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1.
Ethn Health ; 24(7): 767-778, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28870122

RESUMEN

Background: Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. Purpose: The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM. Methods: A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c. Results: The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale (P = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years (P = 0.05) and a higher number of diabetes complications (P < 0.001) were associated with higher HbA1c levels. However, advanced age (P = 0.055), female gender (P = 0.003), and diabetes education (P = 0.011) were significantly associated with lower HbA1c levels. Conclusion: This is the first study in the Arab region that identifies diabetes fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes.

2.
PLoS One ; 13(1): e0190719, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29324827

RESUMEN

BACKGROUND: There are widespread fatalistic beliefs in Arab countries, especially among individuals with diabetes. However, there is no tool to assess diabetes fatalism in this population. This study describes the processes used to create an Arabic version of the Diabetes Fatalism Scale (DFS) and examine its psychometric properties. METHODS: A descriptive correlational design was used with a convenience sample of Lebanese adults (N = 274) with type 2 diabetes recruited from a major hospital in Beirut, Lebanon and by snowball sampling. The 12- item Diabetes Fatalism Scale- Arabic (12-item DFS-Ar) was back-translated from the original version, pilot tested on 22 adults with type 2 diabetes and then administered to 274 patients to assess the validity and reliability of the scale. Confirmatory factor analysis (CFA) was used to test the hypothesized factor structure. Cronbach's alpha was used to test for reliability. RESULTS: CFA supported the existence of the three factor hypothesis of the original DFS scale. The five items measuring "emotional distress" loaded under Factor 1, the four items measuring "spiritual coping" loaded under factor 2 and the last three items measuring "perceived self-efficacy" of the original scale loaded under Factor 3 (p <0.001 for all three subscales). Goodness of fit indices confirmed adequateness of the CFA model (CFI = 0.97, TLI = 0.96, RMSEA = 0.067 and pclose = 0.05). The 12-item DFS-Ar showed good reliability (Cronbach's alpha of 0.86) and significantly predicted HbA1c (ß = 0.20, p < 0.01). After adjusting for the demographic characteristics and the number of diabetes comorbid conditions, the 12-item DFS-Ar score was independently associated with HbA1c in a multivariable model (ß = 0.16, p < 0.05). CONCLUSIONS: The 12-item DFS-Ar demonstrated good psychometric properties that are comparable to the original scale. It is a valid and reliable measure of diabetes fatalism. Further testing with larger and non-Lebanese Arabic population is needed.


Asunto(s)
Diabetes Mellitus Tipo 2/psicología , Psicometría , Anciano , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
3.
J Relig Health ; 57(3): 858-868, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28597199

RESUMEN

Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716-724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (ß = -.14, 95% CI -.27, -.002), BMI (ß = .35, 95% CI .15; .54), level of education (ß = -3.98, 95% CI -7.64; -.32) and number of diabetes problems (ß = -5.03, 95% CI -9.89; -.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores' change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.


Asunto(s)
Árabes/estadística & datos numéricos , Actitud Frente a la Salud , Diabetes Mellitus Tipo 2/etnología , Diabetes Mellitus Tipo 2/psicología , Adulto , Anciano , Árabes/psicología , Estudios Transversales , Diabetes Mellitus Tipo 2/mortalidad , Femenino , Humanos , Líbano/epidemiología , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Encuestas y Cuestionarios
4.
Int J Nurs Educ Scholarsh ; 14(1)2017 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-28976908

RESUMEN

Evidence-based practice (EBP) is defined as "the conscientious use of current best evidence in making clinical decisions about patient care." This paper describes how we have developed the evidence-based practice concept and integrated it into two courses at two different levels of the BSN curriculum. Students apply EBP knowledge and process by using the PICO clinical question (Population, Intervention, Comparison and Outcome), whereby they observe a selected clinical skill, and then compare their observations to hospital protocol and against the latest evidence-based practice guidelines. The assignment for the second course requires students to pick a more complex clinical skill and to support proposed changes in practice with scholarly literature. Assessment of student learning and course evaluation has shown that the overall experience of integrating EBP projects into the curriculum is fruitful for students, clinical agencies, and faculty.


