Educational Programmes in Self Management for Patient with Type 2 Diabetes - Dissertation Example

?How Effective Are Educational Programmes in Improving Self-Management for Patient with Type 2 Diabetes Table of Contents 0. Introduction 3 2.0. Background/Justification of the Review 4 3.0 Aim, Objective and Purpose of Proposed Review 7 4.0 Methodology 7 4.1 Search Methods 7 4.2 Critical Appraisal 9 4.2.1 Research Aims and Hypothesis 9 4.2.2 Literatures Reviewed 10 4.2.3 Research Design and Sampling 11 11 4.2.4 Instruments and Procedures for Collecting Data 12 4.2.5 Reliability and Validity 12 4.2.6 Data Analysis 13 4.2.7 Findings and Interpretation of Study 13 4.3 Data Extraction 14 4.4 Synthesis 14 4.4.1 Statistical Methods 14 4.4.2 Ethical Implications 15 5.0 Results and Discussion 15 5.1 Evidence 15 5.2 Plan of Work 16 17 6.0 Conclusion 18 References 19 1.0. Introduction Self management is considered to be highly essential in controlling and effectively minimising the ill-effects of ‘type 2 diabetes’ which is often proposed to be encouraged with effective educational programs. This research proposal hereby intends to depict the planning developed for evaluating the issue identified in terms of the role played by educational programs to enhance self-management amid the patients who are observed to be suffering from type 2 diabetes with due concern to critical review of various literatures, considering them as secondary sources. It is worth mentioning in this context that conducting a literature review is quite vital for health and social care environment as it seeks to summarise the different articles which are accessible on any given subject or identified issue. Hence, it has often been attributed that literature review can provide a rational and strong sense to the research subject which can further assist in comprehending the issue identified in a more realistic way. Conducting critical literature reviews can also be regarded as advantageous to elaborate on an identified issue owing to the fact that even though a wide range of literatures, the discussion presented in these secondary sources are highly diversified and presented from a broad perspective. Thus, literature review tends to assist in presenting a comprehensive understanding of the phenomenon already studied in a more comprehensive way, obtaining a complete picture of research subject. Subsequently, the comprehensive understanding of a phenomenon with the virtues of critical review of selected literatures can also reveal new evidences inspiring objective-oriented thinking on the research problem (Aveyard, 2010). 2.0. Background/Justification of the Review ‘Type 2 diabetes’ is considered as a chronic disease which causes strong negative impacts on health inhibiting the life span of the sufferer. ‘Type 2 diabetes’, represents majority of diabetes patients in the world population, being one of the most common long-lasting endocrine illness. Medical observation depicts that in the short run, ‘type 2 diabetes’ may lead to physical weakness, while in the long run it can also cause sightlessness and renal failure among others. There are several strict guidelines adviced to be followed by the sufferers of type 2 diabetes in order to stay healthy and fit. As stated by Cilia (2007), continuous observations revealed that in spite of strict clinical guidelines for diabetes control, almost 60% of diabetes patients do not satisfy suggested clinical objectives, resulting in the increasing number of medical cases confirming ‘type 2 diabetes’ syndromes. With increasing occurrences of ‘type 2 diabetes’ among people, it becomes quite likely that more patients will have a need for rigorous controlling of health in terms of proper dietary habits, exercise and medication. It has also been observed in this regard that the actual challenge for ‘type 2 diabetes’ patients is to balance the short run and long run life quality against the stress of regular and thorough self-management (Cilia, 2007). In recent times, various suites to educate the patients about self-management have become the focal point among healthcare researches which has evidently attracted the concern of executives. Based on the growth of awareness and interests amid the medical care sector, various educational packages are designed with the aim to encourage patients towards better self-management. It is in this context that self-management has been regarded as a way to obtain the abilities essential for maintaining health conditions in the long run. In addition, it is also being proposed that education on the aspect of self-management can play an essential role towards influencing the effective of treatments rendered to the patients suffering from ‘type 2 diabetes developing their metabolic control, concordance with medication decisions, risk aspects and life span by a considerable extent (Khunti & et. al., 2012). From a similar perspective, in the international premises, self-management education is recognised as a vital component for rendering effective treatments to patients