PURPOSE: This study was conducted to develop and to test the effects of an educational program for coping with problem situations as a nursing intervention in the diabetic patient. METHOD: A non-equivalent control group pretest-posttest design was used in this study. Data were collected from January to March, 2002. The subjects of the study consisted of 31 diabetic patients(experimental group : 17 patients, control group : 14 patients). The intervention of an educational program for coping with problem situations was applied to the experimental group for 4weeks(total 8 hours). Data were collected before the educational program, immediately after and 1 months later and were analyzed with repeated measures ANOVA, t-test, and paired t-test. RESULT: 1. There was a significant difference in self efficacy between the experimental and control groups (F=13.793, p=0.001). 2. There was a significant difference in self care behavior between the experimental and control groups (F=4.583, p=0.041). 3. There was a significant difference in coping behavior of the problem situation between the experimental and control groups (F=62.018, p=0.000). There was a significant difference according to experimental stages(F=4.546, p=0.015) and interaction between education and experimental stages(F=12.039, p=0.000). 4. There was a significant difference in glycemic control between the experimental and control groups (t=-3.112, p=0.004). CONCLUSION: These results support that a diabetic educational program for coping with problem situations is effective in promoting and maintaining self efficacy, self care behavior, problem coping behaviors and in improving glycemic control. Thus this program can be recommended as an effective nursing intervention of in-depth education for diabetic patient.
*Adaptation, Psychological ; Adult ; Aged ; Blood Glucose/*analysis ; Diabetes Mellitus, Type 2/blood/nursing/*psychology ; Female ; Humans ; Male ; Middle Aged ; *Patient Education as Topic ; *Self Care ; *Self Efficacy

PURPOSE: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. METHOD: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. RESULT: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. CONCLUSION: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.
Walking ; *Self Care ; *Problem Solving ; Middle Aged ; Male ; Humans ; Female ; *Exercise ; Diabetes Mellitus, Type 2/blood/*nursing/psychology ; *Counseling ; Blood Glucose/*analysis ; Aged ; *Adaptation, Psychological

PURPOSE: The purpose of this study was to explore adult diabetics' eating styles and factors which influence them. METHOD: The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique. RESULT: The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered. CONCLUSION: A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.
Middle Aged ; Male ; Korea ; Humans ; *Food Habits ; Female ; *Eating ; Diabetes Mellitus, Type 2/*diet therapy/nursing/psychology ; Culture ; *Attitude to Health ; Aged

PURPOSE: Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS: cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS: The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R2 values, the final model accounted for 20.0% of the variance in selfefficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS: This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*nursing/*psychology ; Female ; *Health Knowledge, Attitudes, Practice ; *Health Literacy ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Quality of Life/*psychology ; Republic of Korea ; Self Care/*psychology ; *Self Efficacy ; Surveys and Questionnaires ; Young Adult