Asunto(s)
Competencia Clínica , Bachillerato en Enfermería/organización & administración , Enfermería Basada en la Evidencia/educación , Estudiantes de Enfermería , Curriculum , Países en Desarrollo , Femenino , Humanos , Líbano , Masculino , Investigación en Educación de Enfermería , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios
5.
Res Theory Nurs Pract ; 30(1): 60-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27025000

RESUMEN

Translation of instruments needs to ensure equivalence between the source and the target language to establish the psychometric properties of the translated version. The purpose of this study was to examine the psychometric properties of the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument. The 12-item English version of the SDSCA was translated into Arabic using back translation on a sample of 140 Lebanese participants with Type 2 diabetes. Construct validity was measured using exploratory factor analysis with varimax rotation. Multitrait scaling analysis was used to test for item convergent and discriminant validity based on item-scale correlations. Conceptual and content validity were examined by an expert panel in diabetes. Internal consistency reliability R was assessed using interitem correlations. The average interitem correlation for the four subscales ranged between--.05 for Diet and .66 for Glucose Testing. Factor analysis identified four factors which accounted for 60% of the variance. The preliminary results of Summary of Diabetes Self-Care Activities-Arabic Version (SDSCA-Ar) are comparable to the psychometric properties the original SDSCA. SDSCA-Ar is a valid measure of diabetes self-care in Lebanese patients with diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Cooperación del Paciente/estadística & datos numéricos , Autocuidado/métodos , Anciano , Anciano de 80 o más Años , Características Culturales , Análisis Factorial , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Traducciones
6.
Worldviews Evid Based Nurs ; 13(1): 59-65, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26773417

RESUMEN

BACKGROUND: As the world becomes increasingly digital, advances in technology have changed how students access evidence-based information. Research suggests that students overestimate their ability to locate quality online research and lack the skills needed to evaluate the scientific literature. Clinical nurses report relying on personal experience to answer clinical questions rather than searching evidence-based sources. To address the problem, a web-based, evidence-based research (EBR) tool that is usable from a computer, smartphone, or iPad was developed and tested. The purpose of the EBR tool is to guide students through the basic steps needed to locate and critically appraise the online scientific literature while linking users to quality electronic resources to support evidence-based practice (EBP). METHODS: Testing of the tool took place in a mixed-method, quasi-experimental, and two-population randomized controlled trial (RCT) design in a U.S. and Middle East university. RESULTS: A statistically significant improvement in overall research skills was supported in the quasi-experimental nursing student group and RCT nutrition student group using the EBR tool. A statistically significant proportional difference was supported in the RCT nutrition and PharmD intervention groups in participants' ability to distinguish the credibility of online source materials compared with controls. The majority of participants could correctly apply PICOTS to a case study when using the tool. CONCLUSIONS: The data from this preliminary study suggests that the EBR tool enhanced student overall research skills and selected EBP skills while generating data for assessment of learning outcomes. LINKING EVIDENCE TO ACTION: The EBR tool places evidence-based resources at the fingertips of users by addressing some of the most commonly cited barriers to research utilization while exposing users to information and online literacy standards of practice, meeting a growing need within nursing curricula.


Asunto(s)
Práctica Clínica Basada en la Evidencia/educación , Difusión de la Información/métodos , Evaluación de Programas y Proyectos de Salud , Enseñanza/métodos , Humanos , Internet , Medio Oriente , Investigación/normas , Estudiantes de Enfermería , Estados Unidos
7.
Holist Nurs Pract ; 29(1): 37-47, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25470479

RESUMEN

The purpose of this study was to assess the relationship between diabetes self-care, diabetes-specific emotional distress, and social support and glycemic control (hemoglobin A1C levels: HbA1c) among a sample of Lebanese adults with type 2 diabetes. A descriptive correlational design was adapted with descriptive statistics and multiple logistic regressions for analyses. A convenience sample of 140 adults diagnosed with type 2 diabetes was recruited from 2 diabetes clinics in Greater Beirut. Participants were asked to complete 4 questionnaires in Arabic. Significant associations (P < .05) were found between following a general diet for more than 3.5 days per week and higher social support and HbA1c levels of 7% or more. Social support was positively associated with HbA1c levels such that participants with uncontrolled glycemic levels, as evidenced by higher values for HbA1c, received more support from their social network.


Asunto(s)
Árabes/psicología , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Conductas Relacionadas con la Salud , Autoeficacia , Apoyo Social , Adaptación Psicológica , Adulto , Femenino , Humanos , Líbano , Masculino , Persona de Mediana Edad , Autocuidado/métodos , Factores Socioeconómicos , Encuestas y Cuestionarios
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