Thinking About Cognitive Function: Perceptions of Cognitive Changes in People With Type 2 Diabetes

Abstract

Purpose The purpose of this study is 2-fold: (1) to explore how people with diabetes view diabetes-related cognitive problems and (2) to examine participants' ideas on a cognitive rehabilitation intervention to adapt it for persons diagnosed with type 2 diabetes (T2DM). Methods A qualitative descriptive study based on narrative interviews was conducted with adults (n = 10) with T2DM. The interview data were analyzed using content analysis. Results The interviews reflected 4 major themes: search for advice regarding cognitive complaints, cognitive symptoms, impact of perceived cognitive dysfunction on diabetes self-management, and maintenance of cognitive health. Specific areas of interest for an intervention included the following: understanding how cognitive function relates to diabetes, dealing with cognitive barriers to self-management, and learning how to incorporate a "brain healthy" lifestyle into daily activities. Conclusions Findings showed that perceived cognitive impairment impacted self-management and suggested that cognitive rehabilitation interventions have potential utility for people with T2DM. Existing successful interventions can be tailored to meet the needs of those whose diabetes self-management is impacted by cognitive problems.

Participant Perspectives of Cognitive Rehabilitation for Type 2 Diabetes: Expectations and Impact

“…Participants often described not meeting the self-management standards that were set for them (by themselves or by their health-care provider) and felt that anything they could do to improve cognitive function would also help with diabetes self-management. The relationship of perceived cognitive function and diabetes self-management has been seen in the recent literature [13, 25] and suggests perceived executive function and memory capabilities are significantly associated with diabetes self-management adherence. Other studies have also found that self-management and glycemic outcomes are even worse when screening for cognitive dysfunction is delayed despite complaints of cognitive problems [26].…”

Effect of Interactive Education on Diabetic Self-Foot Examinations in Type 2 Diabetes

“…8,13 Perceived barriers alter rates of self-care and daily self-foot examinations. 13,[21][22][23] Decreased rates of self-foot examinations were associated with patient beliefs that foot examinations take too much time, are too much trouble, and are not important. 21,23 Patients who reported higher rates of daily self-foot examinations perceived fewer barriers.…”

“…21,23 Self-efficacy and awareness of a neuropathy diagnosis are associated with higher rates of daily self-foot examinations. 21,22 The purpose of this project was to provide interactive self-foot examination education in an outpatient office setting and assess whether rates of daily self-foot examinations were affected. Perceived barriers to self-foot examinations were also assessed.…”

“…Patients were supplied at check-in with a preintervention survey based on the Diabetic Foot Ulcer Health Belief Scale (DFUHBS), which addressed patients with type 2 diabetes and written education emphasizing the skills, ease, and importance of daily self-foot examinations. 8,22 The DFUHBS-based survey consisted of 3 demographic, 2 frequency of self-foot examination, and 7 perceived barriers to self-foot examination questions. 22,23 It was a 1-sided, 1-page questionnaire written at a fifth-grade literacy level.…”

“…8,22 The DFUHBS-based survey consisted of 3 demographic, 2 frequency of self-foot examination, and 7 perceived barriers to self-foot examination questions. 22,23 It was a 1-sided, 1-page questionnaire written at a fifth-grade literacy level.…”