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Effectiveness of a peer-led self-management program for older people with type 2 diabetes in ChinaShen, Huixia January 2008 (has links)
Type 2 diabetes is a common chronic disease, which has a negative health impact and results in enormous economic burden. The prevalence of type 2 diabetes is increasing dramatically and it affects older people disproportionately. The healthcare system in China is faced with an overwhelming burden due to a large ageing population, high prevalence of diabetes and limited healthcare resources. Self-management has been widely accepted as the cornerstone of the clinical management of type 2 diabetes. Since self-management usually involves complex behaviour change and can be emotionally challenging, effective education is essential to facilitate this transition. However, there has been no existing program of type 2 diabetes self-management for older patients in China until now. Furthermore, the generalisation of any health education programs is often hampered due to limited healthcare resources in China.
The primary purpose of this study was to develop a socially and culturally suitable self-management program, which addressed self-efficacy and social support to facilitate behaviour change and subsequent health improvement, for older people with type 2 diabetes living in the community in China. The secondary purpose was to test a feasible delivery model of the program through involvement of peer leaders and existing community networks.
This study was conducted in three phases. Phase one gathered information about barriers related to self-management behaviours and help needed to address them, from the perspective of older people with type 2 diabetes and community health professionals, through focus group discussion. Data from Phase One, together with guidelines of the selected theoretical frame work, results from an extensive literature review, and experiences of previous relevant studies provided the basis for development of a peer-led type 2 diabetes self-management program (Phase Two). Phase Three involved a pre-test, post-test non-equivalent control group design to test the effectiveness of the self-management program on older people with type 2 diabetes in the community. The impact of the program on peer leaders was examined using a one group pre-test, post-test design. In addition, evaluation of the program from peer leaders’ and older people’s perceptions was conducted through a post-test questionnaire.
Older people with type 2 diabetes and health professionals expressed broadly the same concerns, which were: social support; confidence to practice self-management behaviours; self-management behaviours; barriers to self-management behaviours; and advice for ongoing health education. However, their points of view were not always identical and different emphases were identified.
The peer-led program produced significant improvement in social support, self-efficacy, self-management behaviours and depressive status in the experimental group, as compared to the non-equivalent control group. However, there was no significant effect on quality of life nor health care utilisation. Therefore, the effectiveness of the program among older people with type 2 diabetes was partially confirmed. In addition, the participants were supportive, giving positive feedback about the program. Suggestions for future improvement were provided as well.
After receiving specific peer leader training and assisting in most of the delivery process of the program, the peer leaders improved, significantly, in overall self-management behaviours and in specific areas of social support and self-efficacy, though they did not improve in depressive status, quality of life and health care utlisation. In addition, these peer leaders enjoyed being peer leaders, and gave very positive feedback about the whole program.
In conclusion, this study has implications for understanding and facilitating self-management behaviours for older people with type 2 diabetes in China. The peer-led self-management program was effective in improving levels of self-efficacy, social support, self-management behaviours and depressive status among older people with type 2 diabetes living in the community in China. The delivery process involving peer leaders was deemed feasible to implement within the health care system in China. The program is suitable to be used by community health professionals in their practice in China. The study also has potential wider benefit to nursing practice and global health practice.
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The role of self-regulation in decision making by entrepreneursBryant, Peter Thomas January 2006 (has links)
Thesis (PhD)--Macquarie University (Macquarie Graduate School of Management), 2006. / Bibliography: leaves 243-283. / Introduction -- Literature on entrepreneurship, self-regulation and decision making -- Literature on decision making by entrepreneurs -- Methodology -- Results -- Discussion of empirical findings. / This thesis explores the role of self-regulation in decision making by entrepreneurs. It builds on prior research which has focussed on the cognitive aspects of key decisions made by entrepreneurs. Among these key decisions are career choice, opportunity evaluation and opportunity exploitation. One area of this ongoing reearch program is the exploration of social congition and self-regulatory factors in decision making. Hower, this area is still in its infancy, significant gaps remain and there are no coherent theories about such phenomena in the field of entrepreneurship. The purpose of this thesis is to contribute to theory development on these topics. / Mode of access: World Wide Web. / viii, 283 leaves ill
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Adolescent participants in a wilderness-based challenge : an evaluation of a primary and secondary prevention program /Sveen, Robert L. January 1994 (has links)
Thesis (M. Ed.)--University of Tasmania, 1996. / Library has additional copy on CD-ROM. Includes bibliographical references (leaves 89-108).
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New opportunities or difficult challenges? : self-regulation of learning of Chinese students in a western university setting : a thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in Higher Education in the University of Canterbury /Hardie, Julie Christine. January 2009 (has links)
Thesis (Ph. D.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (leaves 232-265). Also available via the World Wide Web.
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An exploration of the individual characteristics and abilities that contribute to competent professional performance in social work practitionersSchuurman, Shelley D. January 2008 (has links)
Thesis (PH.D.)--Michigan State University. Social Work, 2008. / Title from PDF t.p. (viewed on Aug. 11, 2009) Includes bibliographical references (p. 169-173). Also issued in print.
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Personal purpose as self-management a biblical argument and practical implementation /Walker, Steven A. January 1996 (has links)
Thesis (D. Min.)--Western Conservative Baptist Seminary, 1996. / Abstract. Includes bibliographical references (leaves 291-295).
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An evaluation of the effects of teaching students in a resource classroom a self-regulated assignment attack strategy /Ness, Bryan, January 2009 (has links)
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 109-117). Also available online in Scholars' Bank; and in ProQuest, free to University of Oregon users.
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Perceived social support and self-management of diabetes among adults 40 years and overSchwartz, Abby Jill. January 2005 (has links)
Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2005. / Title from first page of PDF document. Document formatted into pages; contains [1], vi, 69 p. Includes bibliographical references (p. 65-69).
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The interaction of temperament and childhood sexual abuse in predicting symptoms of borderline personality disorderRobertson, Christopher. January 1900 (has links)
Thesis (M.A.)--The University of North Carolina at Greensboro, 2008. / Directed by Rosemery Nelson-Gray; submitted to the Dept. of Psychology. Title from PDF t.p. (viewed Apr. 13, 2010). Includes bibliographical references (p. 32-42).
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The examination of an empowerment approach in a healthy living initiative of a non-profit organizationLawrence, Tamara. January 2006 (has links)
Thesis (M. A.)--University of British Columbia, 2006. / Includes bibliographical references.
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