scholarly journals The Impact of a Diabetes Self-Management Education Program Provided through a Telemedicine Link to Rural California Health Care Clinics

2013 ◽  
Vol 6 ◽  
pp. HSI.S10924
Author(s):  
Jim Nuovo
Keyword(s):  
Rural Health ◽  
Education Program ◽  
Management Education ◽  
Self Care ◽  
Self Management ◽  
Post Intervention ◽  
Health Clinics ◽  
Number Of Patients ◽  
Rural Health Clinics ◽  
The Impact

Background This project investigated the impact of a DM self-management education program provided through a telemedicine link at nine rural health clinics in Northern California. Methods Two hundred thirty nine patients were provided with a single 2-hour class on DM delivered through a live televideo connection. Patients provided pre-intervention information on: demographics and overall health, self-care behaviors, and knowledge about DM. All participants completed a post-education survey on knowledge and self-care behaviors. Results There was a significant decrease in the number of patients who felt overwhelmed with their DM; pre-intervention 18.8%; post-intervention 5.4% ( P < 0.0001). Patients increased the number of days they exercised; pre-intervention 3.4 days; post-intervention 3.9 days ( P = 0.02). Patients increased the number of days they checked their feet; pre-intervention 4.2 days; post-intervention 5.6 days ( P < 0.01). Knowledge about DM improved over the study period ( P < 0.01). Conclusions A single 2-hour class on DM administered through a telemedicine link to patients in rural health clinics resulted in feeling less overwhelmed, more knowledgeable about DM, and demonstrated an increase in self-care behavior; ie, exercise and foot care.

Family planning and fertility decline in rural Iran: the impact of rural health clinics

2010 ◽  
Vol 19 (S1) ◽  
pp. 159-180 ◽  
Author(s):  
Djavad Salehi-Isfahani ◽  
M. Jalal Abbasi-Shavazi ◽  
Meimanat Hosseini-Chavoshi
Keyword(s):  
Family Planning ◽  
Rural Health ◽  
Fertility Decline ◽  
Health Clinics ◽  
Rural Health Clinics ◽  
The Impact

scholarly journals Efektivitas Peer Group Diabetes Self Care Education terhadap Diabetes Self Care Activities Pasien DM

2018 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Tramirta Trendi Iriani ◽  
Haryani ◽  
Khudazi Aulawi
Keyword(s):  
Education Program ◽  
Management Education ◽  
Peer Group ◽  
Self Care ◽  
Self Management ◽  
Control Group ◽  
Post Test ◽  
And Control ◽  
Group Self

ABSTRAKLatar belakang: Pasien diabetes melitus (DM) perlu mengontrol kadar glukosa darah dengan melakukan perawatan DM yang terdiri dari pengobatan, latihan, diet, dan edukasi. Peer group pada pasien DM dimungkinkan membantu perawatan DM. Tujuan penelitian: mengetahui efektivitas peer group diabetes self management education program (DSMEP) terhadap diabetes self-care activities DM tipe 2. Metode: Pre-eksperimental dengan rancangan one group pre-test-post-test design with control group. Pengambilan sampel menggunakan purposive sampling dari November-Maret 2013, dengan kriteria inklusi: DM tipe II dan >18 tahun. Jumlah sampel masing-masing 13 pasien untuk kelompok intervensi dan kontrol. Kelompok perlakuan mendapatkan DSMEP, kelompok kontrol mendapatkan edukasi standar. Pretest diberikan sebelum intervensi, post test diberikan sebulan sesudah intervensi. Instrumen The Summary of Diabetes Self-Care Activities (validitas nilai r 0,361, Cronbach’s Alpha 0,847) digunakan untuk mengukur aktivitas perawatan diri. Analisis data menggunakan t-test berpasangan dan tidak berpasangan. Hasil: Kebanyakan responden perempuan, lama pengobatan 10 tahun. Mayoritas pendidikan perguruan tinggi, suku Jawa, Islam, dan menikah. Terdapat perbedaan aktivitas perawatan diri sebelum dan sesudah dilakukan intervensi antara kelompok intervensi dan kontrol pada komponen pengobatan pasien DM (p=0,005), tetapi tidak ada perbedaan yang signifikan pada komponen diet (p=0,077), olahraga (p=0,259), tes gula darah (p=0,058), dan perawatan kaki (p=0,309). Kesimpulan: Peer group diabetes self management education program (DSMEP) dapat meningkatkan kemampuan perawatan diri pasien DM tipe 2.Kata Kunci: diabetes, peer group, self care, activitiesEFFECTIVENESS OF PEER GROUP-BASED DIABETES SELF-CARE EDUCATION ONDIABETES SELF-CARE ACTIVITIES IN DM PATIENTSABSTRACTBackground: Diabetic patients need to control their blood glucose level through DM management consisting of medication, exercise, diet, and education. Peer group in DM patients may help DM treatment. Objective: To identify the effectiveness ofpeer group-based diabetes self-management education program (DSMEP) on diabetes self-care activities of type 2 DM. Methods: This study was pre-experimental with one group pre-test-post-test design with control group design. Samples were taken using purposive sampling from November to March 2013, with inclusion criteria of DM type II and >18 years old. The sample size was 13 patients for each of the intervention and control group. The intervention group received DSMEP, while the control group received standard education. Pretest was given before the intervention and posttest was given a month after the intervention. The Summary Instrument of Diabetes Self-Care Activities (validity value r>0.361, Cronbach’s Alpha=0.847) was used to measure self-care activities. Data were analyzed using paired and unpaired t-test. Results: Most of the respondents were female and received more than 10years of treatment. The majority of the respondents were tertiary educated, Javanese, Islamic, and married. There was a difference in self-care activity before and after intervention between the intervention and control groups in the component of DM patient treatment (p=0.005), but there was no significant difference in the components of dietary (p=0.077), exercise (p=0.259), blood sugar test (p=0.058), and foot care (p=0.309). Conclusion: Peer group-based diabetes self-management education program (DSMEP) can improve self-care ability of type 2 diabetes patients.Keywords: diabetes, peer group, self-care, activities

