Publication Date

Spring 2024

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Michelle D. Hampton

Second Advisor

Lisa Walker-Vischer

Third Advisor

Wendi L. Koonce Morse

Keywords

Type 2 diabetes, glycated hemoglobin, group visits, self-care management, veterans

Abstract

Individuals diagnosed with type two diabetes mellitus (DM2) can be overwhelmed by daily choices, leading to self-care neglect. Self-care is vital to DM2 management to avoid chronic complications. This project utilized group visits to increase self-care management and improve outcomes among veterans with poorly controlled DM2.

This evidence-based practice (EBP) project used a single-group quasi-experimental pretest-posttest design to evaluate a self-care management program for US veterans with poorly controlled DM2 who were enrolled a clinic within the Department of Veterans Affairs (VA), Northern California Healthcare System (NCHCS). The study facilitator provided education on DM2, medication, diet, and exercise. Participants (N = 6) attended 60-minute group classes delivered bi-monthly for 12 weeks. The revised Summary of Diabetes Self-Care Activities (SDSCA-revised) was used to evaluate changes in self-care management. Also, glycated hemoglobin (HgbA1c) and weight were measured before and after the intervention.

While HgbA1c and fasting blood glucose testing remained unchanged, there were significant improvements in participants weight, exercise frequency, diet, and footcare.

Group visits were feasible, acceptable, and resulted in improvements in several DM2 outcomes. With sustained lifestyle changes, self-care management has the potential to lead to improved HgbA1c and reduce the risk for diabetes-related complications.

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