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QUERI Project


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DII 99-097
 
 
Improving Health Outcomes of Diabetic Veterans: A Diabetic Self-Management Program
Virginia Nodhturft EdD RN
James A. Haley VA Medical Center
Tampa, FL
Funding Period: April 2000 - September 2002

BACKGROUND/RATIONALE:
Control of the blood sugar prevents complications and results in extra years of life in patients with diabetes. Practice Guidelines delineating specific ways physicians manage diabetes have been outlined. Missing are guidelines for health care providers to encourage patients to take responsibility for their diabetes. Traditional patient education models have been ineffective in managing diabetic persons because they have relied upon information given alone and are disease centered rather than patient centered. This study will explore the role of self-efficacy in helping veterans move toward healthy behaviors.

OBJECTIVE(S):
The long-term objectives are to: 1) increase recognition of veteran’s responsibility for health; 2) develop more effective skills in managing chronic conditions; and 3) explore the role of self-efficacy in facilitating improvements in health behaviors and health care utilization.

METHODS:
This is a prospective, randomized controlled clinical trial of 2,068 cognitively intact, diabetic veterans. The outcome measures (health behaviors, self-efficacy, health status and health care utilization) will be measured using self-rated scales developed and tested by Lorig and colleagues from Stanford University. Glucose levels and BMI changes will be evaluated using information documented in the medical record.

FINDINGS/RESULTS:
This project is complete.

IMPACT:
Once the analysis is complete, insight will be gained into the role that self-efficacy plays in: 1) helping veterans take greater responsibility for their health; 2) whether the intervention increases health behaviors among veterans with diabetes; and 3) whether changes in health care utilization can impact on cost savings.

PUBLICATIONS:

Journal Articles

  1. Nodhturft V, Schneider JM, Hebert P, Bradham DD, Bryant M, Phillips M, Russo K, Goettelman D, Aldahondo A, Clark V, Wagener S. Chronic disease self-management: improving health outcomes. The Nursing Clinics of North America. 2000; 35(2): 507-18.


DRA: Chronic Diseases, Health Services and Systems
DRE: Quality of Care, Resource Use and Cost, Treatment
Keywords: Behavior (patient), Diabetes, Self-care
MeSH Terms: none