Enhancing Diabetes Self-Management

“Lived Experience of Diabetes Among Older, Rural People” Research Article

What is the purpose of this research?

The study by George and Thomas, (2010) was aimed at revealing how the aged (65 years and above) were diagnosed with insulin-dependent diabetes and living in rural areas perceive self-management. Moreover, the study was to explicate the participants’ experiences with the disease according to their narration.

What is the research question (or questions)? This may be implicit or explicit

The authors selected an elderly sample to establish if there are age-related issues about the experiences and self-management of diabetes. Therefore, they sought to establish how diabetes affected the participants’ lives and what the participants did to help their situations. As such, the key question was “please tell me what it is like for you living with diabetes” (George & Thomas, 2010, p. 1095).

Did the authors describe the research design of this study? If so, give a description

George and Thomas (2010) used a phenomenological design in their study where they used face-to-face interviews.

Describe the population (sample) for this study

The authors drew the sample for the study from local agencies and got English-speaking participants between ages between 65 and 85 years. It is worth noting that the participants were willing to share their experiences with the researchers. The racial demographics of the participants included eight African Americans and two whites. All the participants were female (widowed except one) living in the rural areas whose sole source of livelihood was social security. About their experiences with diabetes, five participants had been diagnosed 25 years (with the longest being 37 years) while five received their diagnosis less than 12 years (with the shortest being 7 years) before the study. All the participants had observable confirmations of diabetes-related problems and complications.

Was the sample adequate for the research design that was selected?

The sample was adequate for face-to-face interviews. Although the sample had no male participants and people from other minority groups such as Hispanics (George & Thomas, 2010), it could be considered adequate for the research design since the data collected had a valuable contribution. Considering the sample size and its appropriateness, it could be resolved that the size was adequate because many phenomenological research designs use samples ranging from six to 12 participants (George & Thomas, 2010).

Describe the data collection procedure

George and Thomas, (2010) collected data using face-to-face interviews where they visited the participants’ homes. The participants were not given any specific instructions and they were made aware that they could freely discuss any experiences they were supposed to signify their diabetes and their experiences with diabetes self-management matter. Although the interviews took 1 to two hours, the participants were given all the time they required to share their experiences comprehensively. Questions and follow-up questions were administered and responses were obtained. Lastly, a survey to evaluate pertinent issues, including regularity of testing blood glucose levels among participants was done (George & Thomas, 2010).

How were the data analyzed after collection?

The audiotaping and exact transcribing of all the interviews started the data analysis procedure. Reading and re-reading of the transcriptions were done while listening to the audiotape to certify that the transcription process was precise and free from errors. Once the accuracy of the transcription was established, the transcripts were read and re-read to understand the insight provided by the participants. An interdisciplinary research group used the Thomas and Pollio approach (George & Thomas, 2010) to carry out an analysis. Word by word scrutiny was done and the meaning of themes and units obtained.

Discuss the limitations found in the study

The selected sample lacked members from very significant populations. There were neither male partakers nor participants from minority groups that have high occurrences of diabetes. Moreover, the study had drawbacks emanating from the environmental location. Lastly, the transferability of the findings is over-reliant on the reader of the report. It is worth noting the authors justified the small size of the sample used arguing that a majority of similar studies adopt samples of 6 to 12 participants (George & Thomas, 2010).

Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

George and Thomas (2010) conclude that diabetes self-management programs should incorporate patients’ insight and experiences. As such, care providers should always consider patients’ inputs and experiences whenever modifications and adaptations are warranted. As such, self-management programs should not be forced on clients without regarding their intellectual, financial, and psychological systems and backgrounds. The lack of client involvement in designing self-management procedures may result in frustrations, complications, and non-compliance.

Moreover, there is a need to design care programs that cater to the age-related issues among elderly diabetics.

The conclusions are based on the collected data since most of the applicants complained that their experiences with self-management programs provided without their inputs were negative.

How does this advance knowledge in the field?

This paper adds a vital insight regarding poorly controlled diabetes among the elderly, which led to introspections and existential questioning. In addition, the study provides a comprehensive model with four interrelated themes, including “’Your Body Will Let You Know’; ‘I Thought I Was Fine, But I Wasn’t’; ‘The Only Way Out is to Die’; and ‘You Just Go On’.” (George & Thomas, 2010, p. 1098).

