Differences in compliance with diabetic self-care practices and glycosylated hemoglobin in Type 2 diabetic patients following a diabetic education program

Diabetes mellitus is one of the most significant and challenging health problems in the United States. Diabetes, if uncontrolled, can lead to degenerative complications such as heart disease, nephropathy, retinopathy and neuropathy. Self-care is important in controlling blood glucose levels, preventing complications and promoting health. Many diabetic patients, however, do not participate in self-care practices that lead to compliance with a disease treatment plan.The purpose of this study is to examine differences in compliance with self-care practices and differences in the amount of hemoglobin Alc in the blood of type 2 diabetic patients following a diabetic education program, at the completion of the program, at two months, and at six months.The framework for this study is Dorthea Orem's Self-Care Deficit Theory. Self-care involves the actions that individuals initiate to maintain life, health, and well-being. Self-care actions aim to satisfy three types of requisites: universal, developmental, and health deviation requisites. According to Orem, all persons engage in universal self-care requisites including maintenance of air, water, and food, providing elimination, and balancing rest and activity. Diabetic patients experience a health deviation requiring self-care actions to satisfy health deviation requisites including seeking and securing medical assistance, attending to the pathological condition and carrying out therapeutic measures with the goal of controlling underlying pathology and prevention of complications.The sample will include 40 type 2 diabetic patients enrolled in a community diabetic education program at a healthcare institution in the Midwest. The Exercise of Self-Care Agency Scale will measure self-care practices at the completion of the program, at two months, and at six months post diabetic education program. Glycosylated hemoglobin (HbAlc) will also be evaluated at the completion of the diabetic education program, and at two months, and at six months. A simple, interrupted time series design will be used with a repeated measures ANOVA data analysis.Permission will be obtained from Ball State University and the participating institution to conduct the study. The diabetic patients enrolled in the diabetic education program will receive an invitation to participate in the study. A letter explaining the study outline and the voluntary nature of the study will be given to all patients. Responses collected will be confidential and patients will remain anonymous. No risks have been identified.This study is significant in order to assist diabetic educators in identifying diabetic patient needs related to compliance of diabetic self-care practices. Identifying complianceissues will assist diabetic educators in developing diabetic education programs to help diabetic patients improve compliance of self-care practices, which will in turn, maintain or improve hemoglobin Al c blood levels, and decrease or minimize diabetic complications.School of Nursing"July 2003."Thesis (M.S.