Objective: Test the effectiveness of a standardized chronic disease self-management intervention delivered to groups of older adults with type 2 diabetes.
Design: Prospective, randomized trial.
Sample/Setting: The sample (N = 160, 80% power) consists of older adults with type 2 diabetes who reside in independent living communities.
Concepts Studied Together: As guided by the Interaction Model of Client Health Behavior, 3 major categories of concepts are being studied: 1. Element of Client Singularity that includes concepts of background variables, intrinsic motivation, cognitive appraisal, and affective response; 2. Element of Client-Professional Interaction that consists of the group intervention versus standard care; and 3. Element of Health Outcome that includes concepts of clinical status indicators, participation in diabetes self-management, and health care utilization.
Methods: A 2 by 4 design with repeated measures is being used, where group is the between subject factor at two levels (control, intervention) and time the repeated measures factor at four levels (baseline, 8, 12, and 24 weeks). Data analysis will include repeated measures ANOVA and ANCOVA, generalized estimating equations, logistic regression, path and structural equation modeling, and psychometric testing of instruments.
Findings/ Conclusions: The research is in progress, but preliminary results will be available for the November 2003 Biennial Convention.
Implications: Older adults receive sub-optimal disease management services and have low self-management skills. The research is significant in that it seeks to build evidence-based knowledge to improve nursing practice and the self-management behaviors of older adults living with type 2 diabetes. Greater understanding of the multi-dimensional factors that influence the quality of life of older adults living with chronic illnesses can enhance the development of nursing theory aimed at promoting illness management and foster nursing research that tests the benefits of nursing therapeutics using standardized outcome measures.
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