STUDYING LEVEL OF KNOWLEDGE ABOUT OF DIABETES AND ITS RELATIONSHIP WITH DEMOGRAPHIC IN NURSES TO HYGIENIC AND MEDICAL CENTERS IN SANANDAJ CITY, IN 2007

N. Aliramaei (1), N. Sharifi (1), M. Sabery (1), L. Moradi (1)

1 Kurdistan University of Medical Science, Sanandaj, Iran

Introduction: Diabetes is the third leading cause of death from disease. In 2000, according to the World Health Organization, at least 171 million people worldwide suffer from diabetes, or 2.8% of the population. Diabetes mellitus occurs throughout the world, but is more common in the more developed countries. The greatest increase in prevalence is, however, expected to occur in Asia and Africa, where most patients will probably be found by 2030. Nurses who care for patients with diabetes must help them develop self –care management skills.

Method: This was a descriptive and analytical study. The research samples based on aim contain 180 persons. Data collection tools include questionnaire containing 10 questions relating personal information and 18 questions relating the rates of knowledge and using chi – square.

RESULTS: The findings showed that most test subjects were female (77.2%) and (55.6%) between 31-40 years old. More than (78.3%) married , and more than (71.7%) nurse for over 10 years (51.1%) , and also (37.8%) working in evening and night shift  and suffering from knowledge it (23/2%) well (56/4%) average and (40/4%) weak, Also finding , showed that the rate of knowledge was good (8.3%) , medium (70%) and weak (21.7%).

Conclusion: Diabetes is a self – managed disease that requires many strategies to keep it under control and a system of care to monitor the prevention and provide early treatment of complications. Patients are often more comfortable with nurses, and nurses spend more time with patients and have the expertise to teach them to manage their diabetes properly. The provision of care in nurse – directed clinics ma contribute to keeping patients with diabetes healthy and free of complications.

CORRELATES OF SUCCESSFUL COMPLETION OF THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM BY DIABETICS

S.N. Forjuoh (1), J.N. Bolin (2), C. Huber (3), J.W. Helduser (2), D. Begaye (1), J. Schimank (2), M.G. Ory (4)

1 Texas A&M HSC College of Medicine, Department of Family & Community Medicine, Temple, Texas, USA

2 Texas A&M HSC School Of Rural Public Health, Department Of Health Policy & Management, College Station, Texas, USA

3 Texas A&M HSC School Of Rural Public Health, Department Of Epidemiology & Biostatistics, College Station, Texas, USA

4 Texas A&M HSC School Of Rural Public Health, Department Of Social & Behavioral Health, College Station, Texas, USA

Background: The Chronic Disease Self-Management Program (CDSMP) is a 6-session workshop designed to address the need for self-management education in persons with chronic disease, including T2DM.

Purpose: To identify factors that may be associated with successful completion of the CDSMP.

Methods: A survey of 113 patients with T2DM (HbA1c >= 7.5) in an HMO. Survey questions included demographics, health-related quality of life, physical activity measures, pain and fatigue, as well as diet, exercise, home blood glucose monitoring (HBGM), and foot care measures. Clinical data included height, weight, BMI and HbA1c. Successful completion was defined as attendance in at least 4 of 6 sessions.

Results: 71% of participants successfully completed the CDSMP. There were no significant differences between completers and non-completers with regard to age, race/ethnicity, gender, general health, and responses to questions on physical activity, nutrition, HBGM, and foot care. However, the average number of days/week that completers participated in self-care activities was greater than that for non-completers for almost every positive self-care task including HBGM (5.10 vs. 4.96), checking of feet (4.94 vs. 4.44), following a healthful eating plan (3.98 vs. 3.48), spacing carbohydrates (3.65 vs. 2.80), and participating in >30 min exercise (2.71 vs. 2.26) although not significantly different.

Conclusion: Completion of the CDSMP was not found to be associated with race/ethnicity or socioeconomic status ¨C factors that have been linked to health disparities. Successful completion of the CDSMP may therefore imply better adherence to diabetes self-care activities, although this outcome needs to be explored further.