suffering from ‘type 2 diabetes’. The aim of this kind of education program is to develop knowledge, understanding and confidence among the patients, hence allowing them to take a greater control on their individual health situations and incorporate effective self-management practices into their regular life. It has also been attributed by various experts that well-designed and well-implemented educational programmes are probably worthwhile for people with ‘type 2 diabetes’ and must be delivered to every patient during the period of diagnosis. The following are some of the benefits which can be attained by ‘type 2 diabetes’ patients by going through educational programmes: Enhancement of knowledge, health philosophies and changes in habits Improvement of health such as weight reduction, low level of lipid, reduction and even discontinuation of smoking activities along with development of psychological strength in terms of better life quality and lower degree of depression Better physical fitness Reduction of the requirement for and better pursuing of treatment and other assessments such as blood testing (Khunti & et. al., 2012) As stated by Norris & et. al. (2001), self-management is the procedure of making individuals adequately aware regarding the methods of mitigating the ill-effects of diabetes. This, it can be considered as a significant facet of healthcare management. The objective of serving the patients suffering from type 2 diabetes with educational programs is to assist them in enhancing their metabolic control, inhibiting serious and long-lasting problems as well as improving life quality on a regular basis in a self monitored way (Norris & et. al., 2001). In the UK, diabetes health program is concentrated on motivating people to become more educated regarding the disease, thereby improving their self-management capability by a considerable extent. From a similar concern, as mentioned by Sturt & et. al. (2005), different educational programmes are available for ‘type 2 diabetes’ patients in the UK. These programmes tend to provide training and education to patients, which in turn intend to enhance their capability to appraise their health related issues, adopting appropriate decisions and measures so as to mitigate the consequences of such illness (Sturt & et. al., 2005). 3.0 Aim, Objective and Purpose of Proposed Review The main objective of the proposed review will be to discover the efficiency of educational packages in improving self-management within ‘type 2 diabetes’ patients. Considering the aim, the purpose of the review will be to establish a strong relationship between educational programmes and self-management activities of ‘type 2 diabetes’ patients which is identified as a chronic disease which require patients to consider reframing their lifestyle choices in order to control blood pressures, level of cholesterol and glycosylated. The decisions of patients include aspects such as eating, taking medicines as per instructed, regularly monitoring cholesterol level, along with other measures to attain a healthy and longer life span. It was in this context that diabetes related education sessions have been recommended as one of the most effective methods for patients to learn about the health care solutions to the diabetes related problems and correspondingly develop proper decisions (Brown, 2011). 4.0 Methodology 4.1 Search Methods Different secondary sources will be used for undertaking the literature review. The healthcare literatures which have been published within 1988 to 2012 will be used for the research which would render an understanding of the gradual changes occurred in relation to the statistics of patients affected by ‘type 2 diabetes’ and medical strategies. Numerous medical databases and educational libraries will be used when searching for adequate numbers of different articles and reviews for research study. Several journals and books related to healthcare education in case of such acute diabetes problems will also be included in the research. Investigations done by other researchers will thus be considered as vital elements for conducting the research study, as it will provide valuable understanding on the research subject elaborating on the logical and rational relationship of the identified research elements, such as the increasing numbers of ‘type 2 diabetes patients’, influence of education facilities on patient’s healthcare as well as the perceptions of patients and the physicians when availing or rendering the planned educational facilities. Thus, a systematic approach will be followed to search for appropriate articles when undertaking the review study. This particular approach can be identified as quite useful as it tends to be highly comprehensive and systematic which shall render with more specific results than those attained from narrative or traditional methods. The literature searches will be undertaken by using electronic databases primarily. It is expected that electronic databases will provide access to a vast amount of information, which