scholarly journals Effect of diabetes self-management education program on glycemic control in diabetic patients attending the family medicine outpatient clinic, Suez Canal University Hospital, Ismailia, Egypt

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Reham Abo Emara ◽  
Madeha Hamed ◽  
Mohamed Awad ◽  
Wael Zeid
Keyword(s):  
Glycemic Control ◽  
Family Medicine ◽  
Education Program ◽  
Management Education ◽  
Self Care ◽  
Suez Canal ◽  
University Hospital ◽  
Self Management ◽  
The Family ◽  
Patients With Diabetes

Abstract Background Diabetes mellitus (DM) is a chronic disease with debilitating complications. Patients with diabetes are recommended to take various self-management decisions and carry out complex care activities. Diabetes self-management education (DSME) and support help people with diabetes to take these decisions and activities to improve health outcomes. DSME may serve as the basis to minimize and avoid catastrophic diabetes-related complications and the resulting financial and personal costs associated with this disorder. We aimed to assess the effect of diabetes self-management education program on glycemic control on patients with diabetes. A quasi-experimental pre-post study was conducted at the family medicine clinic in Suez Canal University hospital, Ismailia, Egypt. A total of 116 patients with uncontrolled DM were recruited by a simple random technique after applying the inclusion and exclusion criteria. Participants were subjected to a 12-week health education program (1 session/week). The sessions focused on areas of diabetes self-management based on the American Diabetes Association (ADA) guidelines. The glycosylated hemoglobin (HbA1c) was assessed at baseline and again at the end of the program. Also, self-care activities were evaluated pre-post intervention using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument which measured the activities related to diet, exercise, blood sugar testing, foot care, and medications. Results The mean age of participants was 47 years (± 11.54), male patients represented 54%. About two-thirds (67%) were from urban areas and came from a middle socioeconomic level. About half of the participants (51.7%) were diagnosed as diabetics for 5–10 years duration. More than half (52.7%) were on combination therapy of insulin and oral antidiabetic drugs. After the intervention program, there was a statistically significant decrease in HbA1c level (p value < 0.001), and 21% of the participants reached the ADA treatment goal for HbA1c below 7. Conclusion Appropriate DSME programs are practical and have a benefit to patients with diabetes.

An Empowerment-Based Diabetes Self-management Education Program for Hispanic/Latinos

2011 ◽  
Vol 37 (6) ◽  
pp. 770-779 ◽  
Author(s):  
Ninfa C. Peña-Purcell ◽  
May M. Boggess ◽  
Natalia Jimenez
Keyword(s):  
Low Income ◽  
Education Program ◽  
Self Efficacy ◽  
Management Education ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Repeated Measures Design ◽  
Spanish Speaking ◽  
Hispanic Latinos

