The Effects of Problem Solving Nursing Counseling and Intensified Walking Exercise on Diabetic Self-care, Coping Strategies, and Glycemic Control among Clients with DM Type II

문제해결식 간호상담과 강화된 걷기운동이 제2형 당뇨병 대상자의 자가간호, 대처기전 및 당대사에 미치는 효과

  • Lee Hae-Jung (Department of Nursing, College of Medicine, Pusan National University) ;
  • Park Kyung-Yeon (Department of Nursing, College of Medicine, Pusan National University) ;
  • Park Hyeong-Sook (Department of Nursing, College of Medicine, Pusan National University) ;
  • Kim In-Joo (Department of Medicine, College of Medicine, Pusan National University)
  • 이해정 (부산대학교 의과대학 간호학과) ;
  • 박경연 (부산대학교 의과대학 간호학과) ;
  • 박형숙 (부산대학교 의과대학 간호학과) ;
  • 김인주 (부산대학교 의과대학 의학과)
  • Published : 2005.12.01

Abstract

Purpose: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. Method: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. Result: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. Conclusion: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

Keywords

References

  1. American Diabetes Association. (2003). Standards of medical care for patients with diabetes mellitus, 26(suppl 1), S33-S50 https://doi.org/10.2337/diacare.26.2007.S33
  2. Anderson, S. E., Wadden, T. A., Bartlett, S. J., Zemel, B., Verde, T. J., & Granckowiak, S. C. (1999). Effects of lifestyle activity vs structured aerobic exercise in obese women: A randomized trial. JAMA, 281, 335-340 https://doi.org/10.1001/jama.281.4.335
  3. Borenstein, M., Rothstein, H., Cohen, J. (2001). Power and precision: A computer program for statistical power analysis confidence intervals. Englewood, NJ: Boostat
  4. Cameton, K., & Gregor, F. (1987). Chronic illness and compliance. J Adv Nurs, 12, 671-676 https://doi.org/10.1111/j.1365-2648.1987.tb01368.x
  5. Cook, S., Herold, K., Edidin, D. V., & Briars, R. (2002). Increasing problem solving in adolescents with type 1 diabetes: The choices diabetes program. Diabetes Education, 28(1), 115-124 https://doi.org/10.1177/014572170202800113
  6. Didjurgeit, U., Kruse, J., Schmitz, N., Stuckenschneider, P., & Sawicki, P. T. (2002). A time-limited, problem-oriented psychotherapeutic intervention in type 1 diabetes patients with complications: A randomized control trial. Diabet Med, 19, 814-821 https://doi.org/10.1046/j.1464-5491.2002.00811.x
  7. Fava, S., Aquilina, O., Azzopardi, J., Muscat, H. A., & Fenech, F. F. (1996). The prognostic value of blood glucose in diabetic patients with acute myocardial infarction. Diabet Med, 13, 80-83 https://doi.org/10.1002/(SICI)1096-9136(199601)13:1<80::AID-DIA10>3.0.CO;2-W
  8. Glasgow, R. E., Toobert, D. H., Hampson, S. E., Brown, J. E., Lewinsohn, P. M., & Donnell, J. (1992). Improving self-care among older patients with type II diabetes: The 'Sixty something...' study. Patient Educ Couns, 19(1), 61-74 https://doi.org/10.1016/0738-3991(92)90102-O
  9. Hartemann-Heurtier, A., Sultan, S., Sachon, C. F., & Grimal야, A. (2001). How type 1 diabetes patients with good or poor glycemic control cope with diabetes-related stress. Diabetes Metab, 27(5 pt 1), 553-559.
  10. Hill-Briggs, F. (2003). Problem solving in diabetes self-management. A model of chronic illness self-management behavior. Ann Behav Med, 25(3), 182-193 https://doi.org/10.1207/S15324796ABM2503_04
  11. Hong, Y. H., & Kim, M. A. (2001). An Analysis of Nursing Research on Diabetes Published in Korea from 1981 to 2000. J Fundmental Nurs, 8(3), 416-429
