Term Paper on "Diabetes Mellitus"

Term Paper 19 pages (5199 words) Sources: 10 Style: APA

[EXCERPT] . . . .

Diabetes Mellitus

In this report, Diabetes Mellitus will be discussed, since there are many factors that influence how patients handle the care and the managing of it due to the physical and emotional need of it. Furthermore, the paper will go through the many factors that influence diabetes self-management. It will be shown that some models have not been tested among veterans, which is a unique population with high rates of diabetes. However it will also that despite any demographic an individual's "readiness to change," their confidence in being able to make change (or self-efficacy), in addition to appropriate advice from medical providers, may impact diabetes self-management behavior. Interventions are designed to increase self-efficacy have improved quality of life, patient satisfaction, and glycemic control, and recent studies validate readiness to change as an important predictor of dietary behavior, physical activity and improved glycemic control" (Factors Influencing Disease Self-Management Among Veterans with Diabetes and Poor Glycemic Control 2007). Along with that, this paper will prove people who have diabetes have many factors of it influencing their diabetes care and their lifestyles.

1.2 Problem Statement

Within this dissertation, the purpose is show that there strategies that can be implemented by a practice to promote patient empowerment and self-management, which involve creating patient-centered practices and providing active, ongoing self-management support. This is accomplished through a team approach to care (Funnell and Anderson 2004). This will show patients different ways to take care of their diabetes without hurting their pro

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ductive lifestyles. The following lists some strategies that can help to lead a healthy life with diabetes mellitus, living in any demographic range

Link patient self-management support with provider support (e.g., system changes, patient flow, logistics).

Supplement self-management support with information technology.

Incorporate self-management support into practical interventions, coordinated by nurse case managers or other staff members.

Create a team with other health care professionals in your system or area who have additional experience or training in the clinical, educational, and behavioral or psychosocial aspects of diabetes care.

Replace individual visits with group or cluster visits to provide efficient and effective self-management support.

Assist patients in selecting one area of self-management on which to concentrate that can be reinforced by all team members.

Need

Furthermore, the need of this paper is that patients must watch their HbA1c levels because they are a better measure of glycemia than values on the OGTT for two reasons. First, they reflect months of prevailing glucose concentrations rather than one instance of time (Davidson 2007). For the past six or seven years, there have been five studies in several thousand diabetic patients that have related to the average HbA1c level to the development and progression of the microvascular complications of diabetes.19-24. They all have demonstrated that if the average HbA1c level were <1% above the upper limit of normal (ULN) for the assay used (e.g., <7% for the assay used in the Diabetes Control and Complications Trial, in which the ULN was 6.0%), development or progression of diabetic retinopathy or nephropathy were not occurring.. If the average HbA1c levels were between 1 and 2 percentage points above the ULN, an increase in the development and progression of these complications occurred.. Average values >2% above the ULN were associated with much higher risks for the microvascular complications (Factors Influencing Disease Self-Management Among Veterans with Diabetes and Poor Glycemic Control 2007). Therefore, the up keep of diabetes is highly important because HbA1c levels can be a contributing factor to the care of the disease rather it improves or declines the health of the patients who help with their care.. The follow chart shows that the importance of the management of this for diabetes patients.

Table 3. Distribution (%) of HbA1c Levels

NHANES III

MRG Data Set

Glucose (mg/dl)

No. Of Subjects (%)a

HbA1c (%)b

No. Of Subjects (%)c

HbA1c (%)d

Fasting

2-h OGTT

Delimitations

In this study, it will be shown that social support is related to healthier functioning patients. Support, as a construct, has been defined as a sense of belonging, specifically among peers, teammates, community or family members. Patients reporting strong social support/low isolation exhibit higher levels of resilience and lower levels of depression. Patients are also less likely to be depressed if they perceive their family, friends, and peers to be more accepting, and if they have more positive friendships. Those who feel supported by counselors, parents, or peers exhibit healthier coping mechanisms and maintain a more positive outlook about their future. In contrast, patients who lack social support and experience isolation may behave in self-injurious ways (Rutter 2004).

