Date Approved

12-16-2015

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Cynthia Coviak

Second Advisor

Dianne Conrad

Third Advisor

Lara Jaskiewicz

Fourth Advisor

Holly Dishnow

Abstract

Purpose: People living with diabetes require the appropriate resources, education, and support to avoid long-term complications. Vulnerable people with diabetes are often lacking these vital components, resulting in higher rates of complications, and decreased quality of life. A support group for diabetes in a free health clinic is an effective venue to provide these resources. This project determined the feasibility and factors leading to the potential for sustainability of a diabetes support group for a vulnerable population in West Michigan by implementing a pilot support group. Determinants of feasibility and sustainability were participant and professional feedback, perceptions of value and benefit, operational and financial implications, and projected volunteer availability. Participants: Eight community members and five professional survey participants contributed to this three-week pilot project. Seven participants had diabetes, and one participant was a support person. Methods and Materials: This evidence-based project used a one-group pretest-posttest design using the Diabetes Self-Efficacy Scale (DSES), along with participant and professional surveys designed by the investigator. Bandura’s methods were used to impact self-confidence for diabetes self-management, as well as evidence-based methods of determining feasibility and sustainability. Analysis: Wilcoxon signed-rank non-parametric paired analysis was conducted to test the difference between pre- and post-session DSES scores. A Bonferroni adjustment correcting α = 0.05 for eight tests was performed to determine any possible increases in self-efficacy scores. Therefore, one-tailed results and a corrected significance level of p < 0.00625 were used. Results: Each of the seven participants with diabetes provided pre-post DSES reports, and all eight participants, along with five professional survey respondents, provided survey feedback, contributing to the determination of feasibility and factors supporting the potential for sustainability. Although DSES scores trended higher after attending the support group, no significant change was identified in DSES scores after attending at least one session. Feedback indicated that a support group is feasible and sustainable in this setting. Impact: These findings suggest that a support group for vulnerable persons with diabetes in a free health clinic may impact self-confidence for diabetes management, which in turn has been shown to improve self-efficacy over time. Findings also indicate that a diabetes support group is feasible and has the potential to be sustainable in this setting. Providing education and support to a vulnerable population with diabetes can potentially affect positive health outcomes if a support group is sustained in this setting.

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