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SUPPORT SYSTEMS IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS AND THE RELATIONSHIP TO DIABETES-RELATED STRESS, CONFLICT, AND METABOLIC CONTROL
Title
SUPPORT SYSTEMS IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS AND THE RELATIONSHIP TO DIABETES-RELATED STRESS, CONFLICT, AND METABOLIC CONTROL.
Creator
Foarde, Samuel, LaManna, Jacqueline, University of Central Florida
Abstract / Description
The purpose of this integrated review of the literature was to explore the effects of social support on diabetes-related stress, conflict, and metabolic control in adolescents with type 1 diabetes mellitus (T1DM). Social support was examined in four subgroups: adolescents with T1DM, family caregivers, peers, and teachers. Relevant findings in the literature revealed a significant deficiency of research devoted to adolescent males with diabetes as well as fathers as primary and secondary...
Show moreThe purpose of this integrated review of the literature was to explore the effects of social support on diabetes-related stress, conflict, and metabolic control in adolescents with type 1 diabetes mellitus (T1DM). Social support was examined in four subgroups: adolescents with T1DM, family caregivers, peers, and teachers. Relevant findings in the literature revealed a significant deficiency of research devoted to adolescent males with diabetes as well as fathers as primary and secondary caregivers. Studies highlighted the importance of fostering autonomy and positive self-image in adolescents with T1DM and described effective interventions to improve diabetes-related stress, reduce disease-related conflict, and improve metabolic control. Findings suggested that nurses caring for adolescents with T1DM and their families should foster positive, open communication, while identifying barriers to problem solving, coping, stress, and optimal glycemic control. Interventions that educate caregivers and peers on how to better communicate and provide support are critical in fostering positive psychological and physiological outcomes in the adolescent with T1DM. The findings of this study may provide guidance in the way that nurses assess, identify, and counsel adolescents with TIDM regarding their disease management and access to support systems.
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Date Issued
2013
Identifier
CFH0004324, ucf:45057
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004324
EXPERIENCES OF HOSPITALIZED PATIENTS WITH DEMENTIA
Title
EXPERIENCES OF HOSPITALIZED PATIENTS WITH DEMENTIA.
Creator
Bainbridge, Samantha, LaManna, Jacqueline, University of Central Florida
Abstract / Description
People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff....
Show morePeople with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.
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Date Issued
2012
Identifier
CFH0004146, ucf:44855
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004146
Early and Intermediate Hospital-to-Home Transition Outcomes of Older Adults Diagnosed with Diabetes
Title
Early and Intermediate Hospital-to-Home Transition Outcomes of Older Adults Diagnosed with Diabetes.
Creator
Lamanna, Jacqueline, Bushy, Angeline, Norris, Anne, Wink, Diane, Gammonley, Denise, University of Central Florida
Abstract / Description
Over 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by...
Show moreOver 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by the continuous interaction of personal, community, and societal-level conditions that facilitate or inhibit the health of a transition. Hospitalization has been described as a series of three successive, interrelated transitions. The aims of this study were to determine whether personal and community transition conditions impacted the early and intermediate post-discharge outcomes in a sample of older adults with diabetes. A simultaneous quantitative/qualitative mixed method design was used to identify factors that impacted the home recovery transition experiences in a sample of 96 older adults with a mean age of 75 years. A supplementary content analysis of free-response data gathered during administration of the Post-Discharge Coping Difficulty Scale (PDCDS) clarified difficulties encountered by elders and caregivers during in the first 30 days following discharge. Four overarching themes emerged: (")the daily stuff is difficult("); (")engineering care at home is difficult("); (")life is stressful(") and (")difficulty managing complex health problems(").Difficulties managing a complex medication regimen, regulating blood glucose, and managing a non-diabetes chronic health problem such as hypertension and chronic lung disease were subthemes that emerged during qualitative data analyses. These subthemes were transposed into discrete nominal level variables and served as additional indicators of post-discharge coping difficulty in the descriptive correlational core component of the research project.Participants in this study who experienced an event of recidivism had lower pre-discharge assessments of readiness on the Readiness for Hospital Discharge Scale (RHDS) (t = 2.274,df = 48, p =.028). Higher PDCDS scores were observed in patients who experienced an event of recidivism within 30 days of discharge (t = -3.363, df=24.7, p = .003) and also in respondents who described difficulties with managing medications, controlling diabetes, and managing a chronic illness. Binary logistic regression was used to identify factors that may predict recidivism risk. No condition-specific predictor variables were identified. A statistically significant three-variable model (X2 = 26.737, df = 3, p (<) .001) revealed that PDCDS scores at 7 days (Wald X2 =3.671, df = 1, p =.050), PDCDS scores at 30 days (Wald X2 = 6.723, df = 1, p =.010), and difficulty managing a chronic health condition (Wald X2 = 8.200, df = 1, p =.004) were predictive of an event of recidivism within 30 days of discharge. Difficulty managing a chronic health problem other than diabetes was particularly predictive of recidivism. The nurse's skill in delivering discharge education was a factor in limiting early post-discharge difficulties. Elders with residual information needs on the day of discharge as measured by scores the Quality of Discharge Teaching Scale (QDTS) reported a lower readiness for discharge (r = -.314, p = .003) and experienced greater difficulties with early post-discharge coping (r =. 288, p = .023). Greater satisfaction with the post-discharge transition was noted in participants with higher QDTS scores (r = .444, p (<).001). Outcomes of the hospital-to-home transition experience were impacted by a variety of personal, hospital, and community factors. Findings of this study suggest that there is a need to better understand the sequential nature of the home recovery transition and the fluid needs of older adults during this high-risk phase of care. The environments in which older adults receive post-discharge care are complex and need to be thoroughly considered when planning the post-discharge transition. Metrics of institutional performance of transitional care practices need to extend beyond events to recidivism and include evaluations of post-discharge coping and transition satisfaction. The nurse as the primary provider of discharge education has the potential to significantly promote positive transition outcomes for older adults and their family care providers.
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Date Issued
2013
Identifier
CFE0004875, ucf:49652
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004875