Self-efficacy and self-care behaviours among adults with type 2 diabetes.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) has an impact on an individuals' health and is influenced by glycemic control. AIM: To examine the relationship between glycemic control, demographic and clinical factors on self-efficacy and self-care behaviours among adults with T2DM. DESIGN: A correlational, descriptive study was used. One hundred and forty Omani adults with T2DM were recruited from a public hospital. METHODS: Data on self-efficacy, self-care behaviours and glycemic control were collected between April and July 2016. The study was approved by the College Ethics Committee and Hospital Board. Bivariate and multivariate analyses were conducted. RESULTS: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating 'uncontrolled' or poor HbA1c of >8% (65%). Variance of self-care behaviour (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. CONCLUSIONS: Adults with T2DM with poor glycemic control were more probable to have poor self-efficacy and self-care behaviours. Glycemic control has an effect on improving diet, exercise, medication, foot care efficacy and behaviours. CLINICAL RELEVANCE: The study recommends using these findings to plan self-efficacy and self-care behaviour to improve glycemic control among adults with T2DM.

Foot care behaviors among adults with type 2 diabetes.

AIM: The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes. METHODS: A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014. RESULTS: Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management. CONCLUSION: Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems.

Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes.

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.

Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

BACKGROUND: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. PURPOSE: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. METHODS: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. RESULTS: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. CONCLUSION: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.

Perception of and satisfaction with the clinical learning environment among nursing students.

BACKGROUND: Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East. OBJECTIVE: The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman. DESIGN: A cross-sectional descriptive design was used. SETTING AND PARTICIPANTS: A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman. METHODS: Ethical approval was obtained from the Research and Ethics Committee, College of Nursing in 2011. A standardized, structured, validated and reliable Clinical Learning Environment Supervision Teacher Evaluation instrument was used. Informed consent was obtained from all the students. Data was analyzed with ANOVA and structural equation modeling. RESULTS: Satisfaction with the clinical learning environment (CLE) sub-dimensions was highly significant and had a positive relationship with the total clinical learning environment. In the path model 35% of its total variance of satisfaction with CLE is accounted by leadership style, clinical nurse commitment (variance=28%), and patient relationships (R(2)=27%). Higher age, GPA and completion of a number of clinical courses were significant in the satisfaction with the CLE among these students. CONCLUSIONS: Nurse educators can improvise clinical learning placements focusing on leadership style, premises of learning and nursing care, nurse teacher, and supervision while integrating student, teacher and environmental factors. Hence the clinical learning environment is integral to students' learning and valuable in providing educational experiences. RELEVANCE TO PRACTICE: The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students.

Women's well-being and reproductive health in Indian mining community: need for empowerment.

This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

Factors associated with health-related quality of life among Indian women in mining and agriculture.

BACKGROUND: Women facing social and economic disadvantage in stressed communities of developing countries are at greater risk due to health problems. This paper investigates the relationships between structural, health and psychosocial predictors among women in mining and agricultural communities. This paper is a report of a study of the predictors of the health-related quality of life among Indian women in mining and agricultural communities. METHODS: A descriptive cross-sectional research design was used. The instruments used are SF-36 Health Survey and Coping Strategy Checklist. ANOVA, MANOVA and GLM were used in the analysis. The study was conducted between January-September 2008 with randomly selected women in a mining (145) and an agricultural community (133) in India. RESULTS: Women in the agricultural community had significantly increased Physical Health, Mental Health and SF36 scores compared with those in the mining community. Years of stay, education and employment were significant predictors among women in the agricultural community. 39% (33%) and 40% (26%) of the variance in Physical and Mental health respectively among women in agricultural and mining communities are predicted by the structural, health and psychosocial variables. CONCLUSION: Perceived health status should be recognised as an important assessment of Physical and Mental Health among women in rural stressed communities. Cognitive, emotional and behavioural coping strategies are significant predictors of health related quality of life. Implications. Nurses should use the SF-36 as a diagnostic tool for assessing health related quality of life among women and discuss coping strategies, so that these can target women's adaptive behaviour. This should be an essential part of the nursing process for facilitating adaptive process for improved health related quality of life.