Purpose The purpose of this pilot study was to evaluate the effects of a culturally sensitive, empowerment-based diabetes self-management education program for Spanish-speaking Hispanic/Latinos. Methods A prospective quasi-experimental repeated measures design tested the effectiveness of the ¡Si, Yo Puedo Controlar Mi Diabetes! diabetes self-management education program. In sum, 144 persons residing in 2 Texas counties at the Texas-Mexico border (Starr and Hidalgo) served as participants. Two groups were formed, an intervention and a control (wait list). Clinical (A1C), cognitive, attitudinal, behavioral, and cultural assessments were collected at baseline and 3 months. Results Demographic characteristics for the intervention and control groups were similar. Both groups were predominately female, low income, older than 40 years, and minimally acculturated. Baseline and posttest findings showed that the intervention group had a significant reduction in A1C values; median difference was 0.3 (n = 45), especially for those with higher baseline values. Participants in the intervention group also improved in their self-efficacy and self-care scores. Conclusions Findings from the study suggest that additional dissemination of a diabetes self-management education program for Spanish-speaking Hispanic/Latinos is warranted to improve clinical outcomes and associated diabetes self-efficacy and self-care behaviors.

scholarly journals Diabetes Self-Management Education: Miles to Go

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Helen Altman Klein ◽  
Sarah M. Jackson ◽  
Kenley Street ◽  
James C. Whitacre ◽  
Gary Klein
Keyword(s):  
Management Education ◽  
Meta Analysis ◽  
Self Management ◽  
Post Intervention ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Impact

This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized controlled trials. The training conditions resulted in significant reductions in A1c levels compared to control conditions. However, the impact of intervention was modest shifting of only 7.23% more participants from diabetic to pre-diabetic or normal status, relative to the control condition. Most intervention participants did not achieve healthy A1c levels. Further, few DSME studies assessed long-term maintenance of A1c gains. Past trends suggest that gains are difficult to sustain over time. Our results suggested that interventions delivered by nurses were more successful than those delivered by non-nursing personnel. We suggest that DSME programs might do better by going beyond procedural interventions. Most DSME programs relied heavily on rules and procedures to guide decisions about diet, exercise, and weight loss. Future DSME may need to include cognitive self-monitoring, diagnosis, and planning skills to help patients detect anomalies, identify possible causes, generate corrective action, and avoid future barriers to maintaining healthy A1c levels. Finally, comprehensive descriptions of DSME programs would advance future efforts.

Care of children with type 1 diabetes mellitus in school – An interventional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Umamaheswari Gurunathan ◽  
Hemchand Krishna Prasad ◽  
Sherline White ◽  
Bala Prasanna ◽  
Thangavelu Sangaralingam
Keyword(s):  
Type 1 Diabetes ◽  
Education Program ◽  
School Teachers ◽  
Post Intervention ◽  
Community Based ◽  
Structured Education ◽  
Type 1 Dm ◽  
The Impact ◽  
Determining Factor

AbstractObjectivesPaucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.MethodsA community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.ResultsForty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).ConclusionThere is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.

Implementing Enhanced Primary Care Registered Nurse Reimbursement in Rural Health Clinics: A Policy Analysis

2021 ◽  
pp. 152715442110119
Author(s):  
Tina Switzer ◽  
Erika Metzler Sawin ◽  
Melody Eaton ◽  
David Switzer ◽  
Christina Lam ◽  
...  
Keyword(s):  
Rural Communities ◽  
Policy Analysis ◽  
Rural Health ◽  
Policy Option ◽  
Care Needs ◽  
Rural Patient ◽  
Health Clinics ◽  
Sustainable Policy ◽  
Rural Health Clinics ◽  
Clinical Resource

Rural Health Clinics (RHCs) were created in 1977 to address the high health care needs, limited provider access, and poor health outcomes of rural Americans. Although innovative at their inception, the provider-centric model of RHC cost-based reimbursement structures has not evolved, leaving limited opportunities for change; many have failed. Comprehensive, proactive change is needed. Registered nurses (RNs) working at the top of their practice scope are a neglected clinical resource that can improve access, quality, value, and satisfaction for rural patient communities. RHC reimbursement policy must evolve to sustain and support this significant RN role. RNs have demonstrated value in care continuity and disease management, but there is little research on the utilization of RNs using their enhanced skill set in RHCs. Using the Bardach and Patashnik’s eight steps of policy analysis, the authors will describe the background and regulations of RHCs, identify current barriers to improving the health of America’s rural residents, and then provide evidence to support a new policy option according to the Quadruple Aim framework. The result is a sustainable policy recommendation designed to best serve rural communities.

scholarly journals Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

2015 ◽  
Vol 4 (5) ◽  
pp. 47 ◽  
Author(s):  
Jean Claude Byiringiro ◽  
Rex Wong ◽  
Caroline Davis ◽  
Jeffery Williams ◽  
Joseph Becker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Success Factors ◽  
Low Cost ◽  
Post Intervention ◽  
Triage System ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
The Impact

Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p < .001. Foot traffic per dayshift hour significantly decreased from 221 people to 160 people (28%, p < .001), and non-A&E related foot traffic decreased from 81.4% to 36.3% (45% decrease, p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.

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