can be saved easily and rapidly than manual search. Conversely, printed materials will render better storage longevity. Furthermore, keyword searches will be used for recognising appropriate literature taking into concern the terms such as ‘diabetes education’, ‘diabetes practices’ and ‘self-management programmes’ among others (Cronin & et. al., 2008). The other strategy which will be used for searching materials for research is scanning of internal components of various articles. As internet searching provides vast amount of articles on a particular subject, it has often been observed that such mechanisms increases the risk of data overflow which might hamper the reliability and comprehensiveness of the entire research process. Thus, the chosen articles will be judged for their relevancy in accordance to the research issue identified. This strategy will help to avoid selecting inadequate articles for the literature review, and also will help to classify those articles which are pertinent for the research. 4.2 Critical Appraisal Searching for appropriate and sufficient research materials can become quite challenging with the presence of countless journals and articles in the area of medical investigation. Hence, shifting through a mass amount of articles can lead to duplicate publications or irrelevant study materials. With this concern, only those articles which directly relate with the subject and have authentic source and publication date will be selected for the purpose of this research. 4.2.1 Research Aims and Hypothesis The primary aim of the research will be to systematically evaluate the effectiveness of educational programs on self-management of patients suffering from ‘type 2 diabetes’, with due concern to secondary sources in terms of literature review. In order to accomplish the aim of the review, the following hypothesis will be tested: Null Hypothesis (H0): “The significance of educational programs has increased substantially since the past decades which indicates its growth preference among the physicians to deal with ‘type 2 diabetes’” Alternate Hypothesis (H1): “No such differences can be witnessed in relation to the significance rendered to educational programs in medical science over the past decades to cure ‘type 2 diabetes’” 4.2.2 Literatures Reviewed Literature review will be conducted with due emphasis on the research subject which elaborates on the role of educational programs in influencing the efficiency of ‘type 2 diabetes’ treatment through self-management. It will be a systematic review where research questions will be formulated, standardised methods will be specified and appropriate writings will be gathered and studied. Usually, the literature review will concentrate on portraying a variety of knowledge in the area of the identified research subject (Kennedy, 2007). 4.2.3 Research Design and Sampling It is a fact that a single study is unable to uncover the true facts related to any research problem. Thus, in order to generate a generalizable absolute understanding, there is need for reviewing multiple literatures. The research uses narrative design in order to review various literatures from 1990 to 2011. Systematic sampling method will be used in order to search for the required literatures. The literatures will be grouped according to years of publications which would assist in reflecting upon the growth of significance rendered towards educational programs by medical practitioners to augment self-management willingness amid the ‘type 2 diabetes’ patients. Group A would therefore comprise of literatures published from 1990 to 1996. Similarly, Group B would comprise of articles published in between 1996 to 2002, while Group C would be based on the assessment of researches carried out from 2002 to 2010. From each group about three to five articles will be selected systemically which would suffice the research subject criteria confirming the level of importance of diabetes education and thereby satisfying the hypothesis developed. 4.2.4 Instruments and Procedures for Collecting Data Apart from library, there are several sources for collecting information. In literature review, the data can be of three kinds which are primary data, secondary data and tertiary data. For the purpose of this study, the primary sources intended to be used for collecting information for the literature review will be lecture notes and speeches of tutors provided in the classroom. Likewise, the secondary sources can be identified as the several records, journals and books which will be gathered from online and offline libraries. The tertiary sources can be regarded as the thesauruses, databanks, reference works, guides and handbooks which will also be useful for gathering adequate information to substantiate and assess the findings obtained through literature reviews. It is worth mentioning that comparatively greater emphasis will be provided on the tertiary sources which can render general contextual information in order to broaden the topic, describe the unfamiliar terms and provide directories for searching other valuable sources (Reed, n.d.). 