Impact of the Home and Community Environment on Diabetes Management Presenter-Hayley Kermond Supervisor-Dr Kieran Broome
Literature Review Strong evidence for; • Physical activity • Healthy diet • Stress reduction • Medications Difficult to make necessary lifestyle changes (Booth et al., 2013;Snowling & Hopkins, 2006; Surwit et al., 2002)
Aim of Study • Determine how the home and community environment can act as a facilitator or barrier to diabetes self-management. • Develop preliminary diabetes-friendly guidelines from the collected and analysed data.
Research Design • Mixed methods design • 2 part study • First part Nominal Group Technique (NGT) • Second part Experienced Sampling Methods (ESM)
Nominal Group Technique • Input from all participants • Diverse opinions • Several ideas for set topic • Identifies priorities (Allen, Dyas & Jones, 2004)
Experience Sampling Methods • Gains immediate lived experience • Gains perspective over time • Reduces need for recall • Convenient (Barrett & Barrett, 2001)
Recruitment • Diabetes support groups • Community health centres • Diabetes Queensland • Medical centres • Retirement villages • University of the third age • Libraries • Social media
“The routine of the work day makes managing programs, whether they be diets, exercise or medication programs, easier.” “I was busy doing tasks so I forgot to do my exercises and walk.” “I manage exercise well now that routine is being re-established.” “Routine always makes managing lifestyle easier.”
Preliminary Guidelines • Establish routine • Strategies for routine changes • Education for social networks • Education on time management
Discussion • Guidelines to improve diabetes self-management. • Evidence base to implement necessary environmental changes. • Evidence base for future research.
Limitations • Small sample size • Exclusion of people who don’t have/use mobile phones • Voluntary sample
Aims Achieved Were the aims of the study achieved? • Barriers and facilitators to diabetes self-management in the home and community environment were identified. • Preliminary diabetes-friendly guidelines were developed.
Conclusion Shift from reactive to proactive role
References Allen, J., Dyas, J., & Jones, M. (2004). Building consensus in health care: a guide to using the nominal group technique. British Journal of Community Nursing, 9(3), 110-114. Retrieved from CINAHL Booth, A.O., Lowis, C., Dean, M., Hunter, S.J., & McKinley, M.C. (2013). Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals. Primary Health Care Research & Development, 14, 293-306. Dunstan, D. W., Zimmet, P. Z., Welborn, T. A., Courten, P. D., Cameron, A. J., Sicree, R. A., Dwyer, T., Colagiuri, S., Jolley, D., Atkins, R., & Shaw, J. E. (2002). The rising prevalence of diabetes and impaired glucose control: The Australian diabetes, obesity and lifestyle study. Diabetes Care, 25(5), 829-834. Retrieved from ProQuest Herman, W.H. (2013). The economic costs of diabetes: is it time for a new treatment paradigm? Diabetes Care, 36(4), 775-6. Jones, L., Crabb, S., Turnbull, D., & Oxlad, M. (2013). Barriers and facilitators to effective type two diabetes management in a rural context: a qualitative study with diabetes patients and health professionals. Journal of Health Psychology, in press. Kuntsche, E., & Labhart, F. (2013). Using personal cell phones for ecological momentary assessment. European Psychologist, 18(1), 3-11.
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