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ABSTRACT: The purpose of this article is to evaluate the contributions of diabetic complications to depression beyond the contributions of demographic characteristics in patients with type 2 diabetes. Further, this article evaluates the contributions of diabetic complications, depression, and quality of life to A1C (also know as HbA1c) beyond the contributions of demographic characteristics in individuals with type 2 diabetes.
A cross-sectional survey of 55 individuals with type 2 diabetes attending an inner city diabetes specialty clinic. Patients completed the Beck Depression Inventory - II, the Inventory of Depressive Symptomatology Self-Report, the Medical Outcome Study Short Form-36, and a demographic questionnaire. A1C and diabetes-related comorbidities were obtained from the patients' medical records.
Being younger and female were associated with depression in individuals with type 2 diabetes. After controlling for age and gender, neuropathy tended to add to the prediction of depression; other comorbidities did not. Being black was associated with poor diabetic control (A1C > 7). After controlling for race, neuropathy and retinopathy predicted poor diabetes control and depression tended to predict poor diabetes control.
Given the high prevalence of depression, the relationship of depression with poor diabetic self-care and medication adherence, and the increased cost of treatment for patients with depression among individuals with type 2 diabetes, assessment of depression is crucial. Further research is needed to establish effective treatment of depression and its effect on glycemic control in patients with type 2 diabetes.
Journal of the American Academy of Nurse Practitioners 04/2009; 21(4):214-24. · 0.82 Impact Factor
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ABSTRACT: Heart failure (HF) is a major public health problem in the United States. Approximately 5 million Americans are living with HF, and each year, 550,000 more are newly diagnosed. With recent, rapidly advancing technologies, many studies have examined the effects of technology-based HF management programs. Most of these studies focused on telemonitoring devices, lacking an aspect to motivate individuals to manage their own illnesses. This exploratory study was conducted to (1) examine the readiness of patients with HF in using an eHealth program that includes both telemonitoring and motivational components (ie, Web learning modules, eCommunication) and (2) assess the specific needs of patients with HF that can be addressed by a future eHealth program. This was a single group descriptive study using a convenience sample. A total of 44 patients with HF (mean age, 72.8 years; range, 55-85 years) were recruited from the pool of enrollees of the Medicare Coordinated Care Demonstration project for HF management that used only a telemonitoring component. Although only 10 participants were users, among 34 nonusers, 17 reported availability of Web access, and 15 reported that they would use the Internet if access and training were available. Overall, confidence for using telemonitoring devices and Web-based health modules was high, with means of 27 (range, 3-30) and 7.6 (range, 1-10), respectively. Confidence for learning health information using Web modules, however, was lower with a mean of 41.5 (range, 8-80). The 2 most highly rated health information needs were research findings (n = 41, 93.2%) and medication (n = 39, 88.6%). Most participants would like to have e-mail communication with healthcare providers. The findings showed the participants' high readiness to use the proposed eHealth program if access and training were provided. This study used a small convenience sample. Further studies are needed with larger, diverse samples.
The Journal of cardiovascular nursing 10/2008; · 1.43 Impact Factor
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ABSTRACT: Heart failure (HF) is a major public health problem in the United States. Approximately 5 million Americans are living with HF, and each year, 550,000 more are newly diagnosed. With recent, rapidly advancing technologies, many studies have examined the effects of technology-based HF management programs. Most of these studies focused on telemonitoring devices, lacking an aspect to motivate individuals to manage their own illnesses. This exploratory study was conducted to (1) examine the readiness of patients with HF in using an eHealth program that includes both telemonitoring and motivational components (ie, Web learning modules, eCommunication) and (2) assess the specific needs of patients with HF that can be addressed by a future eHealth program. This was a single group descriptive study using a convenience sample. A total of 44 patients with HF (mean age, 72.8 years; range, 55-85 years) were recruited from the pool of enrollees of the Medicare Coordinated Care Demonstration project for HF management that used only a telemonitoring component. Although only 10 participants were users, among 34 nonusers, 17 reported availability of Web access, and 15 reported that they would use the Internet if access and training were available. Overall, confidence for using telemonitoring devices and Web-based health modules was high, with means of 27 (range, 3-30) and 7.6 (range, 1-10), respectively. Confidence for learning health information using Web modules, however, was lower with a mean of 41.5 (range, 8-80). The 2 most highly rated health information needs were research findings (n = 41, 93.2%) and medication (n = 39, 88.6%). Most participants would like to have e-mail communication with healthcare providers. The findings showed the participants' high readiness to use the proposed eHealth program if access and training were provided. This study used a small convenience sample. Further studies are needed with larger, diverse samples.
The Journal of cardiovascular nursing 23(6):463-71. · 1.43 Impact Factor
