Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 1998. / Includes bibliographical references.

Thesis (M.S.)--Eastern Illinois University, 2008. / Includes bibliographical references (leaves 68-73).

Thesis (M.S. in human nutrition)--Washington State University, December 2009. / Title from PDF title page (viewed on Feb. 11, 2010). "Program in Nutrition and Exercise Metabolism." Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains v, 113 p. : ill. Includes abstract. Includes bibliographical references (p. 96-113).

Thesis (M.S.)--University of Toledo, 2010. / Typescript. "Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Masters of Science Degree in Pharmaceutical Sciences, Administrative Pharmacy Option." "A thesis entitled"--at head of title. Title from title page of PDF document. Bibliography: p. 61-69.

The AIMS of this study are to: (1) Explore the perceptions and experiences of diabetes consultations from the perspectives of Pakistani patients, health professionals and interpreters (when one was involved). (2) Identify the processes and mechanisms which hinder or foster effective communication between healthcare professionals and their patients. (3) Provide recommendations for ways in which communication can be improved between healthcare professionals and their Pakistani patients STUDY DESIGN: A prospective qualitative study was developed, comprising three sequential components; namely: In-depth interviews with patients prior to a diabetes consultation; observation of the consultation; and, in-depth interviews with patients, health professionals and interpreters (when one was involved) following the consultation. Data were collected in the form of 10 detailed case studies. Each case study involved a Pakistani patient with type 2 diabetes mellitus (T2DM), their practitioner (s) involved in the consultation and an interpreter (if one was used). SAMPLE: Five male and five female Pakistani with T2DM (aged 41-80 years), 12 practitioners (some patients consulted with two people) and three interpreters (two professional and one lay) were recruited through health services and personal contacts within Edinburgh’s Pakistani community. Individual case studies were thematically analysed before all the case studies were compared/contrasted to identify cross-cutting themes. FINDINGS: Alongside language, a range of barriers and issues were identified which impacted upon communication between patients and health professionals in the consultations observed. Because of previous experiences of attending consultations in the UK and also in Pakistan, patients tended to come to their diabetes consultations with limited expectations; namely, to have their medication reviewed and receive test results. Consequently, patients tended not to raise health concerns and other issues unless they perceived these to be directly relevant to the consultation. In some cases, this resulted in patients not disclosing important information relating to their diabetes management and led to health professionals making inappropriate treatment recommendations. The routine and predictable nature of these diabetes review consultations meant that patients could be passive, offer very little information and ‘get by’ in their consultations; for instance, by offering responses after guessing what the professional was asking. As a result, some health professionals were unaware of patients’ poor English and of how little they had understood during the consultation. Health professionals found it difficult to establish understanding and rapport with patients who adopted a passive role in their consultations. This hindered them from identifying, and appropriately addressing, gaps in patients’ diabetes knowledge and any concerns they may have had. Interpreters did not always address the language barrier and edited and misinterpreted information. This is partly because they struggled to interpret medical terminology. However, this research also revealed how interpreters can experience dilemmas and role conflicts by virtue of being members of the same closely-knit Pakistani community as the patients they interpret for. Some of the barriers identified during this study also arose because patients tended to see different professionals at every visit which discouraged patient-provider relationships from being established. CONCLUSION: Patients would benefit from receiving ‘continuity in care’ and education and training on how to use their consultations more effectively. Providers would also benefit from education and training on more effective ways to communicate with these patients.

