Caregivers (CG) often neglect their own self-care which may have deleterious effects if CG have a chronic illness, such as diabetes. Care demands have been linked to CG health, although the mechanisms are unclear. The purpose of this study was to examine the relationships of CG stress, depressive symptoms, and diabetes self-care practices on CG physical health (PH) and glycemic control (GC) in an underrepresented group of Hispanic CG with diabetes. A correlational design was used in a non-random sample of 42 Hispanic CG with diabetes (Type I or II) recruited from two health centers serving the uninsured. CG had diabetes for ≥ 6 months, were on average 48.0 (± 11.4) years old, 73.8% female, and 54.8 % with < 8th grade education. Care recipients were on average 53.9 (± 14.0) years old, 54.8 % male, and were functionally independent. Standard questionnaires for perceived caregiving stress (Caregiver Burden Scale), depressive symptoms (CES-D), diabetes self-care practices (Diabetes Care Profile), PH (PCS of the SF12v2) and CG characteristics were administered in person. GC was measured using the glycosylated hemoglobin A1c (HgbA1c). Statistical analysis included correlations, t-tests, and multiple linear regression. On average CG had poor GC (HgbAlc M = 9.0, ± 2.12), but rated their PH better than others with diabetes. CG with high stress had more depressive symptoms (M = 23.75 ± 12.75) than CG with lower stress (M = 15.75 ± 12.01; t (40) = 2.00, p = .026). Almost half (40.5%) had depressive symptoms indicating possible clinical depression. The hypothesized models of caregiver stress, depressive symptoms, and self-care practices were not associated with CG PH (p > .05) or GC (p >.05); however, more persons in the household was associated with poor GC. This study provided support for the influence of CG stress on psychological health in the experience of Hispanic CG with diabetes. The findings of high levels of depressive symptoms and poor GC suggest the need for health care professionals to assess the psychological health of Hispanic CG and better educate them about the importance of GC for prevention of serious health problems.

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 228-243). Also available on the Internet.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1991.

The aim of this study was to explore and describe the experiences of diabetes mellitus patients at the Piggs Peak Hospital in Swaziland, from the time of diabetes diagnosis to living with diabetes, adherence to treatment and implementing diabetes self-care. A descriptive, exploratory, contextual qualitative research was conducted. Data was gathered through semi-structured interviews with 26 participants purposively selected on diabetes days at the hospital. Data was analysed qualitatively. Results revealed that patients present late for diagnosis. Being diagnosed causes psychological distress of varying intensity and duration. Hospital visits are burdensome due to financial and transport challenges, as well as service shortcomings. Self-care activities are difficult due to financial challenges and nonconducive social circumstances at home. Social support is lacking. Diabetes patients fear insulin use and prefer oral tablets. It is concluded that diabetes self-care is burdensome for most patients of the PPH in Swaziland. The service providers, stakeholders, and government need to explore strategies for mitigating effects of various barriers to self-care as revealed in this study. / Health Studies / M.A. (Public Health)

The aim of this study was to explore and describe the experiences of diabetes mellitus patients at the Piggs Peak Hospital in Swaziland, from the time of diabetes diagnosis to living with diabetes, adherence to treatment and implementing diabetes self-care. A descriptive, exploratory, contextual qualitative research was conducted. Data was gathered through semi-structured interviews with 26 participants purposively selected on diabetes days at the hospital. Data was analysed qualitatively. Results revealed that patients present late for diagnosis. Being diagnosed causes psychological distress of varying intensity and duration. Hospital visits are burdensome due to financial and transport challenges, as well as service shortcomings. Self-care activities are difficult due to financial challenges and nonconducive social circumstances at home. Social support is lacking. Diabetes patients fear insulin use and prefer oral tablets. It is concluded that diabetes self-care is burdensome for most patients of the PPH in Swaziland. The service providers, stakeholders, and government need to explore strategies for mitigating effects of various barriers to self-care as revealed in this study. / Health Studies / M.A. (Public Health)

Type 2 diabetes is a chronic disease whose incidence has increased with more than 200% during the past 20 years. The increasing number of type 2 diabetes patients could result in more patients suffering from lower quality of life and life threatening complications. Furthermore, the growing need of care will increase the load on healthcare. To counteract this effect, digital tools could be used to put more care responsibility on the patient.  The aim of this project was to find and implement the relevant features for a digital type 2 diabetes tool for newly diagnosed patients. The final goal was to encourage self-care, reduce anxiety and thus improve quality of life, while decreasing the risk of complications. The research process of this project consisted of five phases: literature study (to find relevant features and their clinical evidence), interviews (to find the desires of patients and practitioners), data analysis (to prioritise features), development of the features and evaluation of the tool.  The results showed that important features were documentation of blood glucose measurements, patient education, data transfer, communication and care plan overview, but even more importantwas the possibility to individualise the tool for different patients. The evaluation indicated that a clear care plan overview that was easy to understand could help the patient prioritise care activities. Furthermore, patients could be encouraged by reminders, seeing improvements and having continuous communication with healthcare. It was found that for positive clinical outcomes, high usability is essential. To reach patient acceptance the tool must be relevant and easy to use. It must also give valuable output, such as decision support for self-care or new knowledge. To reach practitioner acceptance the tool should be based on evidence based methods and integrate well with existing systems.  Finally it was concluded that the knowledge and technology needed to build a successful tool is already present, they only need to be put together and formulated in a way which is understandable and useful for both patients, caregivers and developers. / Diabetes typ 2 är en kronisk sjukdom vars incidens har ökat med mer än 200% de senaste 20 åren. Det stigande antalet patienter med diabetes typ 2 kan leda till att fler patienter blir lidande av lägre livskvalitet och livshotande komplikationer. Dessutom ökar det stigande vårdbehovet belastningen på vården. För att motverka denna effekt kan digitala verktyg utvecklas så att mer ansvar kan läggas på patienten. Syftet med detta projekt var att hitta och implementera relevanta funktioner för ett digitalt verktyg för nydiagnostiserade patienter med diabetes typ 2. Målet var att uppmuntra egenvård, minska oro och därmed öka livskvaliteten samt minska risken för komplikationer. Projektets forskningsprocess bestod av fem faser: litteraturstudie (finna relevanta funktioner och deras evidens), intervjuer (kartlägga krav från patienter och vårdgivare), dataanalys (prioritera funktioner), utveckling av funktioner i HOPE platform och slutligen utvärdering av verktyget i HOPE platform. Resultaten visade att dokumentation av blodglukosmätningar, patientutbildning, dataöverföring, kommunikation och vårdplansöversikt var viktiga funktioner, men ännu viktigare var möjligheten att individanpassa verktyget för varje patient. Utvärderingen indikerade att en tydlig vårdplansöversikt som är enkel att förstå hjälper patienten att prioritera de viktigaste vårdaktiviteterna. Vidare kan patienter motiveras av påminnelser, att se förbättring och att ha kontinuerlig kontakt med vården. Det konstaterades att hög användbarhet är nödvändig för att uppnå positiva kliniska effekter. För att nå acceptans hos patienterna måste verktyget vara relevant, enkelt att använda och ge något värdefull tillbaka, så som beslutsstöd för egenvård eller ny kunskap. För att nå acceptans hos vårdgivarna bör verktyget baseras på evidensbaserade metoder och vara kompatibelt med nuvarande system. Slutligen drogs slutsatsen att kunskapen och tekniken för att skapa ett lyckat verktyg redan finns, men att kraven måste sammanställas och formuleras på ett sätt som är förståeligt och användbart för både patienter, vårdgivare och utvecklare.