4.2.5 Reliability and Validity Reliability denotes steadiness, constancy and fidelity of data collection instruments. A reliable instrument will produce similar outcome every time even if it is performed by different researchers in varying periods. There are several methods of measuring the reliability. In order to ensure the instruments used in literature review are valid, internal consistency will be evaluated. On the other hand, validity denotes to what extent the research produces a valid outcome. The validity for the literature review will be measured by using content validity method. Content validity will guarantee that the research will cover the known subjects effectively (Wood & Ross-Kerr, 2010). 4.2.6 Data Analysis The data will be analysed by comparing the impact of education on the behaviour of patients suffering from ‘type 2 diabetes’. It is in this context that two methods will be applied with the purpose of analysing the data collected through literature review process. Foremostly, standard deviation, as a statistical tool will be used in order to evaluate the degree of significance rendered to educational programs and thereby test the hypothesis developed. Simultaneously, a descriptive analysis will be constructed to elaborate on the rationality of the findings generated from hypothesis testing. 4.2.7 Findings and Interpretation of Study The hypothesis testing is expected to reveal the increasing significance of educational programs amid the medical practitioners which in turn would depict the preferences for such programs to facilitate ‘type 2 diabetes’ management more efficiently through self-management amid the patients. These findings are proposed to be further interpreted through a descriptive approach taking into concern various other relevant secondary sources substantiating the reliability of the findings obtained through the research. 4.3 Data Extraction Data for the research study will be extracted from suitable articles comprising of descriptive as well as numerical information. The information from various sources will be organised and demonstrated effectively by using charts and graphs. 4.4 Synthesis 4.4.1 Statistical Methods In order to measure the effectiveness of educational programs on self-management activities of patients, statistical relationship between the researches conducted and the significance rendered to educational programs will be observed. Comparisons will be made in order to recognise any differences in the alterations of the degree of significance rendered towards the programs. . Hence, the statistical tool of standard deviation will be utilised to test the hypothesis developed (Norris & et. al., 2001). 4.4.2 Ethical Implications Since the interpretation of the data gathered through literature review depends largely on the researcher’s perceptions and understandings, ethical considerations will be followed strictly in order to undertake the research study and gain higher degree of reliability. The ethical approval for the research will be taken from university, and also from any specific committee relevant to the research as well as hospital authorities (Khunti & et. al., 2012). 5.0 Results and Discussion 5.1 Evidence The above described proposition for the research process is expected to reveal various crucial facts regarding the role played by educational programs in augmenting the efficiency of healthcare facilities rendered to the ‘type 2 diabetes’ patients. As can be observed with reference to the hypothesis developed, the results shall be gathered from a critical point of view to justify whether significance rendered to educational programs in medical science when curing ‘type 2 diabetes’ have increased since the past decades. Correspondingly, an increasing rate would signify that medical practitioners are attempting to render greater significance to such programs depicting that educational facilities possess a positive impact on the treatment procedure for ‘type 2 disease’ through augmented self-management processes and vice-versa. Furthermore, the construction of a descriptive study to elaborate on the findings obtained through hypothesis testing is expected to reveal the causes for such alterations in terms of growth or fall or stability which can again elaborate on the role played by educational programs in the given circumstances. 