Article 1: George, S. R., & Thomas, S. P. (2010). Lived experience of diabetes among older, rural people. Journal of advanced nursing, 66(5), 1092-1100.
1)
The purpose of the study was to examine the perceptions and experiences of diabetes self-management among older people living with insulin-dependent diabetes in a rural area based on their narrations. 2)
The study utilized unstructured questions where the participants were asked to freely describe the life experiences in relation to self-management of diabetes and perception of the disease. Moreover, the participants were informed that there was no time limit and thus could utilize the maximum time in narrating their experiences. The data collected with the use of these questions purposely intended to answer the central research question, “What are the perceptions and experiences of diabetes self-management among older people living with insulin-dependent diabetes in rural areas?”3)
The study utilized a phenomenological study design that focused on direct description of the participant’s individual experience in relation to the study topic. As such, this method utilizes the bracketing component that requires the researcher to separate their knowledge from individual experience during data collection and analysis. This helps to minimize biases or preconceptions that may arise from the researcher’s personal experience. 4)
The study utilized a sample population of ten participants tied to various local agencies on ageing. The participants were aged between sixty five to eight five years and comprised of two white and eight African-American women living in the rural areas and their source of income was limited to social security. In addition, the participants’ length of time with the disease ranged from seven to thirty nine years. Among the participants, five had been diagnosed with the disease twenty five years previously, while the rest had been diagnosed twelve years previously. All the participants had complications related to diabetes and suffered from at least one chronic illness apart from diabetes.
5)
Although, the sample population utilized in the study was relatively small, the sample was adequate for the research design since the suitable population for this design ranges from six to twelve people. Moreover, the main purpose of phenomenological research is to gain an in-depth understanding in regard to the phenomenon, hence the need for a small sample size. 6)
Face-to-face interviews were carried out in the homes of the participants without any specific directions. As such, the participants were asked to freely describe the life experiences in relation to self-management of diabetes and perception of the disease. In addition, the participants were allowed the maximum time possible whereby this enabled them to discuss any relevant information regarding the topic in their own way. All the interviews obtained from the participants were audiotaped and copied for analysis. Subsequently, a survey was conducted to assess various issues pertaining to self-management of diabetes such as the participant’s frequency in regard to testing the level of blood sugar. 7)
The audiotaped interviews were transcribed, the transcripts were read several times while listening to the audiotape to ensure accuracy and gain insight on the participant’s experience in relation to the disease. In order to determine the pattern or themes that emerged from the interview, data collected from the transcripts was reviewed by the members of the interpretive and research group using the relevant method for analyzing data obtained from phenomenological research.
8)
The study utilized a small sample population that limits generalization of the findings. Hence, generalization of the findings is limited to the study location. Thus, the findings obtained may not be a representative figure of the entire population. Additionally, the sample population comprised of women only drawn from two ethnic groups whereby this further limits generalization of the findings.
9)
Nurses often rely on the stipulated guidelines to educate the public about diabetes as well as diabetes self-management. However, education on diabetes self-management should incorporate the client’s experience and insights. Thus, nurses should incorporate the client’s views and experiences in order to develop appropriate education programs on self-management of diabetes and help diabetic patients to regulate their level of blood sugar. More importantly, understanding the client’s worldview and evaluating their environment as well as experiences can help healthcare professionals to create suitable and relevant education programs to educate the public on effective self-management strategies for diabetes. I believe that the aforementioned conclusions are largely based on the data collected since they reflect the pitfalls in using stipulated guidelines to educate people on diabetes management. Furthermore, the conclusion emphasizes the importance of evaluating the client’s experience and environment in developing education programs on self-management of diabetes as depicted by the data collected from the study.
10)
The study provides valuable information that can be used to develop evidence-based interventions to promote diabetes self-management especially among the older population living in the rural areas. In addition, evaluating the patient’s experience and environment can help healthcare workers to customize their intervention according to the patient’s unique needs (Polit & Beck, 2013). Overall, the study sheds light on the need for healthcare workers to understand the patient’s needs and provide the relevant interventions instead of relying on the stipulated guidelines whereby this promotes the advancement of individualized care.
Article 2: Hunt, C., Sanderson, B., Ellison, K., (2014). Support for diabetes using technology: A pilot study toimprove self-management. MedSurg Nursing, 23(4), 231-237.
