A set amount of time to gather the data may create restrictions on who is sampled and what type of analysis is chosen. Delimitations The study is delimited by the following: The study will be conducted in Southeastern Idaho among English speaking patients. In an effort to focus on one type of diabetes, women with other types of diabetes will not be studied, only those who developed GDM during pregnancy. The study will use the Hurley self-efficacy tool. It has been deemed valid through rigorous testing. Terminology The following terms will be used and defined within the context of the study. Certainty: “free from doubt or reservation; confident, sure”. Confidence: “belief in oneself and one’s powers or abilities”. Diabetes: “There are three major types of diabetes mellitus: type 1, type 2 and gestational. All types of diabetes are characterized by abnormally high blood glucose levels, or fasting levels of 126 mg/dL or higher” . Shoulder dystocia: “Blockage or difficulty of delivery due to obstruction of the birth canal by the infant’s shoulders” . Gestational diabetes mellitus: “that in which onset or recognition of impaired glucose tolerance occurs during pregnancy” .
Insulin resistance: “A condition in which cells ‘resist’ the action of insulin in facilitating the passage of glucose into cells” . Metabolic syndrome: “A constellation of metabolic abnormalities that increase the risk of type 2 diabetes, heart disease, and other disorders. It is characterized by insulin resistance, abdominal obesity, high blood pressure and triglyceride levels, low levels of HDL cholesterol, and impaired glucose tolerance. Also called Syndrome X and insulin-resistance syndrome” . Self-efficacy: “Perceived self-efficacy is defined as people's beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives. Self-efficacy beliefs determine how people feel, think, motivate themselves and behave” . Significance Patients with GDM are typically diagnosed around their 24th week of gestation during a usual screening called the Glucose Tolerance Test (GTT). Typical medical management of the condition involves following a specific diet that modifies the level of carbohydrates in the mother’s diet, safe physical exercise, and possible medication to maintain normal ranges of glucose in the blood. Usually the patient is referred to a diabetes educator for a nutrition consultation. In the proposed research geographical area, most of the diabetes educators are registered nurses or registered dietitians who have specialized in diabetes education and are typically associated with a hospital or medical clinic. Typically the education occurs one-on-one with the client.
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places. 7 I’m not sure I’ll be able to follow my diabetic diet when the people around me don’t know that I have diabetes. 1 2 3 4 5 6 8 I’m not sure I’ll be able to follow my diabetic diet every day. 1 2 3 4 5 6 9 When I go to parties, I can follow my diet plan. 1 2 3 4 5 6 Strongly agree agree agree Slightly disagree disagree Strongly disagree 10 I can exercise several times a week. 1 2 3 4 5 6 11 I can’t exercise unless I feel 1 2 3 4 5 6
Strongly agree agree agree Slightly disagree disagree Strongly disagree 17 I can fit my diabetes routine into my usual lifestyle. 1 2 3 4 5 6 18 I think I’ll be able to follow my diabetes plan even when my daily routine changes. 1 2 3 4 5 6 19 To what extent do you believe your diabetes instructor positively influenced your ability to manage your diabetes (to maintain proper blood sugar control, understand gestational diabetes, etc.)? 1 2 3 4 5 6 Write a few sentences to explain your answer above. 20 To what extent do you believe your diabetes instructor negatively influenced your actual 1 2 3 4 5 6
4. I am confident that I could deal efficiently with unexpected events. 1 2 3 4 5. Thanks to my resourcefulness, I know how to handle unforeseen situations. 1 2 3 4 6. I can solve most problems if I invest the necessary effort. 1 2 3 4 7. I can remain calm when facing difficulties because I can rely on my coping abilities. 1 2 3 4 8. When I am confronted with a problem, I can usually find several solutions. 1 2 3 4
Routines 1 visit 2 visit 3 visit 4 visit 4-24 15.75 15.83 18.0 17.0 .63 .83 4 6 1 1 Self-Treat 1 visit 2 visit 3 visit 4 visit 5-30 25.0 25.16 27.0 29.0 4.24 2.78 4 6 1 1 Diet 1 visit 2 visit 3 visit 4 visit 3-18 12.5 13.66 16.0 15.0 4.43 2.94 4 6 1 1 Exercise 1 visit 2 visit 3 visit 4 visit 2-16 7.0 8.5 10.0 7.0 2.44 2.42 4 6 1 1 Certainty 1 visit 2 visit 3 visit 4 visit 4- 26 17.75 18.0 23.0 22.0 3.20 4 6 1 1 Table 3. Diabetes Survey Subsection possible range of scores and descriptive statistics for the current study Table 4.2 Questions 19 & 20 Open-ended Responses Participant Response