Self-Management Support for Insulin Therapy in Type 2 Diabetes

Funnell, Martha M.; Kruger, Davida F.; Spencer, Mark G.

doi:10.1177/014572170403000220

Cited by 64 publications

(59 citation statements)

References 17 publications

(12 reference statements)

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“…This sense of personal failure may leave the patient with feelings of failure and guilt [22] and a belief that they will be unable to control the disease in the future, regardless of treatment, and that insulin will not be effective and will not make a positive difference to their overall health [14,20,24,25,27]. Insulin may also be perceived as a threat or punishment, resulting in anger or betrayal, because patients may feel unfairly punished for poor self-care [12,28].…”

Section: Beliefs and Knowledge About Diabetes And Insulinmentioning

confidence: 99%

“…Additional negative self-perceptions and attitudinal barriers that may play a part in PIR include: wishful thinking that insulin is not necessary, procrastination regarding treatment [21], the belief that people treat insulin users differently [19], that they are no longer ''normal,'' that they are now dependent or like a drug addict [12,29], or that they are inadequately educated or ill-equipped to handle the daily demands of insulin therapy [28].…”

Section: Beliefs and Knowledge About Diabetes And Insulinmentioning

confidence: 99%

“…Patients may have concerns that insulin adds to the burden and stress that they already experience from managing diabetes on a daily basis [28], and do not feel confident that they can handle the day-to-day demands of insulin therapy [11]. Fears, perceived or real, that insulin therapy will be a source of inconvenience and cause a loss of personal freedom [8,10,21,23] that will severely restrict their lives and be too inconvenient, time-consuming, and complex to manage [1,6,11,19,24,25] may also facilitate PIR.…”

Section: Lifestyle Adaptations and Restrictionsmentioning

confidence: 99%

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Psychological insulin resistance: patient beliefs and implications for diabetes management

et al. 2008

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PIR is complex and multifaceted. It plays an important, although often ignored, role in diabetes management. Assisting health care professionals in better understanding PIR from the patient's perspective should result in improved treatment outcomes. By tailoring treatments to patients' PIR, clinicians may be better able to help their patients begin insulin treatment sooner and improve compliance, thus facilitating target glycemic control.

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Section: Beliefs and Knowledge About Diabetes And Insulinmentioning

confidence: 99%

Section: Beliefs and Knowledge About Diabetes And Insulinmentioning

confidence: 99%

Section: Lifestyle Adaptations and Restrictionsmentioning

confidence: 99%

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Psychological insulin resistance: patient beliefs and implications for diabetes management

et al. 2008

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“…In addition, another strategy could focus on educating providers about how to empower patients to better manage their diabetes. [17][18][19] As reported by Reiber et al, 13 diabetes self-management education is a necessary component of care within the VA health system, and, as such, the VA has a number of diabetes education strategies in place. However, the low proportions of veterans in this study receiving these educational strategies (ranging from 7% to 48%) suggest the need for VA administration to rethink the quality and effectiveness of these services.…”

Section: Discussionmentioning

confidence: 99%

Effect of Veterans Administration Use on Indicators of Diabetes Care in a National Sample of Veterans

Lynch

Strom

Egede

2010

Diabetes Technology & Therapeutics

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Background: Diabetes poses a serious health burden, of which veterans have a disproportionate share. Few data exist regarding differences in self-care behaviors and provider-based quality of care indicators among a large sample of veterans. The objective of this study was to determine the effect of Veterans Affairs (VA) use on diabetes quality of care indicators among veterans. Methods: A cross-sectional analysis was done on data from 36,525 veterans in the 2003 Behavioral Risk Factor Surveillance Survey. VA use was defined as receiving some or all health care from a VA facility in the previous 12 months. Diabetes quality indicators such as two or more provider visits, two or more hemoglobin A1c tests, and flu and pneumonia shots were compared between VA users and non-VA users. The independent effect of VA use on each quality indicator was analyzed with multiple regression using STATA version 10 (Stata Press, College Station, TX) to account for the complex survey design and yield population estimates. Results: Among veterans with diabetes, 26.8% were VA users. The only significant difference between VA users and non-VA users was that VA users were significantly more likely to check their feet one or more times daily (75.7% vs. 68.5%, P ¼ 0.015). In final adjusted models, VA users were at least twice as likely as non-VA users to have foot exams by a provider (odds ratio 2.59) and receive flu and pneumonia shots (odds ratio 2.30 and 2.05, respectively). VA users were also more likely to have two or more provider visits, dilated eye exams, and two or more hemoglobin A1c tests than non-VA users. Conclusions: Key quality indicators for diabetes care were better among veterans getting some or all of their care from VA facilities, suggesting more effective care strategies. However, interventions should identify and perpetuate excellent self-care behaviors to more substantially impact adverse diabetes-related outcomes.

