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Thursday, 16 July 2009: 1:45 PM
Learning Objective 1: Learn about complex nursing interventions focusing diabetes self-care to better control the disease.
Learning Objective 2: understand how diferent variables (cognitive, organic, psychosocial) can affect the diabetic patients' behavior.
Purpose: Describe the effect of intervening variables upon the effectiveness of a controlled intervention as reflected on diabetes knowledge. Describe the predictive capacity of empowerment and self-care on a measure of glycaemic control on adults w DMT2. Methods: A two group quasi experimental repeated measures design was applied. Participants were recruited from two underserved communities in Monterrey , México, age 20-60 yrs (16 M-96 W), assigning each community group to the experimental and control conditions. Subjects w renal failure, less than 19 in MMSE were excluded. Type 2 Diabetes BASICS curriculum was the intervention fundament, delivered in four sessions distributed within a six months period. Content included, 1) symptoms, complications and carbohydrates management; 2) glucose self-monitoring and decision making, 3) self-management, 4) problem solving strategies. Measurements included four instruments and biochemical variables. Measures were performed at basal, 6, 12, and 18 months. Results: Participants were similar (p .06) in age, gender, education, BMI, and psychosocial variables, except in HbA1c where the control group had a lower value than the experimental (6.75 VS 7.71%). 1. Effect of the intervening variables upon diabetes knowledge was significant at the 18 months measurement (F 2,41 = 4.26, p = .021; adjusted R2 = .132. A backward regression model showed urine protein and Trail Making A test as the contributors to significance. 2. On the 18 months measurement self-care, empowerment and its interaction, were significant predictors of HbA1c (F 3, 41 = 3.58, p = .026; adjusted R2 = .15). Covariates were evaluated at Self-care 47.48, and empowerment 80.25, mean values. Conclusion: Diabetes knowledge is affected by disease complications as well as by cognitive factors. Intervention was effective improving diabetes knowledge, self-care and empowerment which at the time improved HbA1c values; however the self-care scores were much lower than the empowerment ones, suggesting patients overestimate their power.