EunSeok Cha1, Patricia C Clark2, Carolyn Miller Reilly1, Melinda Higgins1, Maureen Lobb1, Andrew L Smith3, Sandra B Dunbar1. 1. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Cha, Dr Reilly, Dr Higgins, Dr Lobb, Dr Dunbar) 2. Byrdine F. Lewis School of Nursing & Health Professions, Georgia State University, Atlanta, Georgia (Dr Clark) 3. School of Medicine, Emory University, Atlanta, Georgia (Dr Smith)
Abstract
PURPOSE: To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF- DM patients) by describing cognitive and affective factors to provide guidance in developing effective self-management education. METHODS: A cross-sectional correlation design was employed using baseline patient data from a study testing a 12-week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and comorbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t tests, or Mann-Whitney tests were performed to compare HF patients with and without DM. RESULTS: HF-DM patients were older and heavier, had more comorbidities, and took more daily medications than HF patients. High self-efficacy on medication and low-sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication-taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients but clinically higher levels of sodium. CONCLUSIONS: Diabetes educators need to be aware of potential conflicts of treatment regimens to manage 2 chronic diseases. Special and integrated diabetes self-management education programs that incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients.
PURPOSE: To explore the need for self-monitoring and self-care education in heart failurepatients with diabetes (HF- DMpatients) by describing cognitive and affective factors to provide guidance in developing effective self-management education. METHODS: A cross-sectional correlation design was employed using baseline patient data from a study testing a 12-week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and comorbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t tests, or Mann-Whitney tests were performed to compare HF patients with and without DM. RESULTS:HF-DMpatients were older and heavier, had more comorbidities, and took more daily medications than HF patients. High self-efficacy on medication and low-sodium diet was reported in both groups with no significant difference. Although HF-DMpatients took more daily medications than HF, both groups exhibited high HF medication-taking behaviors. The HF-DMpatients consumed significantly lower total sugar than HF patients but clinically higher levels of sodium. CONCLUSIONS:Diabetes educators need to be aware of potential conflicts of treatment regimens to manage 2 chronic diseases. Special and integrated diabetes self-management education programs that incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DMpatients.
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