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“…(2004) çalışmalarında, diyabetliyi doğru açıklamalarla eğitmenin, psikolojik direnci azalttığını ve tedaviyi geliştirdi-ğini saptamışlardır. [38] Bu değerlendirmeler esnasında, uygulamanın verimli olması açısından, geliştirilmiş ölçekler veya formlar kullanılarak diyabetlinin korkusunun olup olmadığı, varsa derecesi tespit edilmelidir. Hastalarda enjeksiyon ya da parmak delme korkusu varsa, öncelikle bu konu mercek altına alınmalı ve durumun üstesinden gelmek için sağlık ekibiyle birlikte hareket edilmelidir.…”

Section: İnsülin Enjeksiyon Ve Parmak Delme Korkusunun Yönetimiunclassified

Insulin injection and finger sticking fear in diabetic people

Çelik¹,

Pınar²

2014

Psi Hem Derg

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ÖZKarmaşık bakım ve tedavi gerektiren diyabette bireylerin kendi sağlık sorumluluğunu üstlenmeleri, gıda alımlarını ve egzersiz ayarlarını yapmaları, insülin enjeksiyonunu uygulamaları, önerilen şekilde kan şekerlerini ölçmeleri beklenmektedir. Ancak bireylerin yaşam tarzı değişikliklerini yapmada zorlandıkları ve uyum güçlüğü yaşadıkları bilinmektedir. Yapı-lan çalışmalarda insülin enjeksiyon ve parmak delme korkusunun tedaviye başlama, tedaviyi sürdürme, kan şekeri takibi yapma konularında engel oluşturduğu, kötü metabolik kontrol ve diyabet komplikasyonları ile ilişkili olduğu gösterilmiştir. Hem evrensel bir tanımının olmaması, hem de sağlık profesyonelleri tarafından gözardı edilmesi, yaygın görülen bu sorunun görünür kılınmasında ve yönetiminde güçlük yaratmaktadır. Diyabetin sonuçlarını önemli ölçüde etkileyen insülin enjeksiyonu ve parmak delme korkusunun belirlenmesi ve yönetiminde diyabet hemşi-relerine önemli sorumluluklar düşmektedir. Diyabet hemşiresi öncelikle bireyin yaşadığı korkunun nedenini tanımlamalı, derecesini tespit etmeli, korkunun yönetiminde hastalara eğitim vermeli, bu konuda diğer sağlık profesyonelleri ile işbirliği içinde çalışmalıdır. Bu derleme diyabetli bireylerde insülin enjeksiyon ve parmak delme korkusu, sonuçları ve yönetme stratejilerini gözden geçirmek amacıyla hazırlanmıştır.

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Self-Management Support for Insulin Therapy in Type 2 Diabetes

Abstract: Education and ongoing self-management support are needed for informed decision making and the initiation and maintenance of insulin therapy. Therefore, diabetes educators have a critical role to play during both the decision-making process and the safe transition to insulin therapy.

Cited by 64 publications

References 17 publications

Psychological insulin resistance: patient beliefs and implications for diabetes management

Psychological insulin resistance: patient beliefs and implications for diabetes management

Effect of Veterans Administration Use on Indicators of Diabetes Care in a National Sample of Veterans

Insulin injection and finger sticking fear in diabetic people

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