Biomedical subjects

M M Funnell

Publications and source records attributed to M M Funnell.

46 records · Page 3Linked to original sources

PubMedDate not supplied

The diabetes education experience of randomly selected patients under the care of community physicians.

The purpose of this study was to describe the diabetes education and nutritional counseling received by patients under the active care of community physicians. The study population consisted of 440 patients with diabetes from the practices of 68 primary care physicians in eight Michigan communities. Fifty-eight percent of the sample reported having received diabetes education, and the mean number of years since the most recent education was 4.15 years. Sixty-six percent reported having seen a dietitian. Patients who had received diabetes education scored higher on a basic diabetes knowledge test (70% correct vs 60%) than patients who had not received diabetes education. From 1981 to 1991, a decline was observed in the percentage of patients who reported having received diabetes education (70% to 58%). Although patient education is an integral part of comprehensive diabetes care, too few patients are receiving it. Furthermore, diabetes education often results in less-than-optimal levels of knowledge. The situation has deteriorated over the past 10 years, and patients who are not on insulin typically are the least well served.

Adult↗

PubMedDate not supplied

Guidelines for facilitating a patient empowerment program.

The traditional medical treatment model often ignores the emotional, spiritual, social, and cognitive aspects of living with a chronic disease such as diabetes. Empowerment programs address these psychosocial areas by helping individuals develop skills and self-awareness in goal setting, problem solving, stress management, coping, social support, and motivation. Although many diabetes educators have been taught to use an empowerment curriculum to facilitate self-management, there is minimal research concerning the actual process of providing such programs to patients. We evaluated an empowerment curriculum (Empowerment: A Personal Path to Self-Care) with a diverse group of individuals with diabetes to determine the key elements of planning and implementing a successful diabetes patient empowerment program.

Adult↗

PubMedDate not supplied

Using focus groups to identify psychosocial issues of urban black individuals with diabetes.

The purpose of this focus group research was to identify issues that could serve as topics for a series of educational videos portraying psychosocial issues of urban black individuals with diabetes. Four focus groups involving 34 black adults were conducted in the Detroit area. Psychosocial issues were identified and rated in order of priority by an expert panel. The major psychosocial issues identified were the importance of food and eating in the black culture, the necessity for learning more about diabetes and its complications, learning to interact effectively with healthcare providers and systems, and the need for help and support in managing psychosocial issues related to diabetes. Black individuals with diabetes face unique psychosocial challenges. Focus groups are an effective method for obtaining relevant, culturally specific, in-depth information about living with diabetes from patients who are members of minority groups.

Adult↗

PubMedDate not supplied

Differences in the impact of dietary restrictions on African Americans and Caucasians with NIDDM.

African-American and Caucasian patients with non-insulin-dependent diabetes mellitus were surveyed to determine differences in self-reported dietary adherence. The relationship between dietary adherence and other psychosocial factors also was explored. The Diabetes Care Profile, an instrument designed to assess psychosocial factors related to diabetes, was completed by 178 patients. Correlation and regression analyses were used to examine the relationship between dietary adherence and 15 other scales in this instrument. Regression analyses revealed that selected scales were better at predicting dietary adherence for African Americans than for Caucasians. Self-care adherence was the most significant predictor of dietary adherence for African Americans while support was the most significant predictor for Caucasians. These findings suggest that cultural and social functions of food and diet should be examined and incorporated in the development of appropriate meal plans and educational interventions.

Black or African American↗

PubMedDate not supplied

Predictors of adherence to nutrition recommendations in people with non-insulin-dependent diabetes mellitus.

The purpose of this study was to determine how the components of psychosocial adjustment to diabetes predict adherence to nutrition recommendations based on self-reported successful completion of contingency contracts. The relationships between the components of psychosocial adjustment and adherence to nutrition recommendations were examined in a convenience sample of patients with non-insulin-dependent diabetes mellitus participating in a contingency contracting intervention with nurses. Patients completed a standardized instrument, the Diabetes Care Profile, at the time they were enrolled into this randomized clinical trial. High and low levels of adherence to nutrition recommendations were identified by a median split of the number of contingency contracts completed for adherence to nutrition recommendations. Subjects who reported higher regimen adherence and a higher support ratio (received more diabetes-specific social support than desired) were significantly less likely to engage in contingency contracting for adherence to nutrition recommendations.