Diabetes has been labelled as one of the largest crises in the twenty-first century. Saudi Arabia is one of the top 10 countries for prevalence of diabetes and one in five people has the condition. Medication adherence assessment is vital to help clinicians reach therapy outcomes and identify gaps in patient management. The aim of this PhD was to explore oral hypoglycaemic medication (OHM) adherence in patients with Type 2 diabetes patients in Saudi Arabia and to identify factors associated with OHM adherence. The aim was addressed by: 1) Conducting a systematic review to identify which tools could be used to measure adherence to OHM as well as to quantify adherence levels across different countries; 2) Undertaking a cross-sectional study to quantify the prevalence of adherence to OHM in a group of patients in Saudi Arabia using a validated measure of adherence. An interview study on a subset of these patients then explored in detail Type 2 diabetic patients' beliefs and attitudes towards their OHM regimen, including factors which helped or hindered their medication taking behaviour. The systematic review included 37 studies. It showed that the level of OHM adherence varied widely across all measures: 36% to 95% when dispensing records were used, 37% to 98% with self-report, and 17% to 97% with pill counts. The term 'adherence' was most commonly used. There was no identified studies assessing OHM adherence in Saudi Arabia. The cross-sectional study showed that the level of OHM adherence was 40%, Lower adherence was associated with patients of younger age (OR, 1.084; 95% CI, 1.056-1.112), individual taking a higher number of non-OHM (OR, 0.848; 95% CI, 0.728-0.986) and having a higher HbA1c level (OR, 0.808; 95% CI, 0.691-0.943). The interview study identified several factors affecting OHM adherence using a validated theoretical framework. Facilitators of OHM adherence were OHM scheduling, knowledge about OHM, knowledge on other relevant behaviours such as diet and physical activity, knowing how to take OHM appropriately and how to manage hypoglycaemia. In addition, OHM adherence was facilitated by beliefs of preventing diabetic complications, avoiding insulin injections, achieving an improved quality of life, accepting diabetes, being optimistic about the future, and having high self-confidence. Conversely, barriers to OHM adherence were forgetfulness, cognitive overload, lack of knowledge of sexual health implications of OHM, and knowledge of OHM side effects or drug-drug interactions. Furthermore, side effects of OHM such as weight gain or hypoglycaemia, knowing how to measure blood sugar, feeling no symptoms, and having many medications to take were additional barriers to OHM adherence. The MASA study also showed that there are several social- and physical-related factors affecting OHM adherence such as the patient-physician relationship and perceived family support. The work in this PhD suggests that targeting suboptimal OHM adherence behaviour needs to be done in a comprehensive manner. The key benefit is to provide future researchers with a comprehensive range of factors that can be targeted when defining targets for an intervention(s). Further systematic intervention development and testing is required to choose and prioritise the most promising interventions to improve OHM adherence.

Thesis (M.S.)--University of Michigan, 1971.

Thesis (M.S.)--University of Michigan, 1971.

Bakgrund: Diabetes mellitus är ett växande hälsoproblem över hela världen. Sjukdomen medför flera komplikationer, vilket innebär en livsstilsförändring för individer som drabbas av sjukdomen. Egenvård är en central del i behandlingen som kan hjälpa att undvika sjukdomskomplikationer. Med stöd av rådgivning, undervisning och handledning kan egenvård främjas, på så sätt kan patienten upprätthålla en god hälsa utifrån sina förutsättningar. Syftet: Syftet med litteraturstudien är att beskriva egenvårdsupplevelser av patienter med diabetes mellitus typ 2.  Metod:  En litteraturstudie med kvalitativ design som följer Polit och Becks niostegsmodell samt Braun och Clarkes modell för tematisk analys. Inhämtade material genomfördes i databaser Pubmed och CINAHL.  Resultat: Resultatet presenteras i tre teman: emotionella aspekter, förståelser och söka kunskap, utmaning vid egenvård.  Slutsats: Patienten är beroende av livsförändringar för att upprätthålla en god egenvård. Sjuksköterskan ska sträva efter att arbeta personcentrerat med avsikt att tillgodose patientens egenvårdsbehov. Patienten ska kunna ta hand om sin diabetes utifrån sina förutsättningar därmed kunna uppleva en god hälsa och välbefinnande trots sjukdomen. / Background: Diabetes mellitus is a growing health problem worldwide. The disease entails several complications, which means a lifestyle change for individuals affected by the disease. Self-care is a central part of treatment that can help avoid disease complications. With the support of counselling, teaching and supervision, self-care can be promoted, in this way the patient can maintain good health based on their conditions. Aim: The purpose of the literature study is to describe self-care experiences of patients with diabetes mellitus type 2. Method: A literature study with a qualitative design that follows Polit and Becks nine-step model and Braun and Clarkes model of thematic analysis. Collected materials are processed in databases Pubmed and CINAHL. Results: The results are presented in three themes: emotional aspects, understandings and search for knowledge, challenge in self-care. Conclusion: The patient is dependent on life changes to maintain good self-care. The nurse must strive to work person-centred with the intention of meeting the patient's self-care needs. The patient must be able to take care of his diabetes based on his conditions to be able to experience good health and well-being despite the disease.