11)
The purpose of the study was to evaluate whether the use of Apple iPad applications that support self-management of diabetes would increase the participants involvement in behaviors that promote self-management, increase their self-efficacy in regard to self-management and improve their outcomes. 12)
While the research questions are not explicitly outlines, from the purpose and objectives of the study, it is apparent that the study was guided by the research question; “Does the use of Apple iPad applications that support self-management of diabetes increase the participants’ involvement in behaviors that promote self-management and increase their self-efficacy?”13)
The study utilized repeated measures study design that comprised of cross over studies. As such, the participants were randomly grouped into two groups i.e. the intervention and the control group. The intervention group received iPads and were instructed on how to use the application on self-management to record their daily behaviors and how to email their records to the investigator on weekly basis. On the other hand, the control group received journals and were instructed on how to record their self-management activates in the journals. Subsequently, the treatments were interchanged after three months whereby the iPad group received paper journals to record their behaviors and the journal group received iPads to record their daily behaviors.
14)
The study comprised a sample population of seventeen participants drawn from an “employee health group of a diabetes and nutrition center”. All the participants were diabetes type II patients with the ability to read as well as write in English. Among the participants, ten were female while eleven were aged above fifty years. Additionally, thirteen of the participants had been diagnosed with the disease about ten years previously.
15)
Although, the sample size used is relatively small, it is adequate for the research design since the research design requires fewer subjects to enable the researcher to make appropriate statistical inferences. Moreover, this type of research design is suitable for longitudinal studies, hence the design involves few participants due to the length of time involved in the study so as to keep track of all the participants. 16)
Basically, questionnaires were used in collecting the participants’ demographic information such as age, race, sex, education level and the length of time an individual had been diagnosed with the disease. In addition, the questionnaires were used in collecting the participant’s self-management activities and self-efficacy behaviors during the initial stages of the study. Baseline A1C value were obtained to evaluate their initial glycemic level. The study utilized self-reporting method where participants in the intervention group were required to record their self-management activities in the iPad while those in the control group were required to record their daily self-management activities in the provided journals. Moreover, the participants in the intervention group were required to email their self-management activities to the investigator weekly. The main self-management activities included; engaging in physical activities, eating healthy diets, monitoring the level of bold sugar as well as diabetes-related complications and taking medications.17)
The used descriptive statistics to analyze A1C values and demographic data. On the other hand, measurements obtained from the pre-test as well as post-test in regard to self-efficacy and self-management activities were analyzed using monitoring method. Furthermore, repeated measures analysis were used to evaluate changes that periodically occurred in self-management behaviors.
18)
The study utilizes a small sample size that may limit generalization of the findings. In addition, the participants had high scores on self-efficacy and excellent glycemic control at baseline whereby this makes it difficult for the researcher to evaluate the effectiveness of the treatment or intervention. The study mainly relied on self-reporting in collecting data, thus the participants may not record the actual information. The participants encountered problems with using the applications on the IPad especially on food entry. 19)
Self-management is a proactive action that requires diabetic patients to effectively understand the various treatment plans so as to modify as well as maintain daily activities that promote optimal management of the disease. As such, healthcare workers should embrace the use of technology to create intervention programs to educate diabetic patients on self-management and assist them to effectively manage the condition. Thus, further research should be conducted to examine the effective technological strategies that can be used to foster optimal self-management of the disease. I believe that the conclusions are based on data collected since the results indicate that the use of IPad applications that support self-management foster the adoption of behaviors that promote effective management of the disease. 20)
The study sheds light on the health benefits of embracing modern technologies such as smartphone applications to educate diabetic patients on effective management of diabetes as well as assist to effectively manage the illness. Building on this, healthcare professionals should integrate modern technologies in healthcare and develop appropriate education programs on self-management of diabetes in order to foster optimal outcomes among diabetic patients and improve their wellbeing (Polit & Beck, 2013).
References
George, S. R., & Thomas, S. P. (2010). Lived experience of diabetes among older, rural people. Journal of advanced nursing, 66(5), 1092-1100.
Hunt, C., Sanderson, B., Ellison, K., (2014). Support for diabetes using technology: A pilot study to improve self-management. MedSurg Nursing, 23(4), 231-237.
Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
