THE RELATIONSHIP OF DIABETIC AUTONOMIC NEUROPATHY TO IMPAIRED FUNCTIONAL ABILITY IN PERSONS WITH INSULIN-DEPENDENT DIABETES MELLITUS.
Contributors: University of Tennessee Center for the Health Sciences.
Published: 1993
Number of pages: 223
Subjects: Health Sciences, Nursing.
Description: Hartwig's model of impaired functional ability proposed that evoked symptomatologies (abnormal autonomic function tests) along with spontaneous symptomatologies of DAN can predict impaired functional ability in patients with insulin-dependent diabetes mellitus. The purpose of this study was to determine the relationship of autonomic function tests to impaired functional ability, and to develop prediction models for impaired functional ability. After elimination of nine outliers, the sample included 56 subjects (8 African-Americans and 48 Caucasians). The 24 males and 32 females ranged in age from 21-55 (mean = 38); duration of insulin-dependent diabetes was 1-40 years (mean = 20). Each subject underwent autonomic function tests (AFTs) after completing the Sickness Impact Profile (SIP), which measures the effect of disease on ability to perform individual activities and social roles. Separate statistical path analyses were performed to identify the direct and joint effects of autonomic function test scores on SIP psychosocial, physical and total scores. Prediction models for each SIP score were developed by multiple regression analysis, using six autonomic function tests, demographic data and symptoms as explanatory variables.

Results of this study support the use of evoked symptoms to predict SIP impaired functional ability in persons with insulin-dependent diabetes mellitus. Taken alone, the six AFTs explained relatively small percentages of the variance in SIP impaired functional ability. They explained the least amount of variance in SIP impaired psychosocial functional ability (R$\sp2$ =.0727), and nearly the same amounts of variance in SIP impaired physical functional ability (R$\sp2$ =.1443) and SIP impaired total functional ability (R$\sp2$ =.1517). Consistent with the study's definition of functional ability as "person/environment interaction," the largest percentages of variance in SIP scores were obtained when AFTs were considered along with demographic and symptom variables. The SIP psychosocial and physical scores were explained as well without as with the AFTs, so the prediction models for each were not sufficient to support the study's conceptual model. SIP total score was best explained by one model, which included age, race, gender, diarrhea, and one AFT, Valsalva Ratio (R$\sp2$ =.41; p $<$.002). Thus, it supported the inclusion of evoked symptomatologies in Hartwig's conceptual model for explaining SIP impaired total functional ability in persons with insulin-dependent diabetes mellitus.
Notes: Source: Dissertation Abstracts International, Volume: 54-12, Section: B, page: 6133.

Thesis (PH.D.)--THE UNIVERSITY OF TENNESSEE CENTER FOR THE HEALTH SCIENCES, 1993.

School code: 0783.