Search PubMed⌕ Search

Biomedical subjects

R M Anderson

Publications and source records attributed to R M Anderson.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

The relationship between diabetes-related attitudes and patients' self-reported adherence.

This study involved 1202 patients who were placed into low adherence or high adherence groups based on their answers to questionnaires. The attitudes of each group were compared for a variety of adherence behaviors. Patients who reported high levels of adherence tended to have attitudes more in accord with diabetes experts. Members of the high adherence group strongly supported the need for special training for health care professionals who treat diabetes, favored team care, accepted the importance of patient compliance, acknowledged the seriousness of non-insulin-dependent diabetes mellitus (NIDDM), and recognized the relationship between glucose control and complications. Differences in attitudes between high- and low adherence groups were more prevalent for difficult adherence areas, eg, diet and exercise, than for easy adherence areas, eg, carrying sweets or diabetic identification. An understanding of patients' attitudes can help diabetes educators and patients develop realistic and relevant self-care plans.

Adult↗
PubMedDate not supplied

Evaluation of an activated patient diabetes education newsletter.

This study evaluated a monthly, activated patient newsletter sent to over 7000 patients in Michigan with diabetes. The newsletter provided concise and action-oriented information about diabetes care. Patients who had signed up to receive the newsletter during the first 4 months of the project (1863) were surveyed to determine how many patients found the newsletter helpful; 80% (1498) of the patients replied. Patients who found the newsletter most helpful were older; had lower incomes, and reported more complications, less understanding of diabetes, and being in poorer overall health. They also were more likely to have non-insulin-dependent diabetes mellitus (NIDDM) than insulin-dependent diabetes mellitus (IDDM). We concluded that the activated patient newsletter is a useful public health/patient education intervention for persons with diabetes. Such a newsletter should be part of a coordinated system of ongoing patient care, education, screening, and social and psychological support.

Adult↗
PubMedDate not supplied

Adapting a diabetes patient education program for use as a university course.

A study was conducted to determine if a patient education program, "Life With Diabetes," could be converted to an undergraduate course. The course consisted of seven 2-hour sessions with presentations by a physician, dietitian, psychologist, and clinical nurse specialists. Topics included definition, treatment, nutrition, monitoring, children, older adults, and patient empowerment. A total of 52 students (45 without diabetes, 7 with diabetes) have completed this one-credit course. A patient diabetes knowledge test and a 50-item Diabetes Attitude Survey were administered before and after the course. For the students without diabetes, mean knowledge posttest scores improved significantly, and significant changes were seen on the attitude subscales, with posttest scores moving closer to those of a national panel of diabetes experts. Students with diabetes scored closer to the national panel on the pretest and improved significantly only on the patient autonomy subscale. This course measurably improved knowledge and attitudes among undergraduates, suggesting that a patient education program can be adapted successfully to provide additional training opportunities for diabetes education programs.

Adult↗
PubMedDate not supplied

The diabetes education experience of randomly selected patients under the care of community physicians.

The purpose of this study was to describe the diabetes education and nutritional counseling received by patients under the active care of community physicians. The study population consisted of 440 patients with diabetes from the practices of 68 primary care physicians in eight Michigan communities. Fifty-eight percent of the sample reported having received diabetes education, and the mean number of years since the most recent education was 4.15 years. Sixty-six percent reported having seen a dietitian. Patients who had received diabetes education scored higher on a basic diabetes knowledge test (70% correct vs 60%) than patients who had not received diabetes education. From 1981 to 1991, a decline was observed in the percentage of patients who reported having received diabetes education (70% to 58%). Although patient education is an integral part of comprehensive diabetes care, too few patients are receiving it. Furthermore, diabetes education often results in less-than-optimal levels of knowledge. The situation has deteriorated over the past 10 years, and patients who are not on insulin typically are the least well served.

Adult↗
PubMedDate not supplied

Guidelines for facilitating a patient empowerment program.

The traditional medical treatment model often ignores the emotional, spiritual, social, and cognitive aspects of living with a chronic disease such as diabetes. Empowerment programs address these psychosocial areas by helping individuals develop skills and self-awareness in goal setting, problem solving, stress management, coping, social support, and motivation. Although many diabetes educators have been taught to use an empowerment curriculum to facilitate self-management, there is minimal research concerning the actual process of providing such programs to patients. We evaluated an empowerment curriculum (Empowerment: A Personal Path to Self-Care) with a diverse group of individuals with diabetes to determine the key elements of planning and implementing a successful diabetes patient empowerment program.