This study provides additional data on health services utilization in depressed individuals with diabetes. In a recent study (3), we showed that compared with nondepressed individuals with diabetes, depressed individuals with diabetes had increased health care use and expenditure. Akin to our earlier finding, this study found that depressed individuals with diabetes were more likely to have primary care and emergency room visits compared with their depressed counterparts without diabetes. In addition, depressed individuals with diabetes were more likely to report visits to a psychiatrist or mental health professional. It is noteworthy that the proportion of patients who visited a psychiatrist was not significantly different. This suggests that the pattern of visits to psychiatrists or mental health professionals did not differ by diabetes status (Egede and Zheng 2003).

Diabetes (n = 176, N = 969, 599)

No diabetes (n = 1,873, N = 11,141,509) value

SE

Race/ethnicity

White

Black

Hispanic/other

Age (years)

0.0001{dagger}

Women

High school education

Poverty ratio (% of federal poverty level)

0.0037{dagger}

Employed

0.0001{dagger}

Married

Health status

0.0009{dagger}

Better

Worse

Obesity status (kg/m2)

0.0001{dagger}

BMI <18.5

BMI 18.5-24.9

BMI 25.0-29.9

BMI >=30.0

Smoker

Major complications -- Yes

0.0001{dagger}

Visited a primary care physician

0.0001{dagger}

Visited a psychiatrist or mental health professional

Visited an emergency room

Source: Egede and Zheng 2003

When affirming a client's thoughts and feelings, it does not mean the counselor is accepting their feelings by default. It only means he or she is trying to get the client to open up with their feelings in order to get them resolved so that the blame will not be put on others. This approach is taking by a humanistic counselor so that the client can see that he or she is blaming others for their problems. From there, affirming the issues does not mean the counselor is accepting their feelings. They are just trying to get them out in the open to correct them.

In Table 4, the characteristics of individuals with major depressive disorder by diabetes status are compared. Among individuals with major depressive disorder, those with diabetes were more likely to be of Hispanic ethnicity, to be aged >50 years, to have less than high school education, and to have household income <124% of the federal poverty level and were less likely to be employed. Individuals with diabetes were more likely to report worsening of their health status and to have BMI 25.0 kg/m2, major complications, primary care physician visits, and emergency room visits, but they were less likely to smoke than individuals without diabetes (Egede and Zheng 2003).

From there, the counselor should not push society's values on the client until the appropriate moment time in the session when they are relax and accepting of further insight into the situation even when it is about anti-Semitism. When a client is not pressured to accept a new way of thinking, they are more open to take the counselor's insights and corrections to their views by listening during the session. From there, the counselor can help the client to rehabilitate themselves, which will help them to accept society's norms for their own.

Rogers' strong belief in the positive nature of human beings is based on his many years of clinical experience, working with a wide variety of individuals (1961, 1965, 1977). The theory of person-centered therapy suggests any client, no matter what the problem, can improve without being taught anything specific by the therapist, once he/she accepts and respects themselves (Shaffer, 1978). The resources all lie within the client. While this may be so, this type of therapy many not be effective for severe psychopathologies such as schizophrenia (which today is considered to have strong biological component) or other disorders such as phobias, obsessive-compulsive disorder or even depression (currently effectively treated with drugs and cognitive therapy). In one meta-analysis of psychotherapy effectiveness that looked at 400 studies, person-centered therapy was found least effective. In fact, it was no more effective than the placebo condition (Glass 1983; cited in Krebs & Blackman, 1988) (Pescitelli).

Research has revealed that the experiences of diabetes can be a lonely and stressful time when compared to experiences of other minorities in the same age group. Young individuals who identify themselves as a part of a minority group often discusses their status with families who affirm their minority identity. Patients are over-represented in homeless populations and many turn to alcohol, drugs, or suicide to escape their hostile environments.

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Quoted Instructions for "Diabetes Mellitus" Assignment:

“

The Hypotheis I want to use for my research is " There is a significant relationship between the demographic variables and quality of life of diabetes patients". Demographic variables include age, sex, income etc. Now i want order the first 3 chapters for the thesis proposal. The proposal and the reference page has to be wriiten in APA format. Also sen me the title page. The following is instructions for the first three chapters. If you have any quaetions feel free to contact me.

Thesis Proposal Format

Chapter I

INTRODUCTION

Chapter I opens with a one- to two-paragraph introduction that establishes the purpose of the study. The purpose of the study is not necessarily the same as the statement of the problem. The purpose is more general than the problem statement and is not specifically testable.