Adaptation, Psychological↗

PubMedDate not supplied

Participation in a diabetes education and care program: experience from the diabetes care for older adults project.

There is very little reported information concerning the participation of older adults in diabetes education and care programs, factors related to their attendance, and the influence of attendance on program outcomes. In this study, which was part of a larger study of insulin therapy, subjects (> or = 65 years old) assigned to the intensive management group (n = 53) were provided with educational sessions during the 18-month study period. Data for this group were examined to determine factors that influenced enrollment and attendance. Attendance rates for individual participants averaged 72% during the first 6 months and 68% during the subsequent 12 months. Demographic factors, baseline knowledge test scores, and baseline glycosylated hemoglobin levels did not significantly influence participation. Greater distance from the clinic and shorter time using insulin were significantly related (P = .05) to attendance. Perceived benefits of the program included diabetes education (45%), glucose control (23%), and interacting with others who have diabetes (23%).

Aged↗

PubMedDate not supplied

Diabetes patient education research: an integrative literature review.

PURPOSE: The purpose of this study is to summarize the accumulated state of knowledge in the area of diabetes patient education research and highlight important issues that research has left unanswered. METHODS: An integrative literature review was conducted on the topic of diabetes patient education between the years 1985 and 1998. Keywords used in the computerized search were diabetes mellitus, patient education, health education, research, and behavior change. The databases searched were MEDLINE, CINAHL, HealthSTAR, EMBASE, and CHID-HE. A total of 78 papers were reviewed. RESULTS: Most studies lacked a theoretical framework and the majority of studies were conducted in an outpatient setting. HbA1c was the most frequently employed outcome measure, with little, if any, description of the interventions. CONCLUSIONS: Much has been learned in terms of the effectiveness of diabetes education on improving knowledge. However, other topic areas and outcomes need further exploration.

Diabetes Mellitus↗

PubMedDate not supplied

Theory is the cart, vision is the horse: reflections on research in diabetes patient education.

PURPOSE: In this paper, we examine the nature of vision and the role it plays in helping educators identify and use theories productively. We also discuss the role of theory in diabetes education and provide criteria for selecting appropriate theories. METHODS: The vision of diabetes education developed at the Michigan Diabetes Research and Training Center was used to illustrate how our vision has influenced our use of educational and behavioral theories. RESULTS: Both our vision and our theoretical assumptions should be articulated, discussed, debated, and studied. CONCLUSIONS: Diabetes patient education research can systematically contribute to the development of a sound, coherent, and progressive body of knowledge that will truly serve diabetes patient education.

Behavioral Sciences↗

PubMedDate not supplied

Effectiveness of a foot care education program on attitudes and behaviors of staff nurses.

The purpose of this study was to determine differences in nurse attitude and clinical practice following a foot care education program. In a survey completed after the program, 23 nurses reported that they had less difficulty touching a smelly foot (p less than .02), that they would be less bothered by a foot with an odor (p less than .03), that they would have less difficulty touching an unsightly foot depicted in a slide (p less than .03), and that they felt less anger at patients who don't follow recommendations (p less than .03). The nurses also expressed more belief that patients quickly forget important information (p less than .03) and that if patients knew the effects of their poor health habits they would change (p less than .02). Ninety-one percent of the RN sample reported that their foot assessment and care practices had changed as a result of the program.

Adult↗

PubMedDate not supplied

The continuing education needs of diabetes nurse educators.

The major caveat regarding this study is the low return rate. We suspect that this is due to the extensive nature of this lengthy questionnaire. A shorter questionnaire sent at the same time to another sample drawn from the same population produced a return rate higher than 50%. However, some benefits were derived from the study. The first is the extensive set of data obtained about both the continuing education needs and the practice patterns of this sample of diabetes nurse educators. (A longer report that includes information about how the nurses spend their time, the types of diabetes education they provide, and the size and scope of the diabetes patient education programs at their institution is available from the first author.) Second, it is reasonable to assume that the nurse educators who took the time to complete this lengthy questionnaire about their continuing education needs and practices are thoughtful consumers of continuing education. Their needs and preferences should be of concern to the individuals and organizations that provide continuing education to diabetes nurse educators. In summary, the nurses in this sample are highly educated and experienced diabetes educators. They indicated a strong desire for obtaining continuing education primarily in behavioral and psychosocial issues, but perceive that they are limited by a lack of financial support and time.

Diabetes Mellitus↗