published randomized controlled trials that evaluated educational and behavioral interventions (no drug interventions) in type 2 diabetes (sample size 210). These criteria were applied to searches of electronic databases and relevant bibliographies. Data were independently abstracted by 2 reviewers and adjudicated by consensus. RESULTS Of the 63 articles that met the inclusion criteria, 18 provided enough information for pooled estimates of glycohemoglobin (total Ghb, HbA1, or HbA1 C). These 18 studies yielded 2720 participants (sample sizes of 18 to 749). Interventions ranged from 1 to 19 months; follow-up ranged from 1 to 26 months. Glycohemoglobin was reduced by a mean of 0.43%. When results were stratified by quality score, glycohemoglobin was -0.50% and -0.38% for studies with high and low quality scores, respectively. When weighting studies by sample size, fasting blood glucose was reduced by 24 mg/dL and weight by 3 lbs. CONCLUSIONS Previous educational and behavioral interventions in type 2 diabetes have produced modest improvements in glycemic control. Future research should refine such interventions and improve methodology.
Intimacy and Women With Type 2 Diabetes: An Exploratory Study Using Focus Group Interviews
Authors: Sarkadi Anna , Rosenqvist Urban 
Published: April 2008

PURPOSE this study explored if and how women perceived diabetes as affecting their social and sexual intimacy and if they wished to receive professional attention for any sexual disturbances that they experience. METHODS A series of five focus group interviews were conducted with 33 women with type 2 diabetes, ages 44 to 80 years, who also completed a questionnaire on sexual functioning. Two thirds were married and one third were sexually active. RESULTS Categories resulting from the qualitative analysis were guilt and embarrassment in diabetes; female intimacy and shame; sexual dysfunction, an invisible problem; and the female patient. Asking women about intimacy revealed self-blame and embarrassment regarding their diabetes and sexual functioning. Several women who had experienced sexual dysfunction described barriers that made it difficult to obtain optimal care and/or self-care measures to cope with vaginal dryness, pain during intercourse, and decreased desire. Many of the women had the social and emotional resources to cope with their disease. Nonetheless, they experienced guilt, shame, and embarrassment, which are potentially oppressive features of having type 2 diabetes. CONCLUSIONS Asking women with type 2 diabetes about intimacy in a contextually adequate way at routine follow-up visits could give them a chance to discuss both sexual and social intimacy concerns related to their diabetes.
Self-Management of Type 2 Diabetes: A Survey of Low-lncome Urban Puerto Ricans
Authors: von Goeler Dorothea S. , Rosal Milagros C. , Ockene Judith K. , Scavron Jeffrey , De Torrijos Fernando 
Published: April 2008

PURPOSE this study explored self-reported barriers to diabetes self-management in a population of urban, low-income Puerto Rican individuals. METHODS A cross-sectional exploratory survey was conducted with 30 Puerto Rican adults with type 2 diabetes. Participants were randomly selected and recruited from a health center, an elder center, and a community outreach database. A survey was used to assess participants' diabetes-related knowledge, attitudes, and patterns of and barriers to self-management. RESULTS Participants were older and had limited education and good access to health care. Although two thirds had participated in diabetes education, most demonstrated major deficits in diabetes knowledge. Negative attitudes about living with diabetes were common as was dietary knowledge and nonadherence. Most participants were overweight or obese, did regular self-monitoring of blood glucose but did not use the results to improve their diabetes control, and frequently missed doses of their diabetes medications. Self-reported barriers to self-management were financial and social obstacles and competing health and family concerns. CONCLUSIONS The knowledge and self-management behaviors in this population of Puerto Rican individuals with type 2 diabetes need to be improved.
The Effect of an Aerobic Exercise Training Program on Quality of Life in Type 2 Diabetes
Authors: Holton D. Robb , Colberg Sheri R. , Nunnold Tanja , Parson Henri K. , Vinik Aaron I. 
Published: April 2008

PURPOSE The purpose of this study was to determine the effect of 10 weeks of moderate aerobic exercise training on quality of life (QOL) and selected physiological parameters in previously sedentary persons with diabetes. METHODS A quality-of-life survey (SF36v2 health survey) and measurement of physiological parameters were completed before and after 10 weeks of supervised aerobic exercise training 3 days a week for 20 to 45 minutes by subjects with diabetes (n=9) and control subjects (n=1 0). Nontraining subjects with diabetes (n=12) and control subjects (n=1 0) also completed the QOL survey at equivalent times. RESULTS Participants in all groups had similar characteristics. A training effect was evident in exercisers, with an increase in lactate threshold and a decrease in percent body fat for both groups. Training did not affect body mass index or interstitial nitric oxide levels. Physical and mental component scores on the QOL survey in the training and nontraining groups did not differ significantly before or after the training, and diabetes status had no significant effect on these scores. CONCLUSIONS No physiological changes were significantly associated with scores on the SF36v2 health survey. In addition, neither training nor the presence of type 2 diabetes significantly affected the physical or mental component scores on the QOL survey.