Adult↗
PubMedDate not supplied

Gender differences in diabetes attitudes and adherence.

This study focused on three questions: Is there a difference in men's and women's diabetes attitudes? Do health professionals give different recommendations to men and women? Is there a difference between men and women in care adherence? A total of 1201 patients with diabetes were surveyed; 65% of these patients were women. Differences in diabetes attitudes (three of seven attitudes) were most evident between men and women with insulin-dependent diabetes mellitus (IDDM). No differences were found in the attitudes of men and women with non-insulin-dependent diabetes mellitus (NIDDM) using insulin, and only one attitude was different for patients with NIDDM not using insulin. Few differences were observed in the recommendations given by health professionals to men and women. Gender differences in adherence to the components of self-care also were minimal. These findings may indicate that there are many similarities in the reactions of men and women who have been diagnosed with diabetes.

Attitude to Health↗
PubMedDate not supplied

Using focus groups to identify psychosocial issues of urban black individuals with diabetes.

The purpose of this focus group research was to identify issues that could serve as topics for a series of educational videos portraying psychosocial issues of urban black individuals with diabetes. Four focus groups involving 34 black adults were conducted in the Detroit area. Psychosocial issues were identified and rated in order of priority by an expert panel. The major psychosocial issues identified were the importance of food and eating in the black culture, the necessity for learning more about diabetes and its complications, learning to interact effectively with healthcare providers and systems, and the need for help and support in managing psychosocial issues related to diabetes. Black individuals with diabetes face unique psychosocial challenges. Focus groups are an effective method for obtaining relevant, culturally specific, in-depth information about living with diabetes from patients who are members of minority groups.

Adult↗
PubMedDate not supplied

Using quantitative and qualitative methods to pretest the publication. Take Charge of Your Diabetes: a Guide for Care.

Quantitative and qualitative methods used to pretest the guidebook Take Charge of Your Diabetes: A Guide for Care are presented in this paper. Questionnaires were used as the quantitative method (completed by 59 diabetes educators and 301 people with diabetes) and focus groups were used as the qualitative method (3 groups composed of 22 black men and women with diabetes) to examine the relevance, purpose, content, and presentation of the Guide. Findings from between-methods triangulation supported the relevance, clarity of messages, identification of groups that would be most likely to benefit, readability, understandability, and credibility of the Guide. Specific areas that needed modification were identified. Each evaluation method provided unique data; for example, quantifiable data on intention to change behavior was provided from one method and a recommendation that diversity be maintained was provided from the other method. The relative strengths and limitations of combining quantitative and qualitative approaches are described.

Adult↗
PubMedDate not supplied

Differences in the impact of dietary restrictions on African Americans and Caucasians with NIDDM.

African-American and Caucasian patients with non-insulin-dependent diabetes mellitus were surveyed to determine differences in self-reported dietary adherence. The relationship between dietary adherence and other psychosocial factors also was explored. The Diabetes Care Profile, an instrument designed to assess psychosocial factors related to diabetes, was completed by 178 patients. Correlation and regression analyses were used to examine the relationship between dietary adherence and 15 other scales in this instrument. Regression analyses revealed that selected scales were better at predicting dietary adherence for African Americans than for Caucasians. Self-care adherence was the most significant predictor of dietary adherence for African Americans while support was the most significant predictor for Caucasians. These findings suggest that cultural and social functions of food and diet should be examined and incorporated in the development of appropriate meal plans and educational interventions.

Black or African American↗
PubMedDate not supplied

Using focus groups to identify diabetes care and education issues for Latinos with diabetes.

The purpose of this study was to identify diabetes care and education issues for Latinos with diabetes. Four focus groups of Latinos with diabetes were held in the Detroit area; these sessions were audiotaped. An expert panel of bilingual health professionals from the United States and Mexico reviewed the audiotapes and identified and prioritized 47 issues using a modified Delphi technique. The highest priority issue identified by a wide margin was the difficulty many Latina women with diabetes have with self-care because of other family responsibilities. Universal diabetes care issues have a specific cultural expression which, when identified, can be incorporated into diabetes care and education programs for a particular cultural group. Focus groups are a useful means for identifying and illuminating such issues.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Into the heart of darkness: reflections on racism and diabetes care.

