Improving Patient Problem Solving to Reduce Barriers to Diabetes Self-Management

Mulvaney, Shelagh A.

doi:10.2337/diaclin.27.3.99

Cited by 13 publications

(14 citation statements)

References 51 publications

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“…Different styles of problem solving, including impulsive or careless problem solving, have also been identified [13]. Across all areas of scholarship, the core process of problem solving has included a set of goal-oriented behaviors that includes identifying a problem, generating a set of potential strategies for problem resolution, selecting the most appropriate strategy, implementing that strategy, and evaluating and potentially revising the strategy [8,14]. The appropriate and successful application of these steps may be influenced by a wide range of additional factors including individual characteristics, prior experience in a given behavioral domain, and relevant social or environmental resources [15–17].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of the diabetes adolescent problem solving questionnaire

Mulvaney

Jaser

Rothman

et al. 2014

Patient Education and Counseling

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Objective Problem solving is a critical diabetes self-management skill. Because of a lack of clinically feasible measures, our aim was to develop and validate a self-report self-management problem solving questionnaire for adolescents with type 1 diabetes (T1D). Methods A multidisciplinary team of diabetes experts generated questionnaire items that addressed diabetes self-management problem solving. Iterative feedback from parents and adolescents resulted in 27 items. Adolescents from two studies (N=156) aged 13–17 were recruited through a pediatric diabetes clinic and completed measures through an online survey. Glycemic control was measured by HbA1c recorded in the medical record. Results Empirical elimination of items using Principal Components Analyses resulted in a 13-item unidimensional measure, the Diabetes Adolescent Problem Solving Questionnaire (DAPSQ) that explained 57% of the variance. The DAPSQ demonstrated internal consistency (Cronbach’s alpha = 0.92) and was correlated with diabetes self-management (r=0.53, p<.001), self-efficacy (r=0.54, p<.001), and glycemic control (r= −0.24, p<.01). Conclusion The DAPSQ is a brief instrument for assessment of diabetes self-management problem solving in youth with T1D associated with better self-management behaviors and glycemic control. Practice Implications The DAPSQ is a clinically feasible self-report measure that can provide valuable information regarding level of self-management problem solving and guide patient education.

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Section: Introductionmentioning

confidence: 99%

Development and validation of the diabetes adolescent problem solving questionnaire

Mulvaney

Jaser

Rothman

et al. 2014

Patient Education and Counseling

Self Cite

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“…Problem solving is a generalizable skill that is recommended as part of diabetes education [11–19]. Problem solving may be best taught with problem-based learning, where a specific relevant and realistic problem situation is presented as a vehicle for the development of generalizable knowledge using inductive reasoning [20–22].…”

Section: Introductionmentioning

confidence: 99%

Self-management problem solving for adolescents with type 1 diabetes: Intervention processes associated with an Internet program

Mulvaney¹,

Rothman²,

Osborn³

et al. 2011

Patient Education and Counseling

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Objective-Describe intervention processes associated with an Internet self-management problem solving program for adolescents with type 1 diabetes, and relate participant characteristics to program use.Methods-Forty-one adolescents with type 1 diabetes, aged 13-17, participated in an Internet intervention.Results-Participants reported psychosocial self-management barriers related to social issues (45%), time pressures (22%), and emotions (25%). Most adolescents (76%) completed the two guided problem solving cycles, and most (97%) problems were appropriate and specific to diabetes. Of the 61 diabetes problems reported, 92% were mostly or completely solved. Baseline hemoglobin A1c, diabetes duration, and age were not related to online activities, however females posted more often to the forum (U=130.0, Z=2.13, p = .033). The majority of parents (87%) interacted with their child about the website.Conclusion-Adolescents experience psychosocial barriers to self-management that can be addressed by teaching problem solving via the Internet.

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“…These activities made us aware that familial support and public understanding of type 1 diabetes were important to improve the HR-QoL for the clinical study participants. As previously reported, familial support is a core aspect of diabetic care, and public understanding of type 1 diabetes in the community and society is a key for translational research [22,23]. However, such familial support and public understanding have not been well evaluated in HRQoL surveys regarding type 1 diabetes and islet cell transplantation.…”

Section: Introductionmentioning

confidence: 93%

Development of a novel scale to assess the quality of life in type 1 diabetic patients for beta cell replacement therapy

et al. 2011

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The main purpose of beta cell replacement therapy for type 1 diabetic patients is to improve their health-related quality of life (HR-QoL). Previous HR-QoL surveys for beta cell replacement therapy on the point of familial support and public understanding have not been studied adequately. We hypothesize that familial support and public understanding have a significant impact on HRQoL of type 1 diabetic patients, and low HR-QoL assessed with a new scale is associated with seeking a new therapy. The initial questionnaire with 26 items was created after content validation based on 778 inquiries from patients or associates. One hundred five type 1 diabetic patients answered the questionnaire as well as separate questions about their opinions on beta cell replacement therapy. Finally, the new scale, named the Japanese InsulinDependent Diabetic Patient QoL (JAPID-QoL) scale, consisted of 19 items with the following three subscales: diabetes status, familial support and social acceptance. Cronbach's a for overall scale was 0.878, and those for three subscales were over 0.70. All items were satisfied with convergent validity. Lower scores on the JAPID-QoL scale were associated with higher interest in and acceptance of beta cell replacement therapy (Spearman's coefficients; r = -0.25, p \ 0.001 and r = -0.33, p \ 0.001, respectively) and also correlated with the necessity of psychosomatic care (r = -0.49, p \ 0.001). Our newly proposed JAPID-QoL scale showed enough reliability and validity to assess HR-QoL of type 1 diabetic patients. The patients who had a low HR-QoL on the JAPID-QoL scale desired to receive beta cell replacement therapy and psychosomatic care.

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Improving Patient Problem Solving to Reduce Barriers to Diabetes Self-Management

Cited by 13 publications

References 51 publications

Development and validation of the diabetes adolescent problem solving questionnaire

Development and validation of the diabetes adolescent problem solving questionnaire

Self-management problem solving for adolescents with type 1 diabetes: Intervention processes associated with an Internet program

Development of a novel scale to assess the quality of life in type 1 diabetic patients for beta cell replacement therapy

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