5.2 Plan of Work In order to undertake the literature review, first the research problem will be identified and on the basis of problem, a prior research will be undertaken to obtain a basic idea about method of conducting research on the basis of problem identified. After prior research, an outline will be designed and research approach will be selected. In this research the framework will be based on literature review where the data gathered will be analysed through hypothesis testing and descriptive approach. After selecting the research approach, the research methods will be selected concerning the analytical procedure to be undertaken. In this research, quantitative method will be followed with the implementation of standard deviation statistical tool. As the critical review is based on healthcare services with the involvement of various literatures and facts, approval will be taken from universities, hospital authorities and ethics committee. After taking the approval from essential authorities for undertaking the research, the literature review will be conducted, through in-depth study of the research subject. With this concern, literatures published since 1990 to 2011 will be considered which will further be classified into three groups chronologically. Finally, the data will be analysed for validity and reliability to declare that the research is valid and reliable through hypothesis testing. The major theme of the research is to determine if the educational program is truly effective for ‘type 2 diabetes’ patients in terms of self-management. The following figure will describe the Gantt chart for schedule of conducting the research: 6.0 Conclusion Self-management education has often been argued to possess considerable significance to control patient’s responsive behaviour to the treatment procedure which in turn tends to improve the health outcomes. Diabetes is often referred as one of the most complex diseases. In order to accomplish best results for treatment of this disease, patients’ must have good knowledge about personal health situation. The patients must therefore follow a vigilant self-management approach to cope up with the problems of ‘type 2 diabetes’. However, with low level of literateness and understanding, it becomes difficult for patients to effectively respond towards the medical treatments for improving their health conditions. Health education includes aspects such as beliefs, empowerments, inspirations and level of capability to deal with the issues of diabetes. Health education is also considered as a key to assist patients to accomplish self-management in long run complex circumstances. Therefore, it can be affirmed that the proposed review shall help to determine how important health education is for managing chronic diabetes and ensuring a healthy lifestyle for the patients (Stiles, 2011). This study will be thus based on the philosophy that education can provide additional support to the diabetes patients and benefits them in terms of better medical consequences. It can provide better management of psychological issues along with enhance their readiness to change bad habits such as smoking, unhealthy eating and drinking among others which tends to increase the ill-effects of such diseases. References Aveyard, H., 2010. Doing a Literature Review in Health and Social Care. McGraw-Hill International. Brown, C., 2011. The Importance of Diabetes Education. University of Maryland Center for Diabetes and Endocrinology. [Online] Available at: http://www.umm.edu/diabetes/importance-diabetese-education.htm [Accessed October 02, 2012]. Cilia, S., 2007. Educational Programme for Patients with Type 2 Diabetes at Community Health Centres: What is the Evidence? Malta Medical Journal, Vol. 19, No. 3, pp. 6-11. Cronin, P. & et. al., 2008. Undertaking a Literature Review: A Step-by-step Approach. British Journal of Nursing, Vol. 17, No. 1, pp. 38-43. California State University, No Date. Bi- and Multivariate Inferential Statistical Tests. When to Use a Particular Statistical Test? [Online] Available at: http://www.csun.edu/~amarenco/Fcs%20682/When%20to%20use%20what%20test.pdf [Accessed October 02, 2012]. Jacobson, A. & et. al., 1988. Reliability and Validity of a Diabetes Quality-of-Life Measure for the Diabetes Control and Complications Trial (DCCT). Diabetes Care, Vol. 11, No. 1, pp. 725-732. Khunti, K. & et. al., 2012. Effectiveness of a Diabetes Education and Self-Management Programme (DESMOND) For People with Newly Diagnosed Type 2 Diabetes Mellitus: Three Year Follow-Up of a Cluster Randomised Controlled Trial in Primary Care. Business Management Journal, pp. 1-12. Kennedy, M. M., 2007. Defining a Literature. Educational Researcher, Vol. 36, pp. 139-147. Keeratiyutawong, P. & et. al., 2006. Effectiveness of a Self-Management Program for Thais with Type 2 Diabetes. Thai Journal of Nursing Research, Vol. 10, No. 2, pp. 85-97. Norris, S. L. & et. al., 2001. Effectiveness of Self-Management Training in Type 2 Diabetes. Diabetes Care, Vol. 24, No. 3, pp. 561-587. Reed, L. E., No Date. Performing A Literature Review. Naval Air Warfare Center Weapons Division. [Online] Available at: http://www.iris.ethz.ch/msrl/education/iris_studies/pdf/literature_review.pdf [Accessed October 02, 2012]. Sturt, J. & et. al., 2005. Education for People With Type 2 Diabetes: What Do Patients Want? Journal of Diabetes Nursing, Vol. 9, No. 4, pp. 145-150. Stiles, E., 2011. Promoting Health Literacy in Patients with Diabetes. Nursing Standard, Vol. 26, No. 8, pp. 35-40. Wood, M. & Ross-Kerr, J., 2010. Basic Steps in Planning Nursing Research: From Question to Proposal: From Question to Proposal. Jones & Bartlett Learning. Read More