“Support for Diabetes Using Technology: A Pilot Study to Improve Self-management” Research Article

What is the purpose of this research?

The study by Hunt, Sanderson, and Ellison (2014) was purposed to establish whether the adoption of applications on Apple® iPad® technology would augment self-efficacy for self-management, upsurge patients’ involvement in self-management activities, and improve clinical outcomes among patients with T2DM.

What is the research question (or questions)? This may be implicit or explicit

The authors sought to answer the question of whether technology (applications on Apple® iPad® technology) can be harnessed to improve self-management programs among diabetic people (Hunt, Sanderson, & Ellison, 2014).

Did the authors describe the research design of this study? If so, give a description

Hunt, Sanderson, and Ellison (2014) said that their study adopted “a two-group, crossover, and repeated-measures design” (p. 233). The sample population was divided into two groups (intervention and control).

Describe the population (sample) for this study

Of the sixty people who show interest in the study, 17 met the qualification and gave their consents to participating in the study. The sample, therefore, was made up of seven males and 10 females. While six of the participants were aged between 19 and 50, 11 were 51 years and above. The racial composition of the sample comprised 3 African Americans, 13 Caucasians, and 1 from other races. One participant had less than high school level, 11 had high school and college certificates, and five were college and professional graduates. Lastly, 13 participants were diagnosed with diabetes in 10 years or less while four were diagnosed 11 years or more before the study (Hunt, Sanderson, & Ellison, 2014). However, three out of the seventeen withdrew from the study.

Was the sample adequate for the research design that was selected?

The sample size was adequate for the research design since the participants could be divided into the required groups. There were members for both the intervention and control groups.

Describe the data collection procedure

After approval and consent, participants were randomly assigned into the two groups and given the materials and instructions on how to use them. Participants in the intervention group (using iPads) were required to email the researcher once a week while the control group used journals to record their logs. Both groups were required to log information about blood glucose monitoring, adherence to eating plans, compliance to medication, and exercising. Three months from the first meeting, materials were interchanged where the intervention group was assigned journals and the control group was to use iPads.

The frequencies and number of logs in both groups and bot intervals were collected (Hunt, Sanderson, & Ellison, 2014).

How were the data analyzed?

The authors used descriptive statistics to analyze data. As such, pre/pro-test quantities of variables were scrutinized through a mixed model analysis of variance where the group was treated as the “between-subject factor and self-efficacy and diabetes self-management behaviors as the repeated factors” (Hunt, Sanderson, & Ellison, 2014, p. 234). Data concerning the changes in self-management behaviors among participants were scrutinized using a repeated measure analysis (Hunt, Sanderson, & Ellison, 2014).

Discuss the limitations found in the study

The sample used was relatively small and, therefore, limiting. It is suggested with more participants could have been used to obtain more generalizable findings. Moreover, the method used in data gathering was flawed since it could not portray the exact information regarding the participants’ activities. There are high possibilities that the participants would fail to log all self-management activities due to various reasons such as time constraints. Lastly, the iPad method of gathering data on self-management activities was said to be tedious and, therefore, not effective (Hunt, Sanderson, & Ellison, 2014).

Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

Hunt, Sanderson, Ellison, (2014) concludes that self-management among T2DM patients is multifaceted and should be approached from a comprehensive understanding of plans and programs. Moreover, self-management is quite challenging and, therefore, care providers should make use of technological improvements to ease the practice. Nevertheless, it is imperative to use the most appropriate and patient preferred technology in monitoring patient activities in self-management of diabetes.

It could be argued that the authors partly used the collected data in concluding. It was evident that some participants registered more logs using the journals than using the iPads and vice versa. Although technological advances can help in simplifying self-management, patient preference in choosing the technology is vital.

How does this advance knowledge in the field?

The study by (Hunt, Sanderson, & Ellison, 2014) gives a significant contribution to the field since it brought out the aspect of the role of technological advancements in monitoring self-management activities among diabetes patients. Moreover, the study highlights the vital element of patient preference in the use of technology. Lastly, the study lays a significant basis for future studies.

References

George, S. R., & Thomas, S. P. (2010). Lived experience of diabetes among older, rural people. Journal of Advanced Nursing, 66(5), 1092–1100.

Hunt, C. W., Sanderson, B. K., & Ellison, K. J. (2014). Support for diabetes using technology: A pilot study to improve self-management. MedSurg Nursing, 23(4), 231-237.