  12. Hwang, A. R., Yoo, J. S., & Kim, C. J. (2001). The effects of planned exercise program on metabolism, cardiopulmonary function and exercise compliance in type 2 diabetes mellitus. J Korean Acad Nurs. 31(1), 20-30
  13. Jalowice, A., Murphy, S., & Powers, M. (1984). Psychometric assessment of the Jalowiec Coping Scale. Nurs Res, 33, 157-161
  14. Jun, J. H., Jung, S. B., & Son, H. S. (1999). Self-Care and Related Factors in Patients with Diabetes. J Korean Diabetes Association. 23(2), 193-206
  15. Jun, J. Y. (1991). The effects programmed jogging on metabolism and cardio-pulmonary function of type E diabetic patients. A doctoral dissertation, Yonsei University, Seoul
  16. Karlsen, B., Idsoe, T., Dirdal, I., Rokne, H. B., & Bru, E. (2004). Effects of a group based counselling programme on diabetes-related stress, coping, psychological well-being and metabolic control in adults with typel and type2 diabetes. Patient Educ Couns Jun, 53(3), 299-308 https://doi.org/10.1016/j.pec.2003.10.008
  17. Kirk, A., Mutrie, N., Maclntyre, P., & Fisher, M. (2003). Increasing physical activity in people with type 2 diabetes. Diabetes Care, 26, 1186-1192 https://doi.org/10.2337/diacare.26.4.1186
  18. Ko, M. J., Yu, S. J, & Kim, Y. G. (2003). The effects of solution-focused group counseling on the stress response and coping strategies in the delinquent juveniles. J Korean Acad Nurs, 33(3), 440-450
  19. Korean Diabetes Association. (2005). http://www.iabetes.or.kr/clinic/knowledge.html
  20. Korean Diabetes Association & Health Insurance Review Agency. (2004). Seminar on Diabetes Mechanics
  21. Lazarus, R. S. & Folkman, S. (1984). Stress, appraisal, and coping. Springer. New York
  22. Lee, H. A., Lim, N. Y., & Park, H. A. (1998). Nursing, medical research and statistical analysis. 3th. edi. Soomoonsa. Seoul
  23. Lee, Y. R., Kang, M. A., Moon, J. S., & Kim, M. K. (2001). The effects of walking exercise on blood glucose level and motivation of exercise in the diabetes mellitus patients. J Korean Public Nurs, 15(1), 172-181
  24. Lerman, C, & Glanz, K. (1997). Stress, Ccoping and Health Behavior. In K Glanz, FM Lewis, BK Rimer, Health behavior and health education: Theory, research, and practice (2nd Ed.). John Wiley & Sons. New York
  25. Miyatake N., Nishikawa, H. Mirishita, A., Kunitomi, M., Wada, J., Suzuki, H., Takahashi, K., Makino, H., Kira, S., & Fujii, M. (2002). Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Res & Clin Pract, 58(2), 101-107 https://doi.org/10.1016/S0168-8227(02)00129-8
  26. Shin, H. S. (1998). Development of a self-management training program of insulin dependent diabetic adolescent. A master's dissertation, Yon-sei University. Seoul
  27. Toobert, D. J., Glasgow, R. E. (1991). Problem solving and diabetes self-care. J Behav Med, 14, 71-85 https://doi.org/10.1007/BF00844769
  28. Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure. Diabetes Care, 23(7), 943-950 https://doi.org/10.2337/diacare.23.7.943
  29. Walker, K. Z., Jones, J. A., Piers, L. S., O'Dea, K., & Putt, R. S. (1999). Effects of regular walking on cardiovascular risk factors and body composition in normoglycemic women and women with type 2 diabetes. Diabetes Care, 22(4), 555-561 https://doi.org/10.2337/diacare.22.4.555
  30. Wilbur, J., Chandler, P., & Miller, A. M. (2001). Measuring adherence to a women's walking program. West J Nurs Res, 23(1), 8-32 https://doi.org/10.1177/01939450122044934
  31. Willoughby, D. F., Kee, C. C, Demi, A., & Parker, V. (2000). Coping and psychosocial adjustment of women with diabetes. Diabetes Educator, 26(1), 105-112 https://doi.org/10.1177/014572170002600111