Problem Statement

The problem statement should be as clear and concise as possible and preferably phrased in question form. The variables, population, and (sometimes) time period involved should be identified. The problem statement expresses a relation between two or more variables and implies possibilities of empirical testing. Remember, many important questions are not amenable to testing and therefore are not scientific questions. The problem statement makes one aspect of the overall purpose of the study manageable and testable.

Need

This section describes the status of the problem area for the profession and/or the status of research on the problem. It provides a snapshot of the climate or context in which the problem arose and persists, with some indication of why a solution is needed. This section may be supported with relevant statistics on the dimensions of the problem for nursing or for health care.

Conceptual (or Theoretical) Framework (Maslow*****s hierarchy or Roy*****s stress adaptation theory can be used here.)

A theory or theoretical framework is a set of logically interrelated statements (concepts, propositions, and definitions) that have been derived from scientific data and from which hypotheses can be deduced, tested, and verified. It is a well formulated deductive system of abstract formal statements.

A conceptual framework or model refers to a less formal or less well developed attempt at organizing phenomena. It lacks a deductive system of propositions that assert relationships between concepts. It may contain elements from one or more theories.

This section of the proposal provides the reader with an overview of the conceptual posture of the study and the theoretical underpinnings that will be guiding the research.

Hypotheses Please use the following Hypothesis(There is a significant relationship between the demographic variables and quality of life of Diabetes patients)

Hypotheses may be derived from previous research or rooted in theory (theoretical hypotheses). Sub-hypotheses should be included if appropriate. Null hypotheses should be avoided. Indicate the direction and level of confidence as needed.

In non-experimental research designs, hypotheses often are supplemented or replaced with objectives, sub-problems, or research questions.

Assumptions

Assumptions are statements generally considered to be true on the basis of reason, general theory, or logic without proof or verification. Assumptions are not scientifically tested in the study, although they are basic premises upon which the study is built. They are neither well known accepted theory, nor are they what is being tested in the project. Very obvious and very general assumptions do not need to be listed. Care should be taken that assumptions are not made on points to be established by the inquiry.

Delimitations

Delimitations are used to describe and narrow the sample and the population from which the sample is selected. This section documents the rationale for the exclusion of any group from the study population.

Definition of Terms

Key terms in the problem statement and hypotheses should be defined. Use operational definitions. An operational definition assigns meaning to a construct or a variable by specifying the procedures, tests, "operations" necessary for measurement. The definition indicates how a variable will be observed and measured in the actual research situation. If you wish to use conventional definitions, begin with these and then include operational definitions as a clarifier (e.g., "in this study, . . .").

Summary

Restate the delimited problem within its theoretical context. Identify the independent and dependent variables and their theoretical relationships, as well as key intervening variables to be controlled. The summary should establish the focus of Chapter II by identifying the relevant areas for the literature review.

Chapter II

REVIEW OF THE LITERATURE

The focus of this chapter is on previous research related to the variables being tested as well as research related to study methods and design. The line(s) of inquiry that serve to support the present study should be traced clearly and completely.

The review should be complete at the time the proposal is submitted for review, and then updated as needed until the thesis is completed.

Research relevant to instruments being used in the study (including development and validity and reliability testing) requires mention in the section on Instruments in Chapter III. Results of such studies which have a bearing on the line of inquiry supporting the proposed study are also reported in this chapter.

Chapter III

RESEARCH METHODS

An introductory paragraph should identify the research design proposed for the study. Research design is the overall plan of investigation. It should explain how the research hypotheses will be tested and/or how the research question(s) will be answered and should specify which of the various types of research (e.g., quasi-experimental, ex post facto, correlational) will be adopted. An overview of the strategy of the research procedures to be used should be provided to orient the reader to the detailed information that will follow.

Population and Sample

The population for the study, or the group to which you hope to generalize findings and from which your sample will be drawn, should be described in detail. Provide a rationale for the identification of this target population, addressing any delimitations that have been imposed.

Procedures for accomplishing the delimitations should be described in detail, as well as the procedures that will be followed in selecting a sample for the study from the target population. A supporting rationale should be included. Include the size of sample to be sought, along with a rationale (usually related to the size of the accessible population, the number of variables being explored, and/or the statistical tests to be used in data analysis).

