Diabetes empowerment related to Pender's Health Promotion Model: A meta‐synthesis

Abstract

Diabetes self-management is a challenge for both clients and health-care professionals. Empowerment plays a vital role in helping clients to achieve successful self-management. This study adopted a meta-ethnographic approach. Nine qualitative studies were synthesized in order to contribute to a deeper understanding of what clients perceive as being important in an effective empowerment strategy for diabetes self-management. Four central metaphors that influenced empowerment were identified: trust in nurses' competence and awareness, striving for control, a desire to share experiences, and nurses' attitudes and ability to personalize. The lines-of-argument synthesis suggested the need for an evaluation system to appraise clients' diabetes knowledge, health beliefs, and negative emotions, as well as the outcome of interventions. Based on Pender's Health Promotion Model, this study emphasizes the fact that health-care professionals need to understand and address modifiable behavior-specific variables. The study suggests that an effective empowerment strategy would be to use activity-related affect, as well as interpersonal and situational influences, as a means of facilitating and enhancing clients' health-promoting behaviors.

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

“…One primary study was included in both Ho et al 97 and Fleming and Gillibrand, 95 and the remaining three were included in both Paterson et al 98 and Campbell et al 55 There was, however, some repetition of authors, for example, there were seven primary studies by Lawton et al, five included in Gomersall et al, 96 one in Ho et al, 97 and one in Fleming and Gillibrand 95 with no overlap. The lack of overlapping studies between reviews highlights potential issues with their searching or screening methods.…”

“…This varied depending on the social environment the stroke survivor inhabited and other factors, such as age One study investigated patients' and carers' problems after stroke to inform the development of a community stroke support service. 97 Stroke patients' problems were diverse, complex, and changed over time; initially practical, and, later, psychological Peoples 2011 (p. 168) 67 The major psychological support valued by the informants included giving them reassurance and a sense of security, offering verbal encouragement, listening to their worries, showing a caring attitude and respecting them as individuals (Lui, 1999) (32) Reed 2012 (p. 558) 68 The majority of studies talked about the long-term (multiple year) nature of recovery and issues with coming to terms psychologically with the losses suffered through stroke…”

“…55,[95][96][97][98] Of those included, only one explicitly focused on adults with T2DM, 96 whereas the others considered adults (although age was not actually specified in all the reviews) with a combination of both T1DM and T2DM. 55,95,97,98 Paterson et al 98 describes the majority of their participants as educated, married women with insulin-dependent diabetes. Fleming and Gillibrand 95 only included studies where the majority were of first-or second-generation South Asian ethnicities.…”

“…Fleming and Gillibrand 95 used the method of theory explication, Campbell et al, 55 Paterson et al 98 and Ho et al 97 used interpretations of the meta-ethnographic framework proposed by Noblit and Hare, 51 and Gomersall et al 96 drew on the data synthesis method of grounded theory (Strauss and Corbin) 24 and the meta-ethnographic approach to theory development (Noblit and Hare). 51 Each review's aims and key findings are detailed in Table 23.…”

“…This is not just control of blood sugar, but of the psychological and social aspects, for example supporting people to cope with the emotions and role implications of being diagnosed with diabetes. 55,96,98 An individual's attitude towards diabetes, such as how serious the condition is and their level of control, 55 knowledge and beliefs 55,95,97,98 were reported to influence their self-management. Support for self-management should help to improve the patient's knowledge about the biological mechanisms and treatments of diabetes, and how to monitor and respond to their bodies.…”