I have learned that effective diabetes care must be tailored to the lived experience of patients. Developing individually tailored self-management plans requires acknowledging the importance of other people's culture, goals, resources, and values. It has involved crossing the social distance created by the roles of healthcare professional and patient, and encountering patients in their full humanity. In these encounters, I have learned about myself as well. My experience over the past 7 years has made it clear to me that I was naive to believe that I could grow up in a country permeated by racism and free myself of its taint by simply rejecting it as an ideology. I have seen how profoundly my attitudes, perceptions, and habits of thought have been shaped by my cultural experience. I have developed a better appreciation of how far I (and we) have to go in achieving an equitable society. At times the process has been difficult and painful. However, I have come to believe that providing effective diabetes care engenders personal learning in both patients and health professionals. I believe that such learning will offer significant benefits to both groups.

Black or African American↗
PubMedDate not supplied

Theory is the cart, vision is the horse: reflections on research in diabetes patient education.

PURPOSE: In this paper, we examine the nature of vision and the role it plays in helping educators identify and use theories productively. We also discuss the role of theory in diabetes education and provide criteria for selecting appropriate theories. METHODS: The vision of diabetes education developed at the Michigan Diabetes Research and Training Center was used to illustrate how our vision has influenced our use of educational and behavioral theories. RESULTS: Both our vision and our theoretical assumptions should be articulated, discussed, debated, and studied. CONCLUSIONS: Diabetes patient education research can systematically contribute to the development of a sound, coherent, and progressive body of knowledge that will truly serve diabetes patient education.

Behavioral Sciences↗
PubMedDate not supplied

Community diabetes care in the 1980s.

This is a study of diabetes care and care outcomes for patients under the active care of private physicians. Randomly selected communities, physicians, and patients in Michigan were the subjects of this study. Data on the care practices of physicians and patients and care outcomes were collected from 1980 to 1981 and again in 1985 from eight communities, 61 physicians, and 261 patients. We found that the use of multiple injections of insulin and self-monitoring of blood glucose increased significantly, whereas hospitalizations for diabetes control decreased. The mean glycosylated hemoglobin values for this cohort of patients remained unchanged. The study results suggest that, for patients under the active care of community physicians, modern methods of diabetes care are being implemented, but the results of improved care do not show an impact on blood glucose control as measured by glycosylated hemoglobin values. The study was not designed to establish causation for the decrease in hospitalizations for these patients, but the data suggest that decreases may be more a function of changes in health-care policies rather than changes in patient health.

Adult↗
PubMedDate not supplied

The continuing education needs of diabetes nurse educators.

The major caveat regarding this study is the low return rate. We suspect that this is due to the extensive nature of this lengthy questionnaire. A shorter questionnaire sent at the same time to another sample drawn from the same population produced a return rate higher than 50%. However, some benefits were derived from the study. The first is the extensive set of data obtained about both the continuing education needs and the practice patterns of this sample of diabetes nurse educators. (A longer report that includes information about how the nurses spend their time, the types of diabetes education they provide, and the size and scope of the diabetes patient education programs at their institution is available from the first author.) Second, it is reasonable to assume that the nurse educators who took the time to complete this lengthy questionnaire about their continuing education needs and practices are thoughtful consumers of continuing education. Their needs and preferences should be of concern to the individuals and organizations that provide continuing education to diabetes nurse educators. In summary, the nurses in this sample are highly educated and experienced diabetes educators. They indicated a strong desire for obtaining continuing education primarily in behavioral and psychosocial issues, but perceive that they are limited by a lack of financial support and time.

Diabetes Mellitus↗
PubMedDate not supplied

Providing for the severely handicapped: a case for competency-based preparation of occupational therapists.

Recent court decisions that mandate the development of new instructional alternatives for severely handicapped children will have significant implications for occupational therapists. Focusing on such issues as mainstreaming, accountability, and certification standards, this paper places in perspective the problems and trends that have led to this new challenge. It also provides suggestions for the development and disposition of training programs that can ultimately result in more appropriate programming for the handicapped children in the new population to be served in the public schools. Illustrated with examples of competency components and behavioral objectives, competency-based occupational therapy preparation programs are emphasized.

Child↗