EXPLORING FOOT CARE EDUCATION IN DIABETIC PATIENTS IN CHANTANBURI, THAILAND

S. Parboteeah (1), T. Namwong (2), L. Rafter (3)

1 De Montfort University, UK

2 De Montfort University, UK

3 Burton Hospitals NHS Trust, UK

There is a close relationship between foot care education in diabetic patients and the development of foot ulcers, amputations and related complications. The aim of this study was to explore what education diabetic patients received in the management of their feet and what advice and education practitioners provided.  Data was collected from 15 patients, 5 educators and 5 practitioners using semi-structured interviews in a District Hospital in the Province of Chantanburi in Thailand. The findings indicate that only 36% of patients receiving hospital treatment for diabetes understood their conditions and that 93% were aware of the complications associated with the disease.  Patients indicated that they had received foot care education. However, patients’ reports suggest that patients did not take sufficient preventive action such as daily foot examinations in order to avoid foot complications. In appropriate foot care and foot wear were contributory factors in the development of foot complications. Both nurses and educators showed poor knowledge in the management of glycaemia, foot care behaviours, nutrition, referral to doctors, blood investigations, footwear, callus management, off loading and any assessments to find patients’ needs.

In conclusion, although foot care education is given to diabetic patients, it is sporadic. A more systematic and organised system of foot care education should be developed supported by a robust audit system for monitoring quality. The findings from this study influenced the development of foot care guidelines using the Delphi Technique.

THE EFFECTS OF VIDEO GAME BASED VIRTUAL REALITY BALANCE EXERCISE ON BALANCE AND FUNCTIONAL AMBULATION ACTIVITIES IN OLDER ADULTS WITH DIABETIC NEUROPATHY

C.H. Song (1), K.J. Lee (2)

1 Department of Physical Therapy, Sahmyook University, Seoul, Korea

This study investigated the effects of a video game based virtual reality balance exercise (VRBE) on balance and functional ambulation activities in older adults with diabetic neuropathy. 62 diabetic patients with signs and symptoms of peripheral neuropathy were enrolled, randomized and subdivided in two groups: a trained group of 32 diabetic participants (75.43+_7.21 years old), and a control group of 30 diabetic participants (74.87+_ 3.24 years old). The trained group practiced a VRBE, using video game (eye toys, Sony, Japan), for 60 minutes, two times a week for 8 weeks. Results were evaluated by both balance (postural sway path, Berg balance scale, functional reach) and functional ambulation activities (Timed Up and Go test, gait velocity). The results showed that postural sway path significantly decreased (p<.05), Berg balance scale, functional reach, improved significantly after VRBE (p<.05). Functional ambulation activities from timed up and go test, and 10m walking time improved significantly after VRBE (p<.05) In conclusion, the VRBE improved balance and functional ambulation activities. These results suggested that a VRBE is suitable for older adults with diabetic neuropathy.

VIETNAMESE DIABETES SELF MANAGEMENT PROGRAM

T. Thai (1)

1 Western Region Health Centre, Victoria, Australia

Introduction: The Vietnamese Community has a low awareness of diabetes. Family support in managing diabetes is found to be paramount in the Vietnamese community. Verbal information is the preferred method of education as literacy levels are low in the elderly. The greatest barrier to the provision of diabetes services for this community is seen as language.

Aim: To provide information about Type 2 Diabetes; to increase knowledge of condition; to increase self management skills; to encourage lifestyle changes and improve an individual’s health; to increase exercise tolerance; and to establish social links, support networks, and activity options in the local community.

Method: A 12 week program, comprising one hour of group education, 30 minutes of discussion and review, and 30 minutes of exercise per week. The program is conducted by a Vietnamese Diabetes Nurse Educator (DNE) and other health professionals within the Community Health Centre.  Each client receives a program outline, and a Type 2 Diabetes Education Booklet in Vietnamese edited by the DNE. The program is evaluated using the Flinders University Chronic Condition Self Management tools that include the Diabetes Risk Calculator and the Partner In Health (PIH) scale a Self Evaluation Questionnaire is also administered. 

Results: Scores from the PIH scale and results of HbA1c have improved overall. The Type 2 Diabetes Education Booklet is useful and informative.