Instruments

Describe the instruments, including the overall purpose of each instrument (what it seeks to measure), task for respondent (what the subject must do), structure of the instrument (how many items, format), and reliability and validity data. Where appropriate, describe how the instrument was developed (e.g., sources of items). If you have developed the instrument for this study, or modified an existing instrument, include a report of the pilot study that tested the instrument. (This must be completed before the proposal is submitted for review.)

Experimental Protocol

If the study involves an experimental or quasi-experimental design, indicate how you will manipulate the independent variable(s). Provide a step-by-step description of experimental treatment procedures.

Plan for Conducting the Study

Provide a detailed description of the steps to be taken in conducting the study. Include information on assignment of study participants to groups/treatments, procedures for securing informed consent from participants and protecting human subjects (confidentiality, anonymity). Describe the setting or conditions under which data will be collected, including the sequencing of events and the time frame(s) for data collection. Indicate those intervening variables which are being controlled, and the mechanism(s) used to establish control. Include detailed information on data collectors, including their qualifications and any training they undergo as well as any efforts to establish rater reliability. Include a rough timetable for data collection. Detailed information here should provide a "road map" to conducting the study, and should provide guidelines for replication.

Report of Pilot Study(if needed)

Pilot studies are conducted to test study procedures (e.g., accessibility of subjects, appropriateness of data collection procedures) and/or to test study instruments.

Describe the purposes for which the pilot study was undertaken, the methods used in conducting the pilot study (including a description of the sample), and results. Indicate what changes, if any, were made in study procedures and/or instruments on the basis of the pilot study. If few or no changes were made, indicate whether pilot subjects will be included in the final study sample.

Every effort should be made to complete the pilot study prior to submitting the proposal for review. However, circumstances may prevent this (e.g., requirements for institutional review), in which case, the purposes of and procedures to be used in the pilot should be described in detail.

Plan for Data Analysis

Identify the statistical tests to be performed to test study hypotheses or answer research questions. Dummy tables help to clarify the nature of the data analysis, but are not required. The plan should address specific tests in relation to design and research questions/hypotheses.

Limitations

Identify all intervening variables with the potential to affect study findings. Indicate those intervening variables which are not being controlled, and the potential effects of this lack of control. Project limitations which may affect generalizability of study results, and the source of these limitations.

REFERENCES

All references cited within the proposal must be listed in the reference list, in alphabetical order. Use APA style in constructing the reference list.

APPENDICES

Appendices are lettered with capital letters (A, B, etc.) and organized according to their first mention in text. Include in the appendices copies of the instrument(s) to be used in the study, along with any written permission for such use.

NOTES ON WRITING THE PROPOSAL

The proposal format should be modified to fit the logic of your own study. Each section should flow logically from the preceding section and set the stage for the next. With minor modifications, such as tense, the proposal should serve as the first three chapters of the final study report. A detailed outline is helpful in organizing your reading and writing for the review of the literature.

Each chapter begins on a new page. Any figures or tables should be placed on the page immediately following their first mention in text. Pagination begins with the first page of Chapter I and continues consecutively through the entire document, including pages containing figures and tables.

Use sub-headings as transitions from one area to the next in the proposal. These signal the reader to a change in content, and eliminate the need for transitional paragraphs. New content areas deserve a brief introductory paragraph to orient the reader to the section to follow. Refer to the APA Manual for the format of sub-headings.

The proposal should follow the style set forth in the 4th edition of the APA Publication Manual. Please note that the proposal requires a title page and table of contents.

How to Reference "Diabetes Mellitus" Term Paper in a Bibliography

“Diabetes Mellitus.” A1-TermPaper.com, 2008, https://www.a1-termpaper.com/topics/essay/diabetes-mellitus-report/8530536. Accessed 3 Jul 2024.

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A1-TermPaper.com. (2008). Diabetes Mellitus. [online] Available at: https://www.a1-termpaper.com/topics/essay/diabetes-mellitus-report/8530536 [Accessed 3 Jul, 2024].

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1. Diabetes Mellitus. A1-TermPaper.com. https://www.a1-termpaper.com/topics/essay/diabetes-mellitus-report/8530536. Published 2008. Accessed July 3, 2024.

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