Front cover image for Assessing the relationship of spirituality on health-related indicators in adults with type 2 diabetes

Assessing the relationship of spirituality on health-related indicators in adults with type 2 diabetes

Description: According to the Center for Disease Control and Prevention (CDC, 2014) 9.3% of the population, or 29.1 million people in the United States are affected by diabetes. The number of persons being diagnosed with diabetes is increasing in epidemic proportions. It is essential that coping methods are identified that will best assist the patient with type 2 diabetes (T2D). The influence of spirituality as an integral part of patient care is a consideration because accrediting bodies such as the Joint Commission on Accreditation of Health Care Organizations (JACHO, 2008) are including outpatient care as a setting that should support the spiritual assessment. Purpose: The purpose of this study was to assess the relationship of spirituality on the health-related indicators of glycosylated hemoglobin (HbA1c) levels, blood pressure (BP), body mass index (BMI), and total cholesterol in adults with T2D. Method/Study Design: In order to adequately assess the relationship of spirituality on health-related indicators, a descriptive correlational design was utilized by the principal investigator (PI). A convenience sample of participants was recruited at the initial or follow-up visit to the center. The Spiritual Well-Being Scale (SWBS) was administered to participants, along with a demographic information sheet. Five research questions addressed the relationship between spiritual well-being, health-related indicators, and demographics of the population studied. Research was conducted at an outpatient Center for Endocrinology, Diabetes and Metabolism. Protection for human subjects was respected through the use of informed consent and Health Insurance Portability and Accountability Act (HIPAA) consent. Sample/Results: A total of 80 individuals with T2D who met the inclusion criteria participated in this study. The sample included mostly female (61.3%), as compared to male (38.8%). Ages were indicated in a range format with 45-65 years (48.8%) as the highest range, to 65-75 years (33.8%) as the next highest range. Most of the participants were Caucasian (92.5%), married (56.3%), Roman Catholic (52.5%), on oral medication and insulin (45%), and had a high school education (35%). Demographic characteristics revealed significance in the method of spiritual expression termed prayer; however, due to the inaccuracy of participant responses to this question, this finding lacks validity and reliability. A level of significance (p<0.05) was not achieved for any of the demographic characteristics. For SWBS and types of diabetes treatment, such as lifestyle changes versus orals versus orals and insulin versus insulin alone p = 0.051. The scores on the SWBS and subscales revealed a level of moderate to high levels of spirituality. Health-related indicators revealed no significant correlations; however, the mean values of SBP, DBP and total cholesterol levels are within the clinical practice recommendations for persons with diabetes by the American Diabetes Association (2015). The mean BMI was elevated (35.8), reflecting current trends in obesity and its correlation to the incidence of T2D. Conclusions: One of the most impressive findings in this patient population was the level of spiritual well-being (SWB), religious well-being (RWB) and existential well-being (EWB). Scored at a moderate to a high level of spiritual well-being, this brings attention to how spiritual persons with T2D in this sample really appear. Conducting this study at multi-specialty offices across the region and perhaps the country may provide more meaningful data related to the relationship of spirituality and health-related indicators in T2D. A more rigorous research design such as a randomized controlled trial may reveal additional significance. The inclusion of cognitive reframing and emotional respite as a component to spirituality at the clinic visit in the outpatient care setting could be very influential in supporting long term outcomes in adults with T2D
Thesis, Dissertation, English, 2016
Sacred Heart University
xiii, 102 leaves : color illustrations ; 29 cm
Chapter 1 Nature of Project and Problem Identification : Background ; Problem Statement/Aim ; Purpose of Study ; Significance to Nursing ; Theoretical Framework ; Theoretical Assumptions ; Research questions
Chapter 2 Literature Review : Search Summary ; Spirituality The Concept ; Spirituality and the Outpatient Clinic Visit ; Spirituality, T2D and Coping ; Spirituality, T2D and Health-Related Indicators ; Integrated Approach of Spirituality in Diabetes Care ; Chapter Summary
Chapter 3 Research Methods : Design ; Setting ; Sample ; Recruitment ; Measures ; Procedures ; Statistical Analysis ; Protection of Human Subjects
Chapter 4 Results and Discussion ; Sample ; Demographic Characteristics ; Spiritual Well-Being ; Spiritual Well-Being and Demographics ; Spiritual Well-Being and Health-Related Indicators ; Religious Well-Being and Existential Well-Being ; Discussion ; Chapter Summary
Chapter 5 Summary, Conclusion, and Recommendations : Pertinent Findings ; Limitations ; Implications ; Recommendations
Appendices : A Spirituality Concept Map ; B Spiritual Well-Being Scale ; C Spiritual Well-Being Scoring ; D Demographic Information Sheet ; E Staff Research Study Description Sheet ; F Recruitment Poster ; G Informed Consent Sacred Heart University ; H Informed Consent and HIPAA Hartford HealthCare
A practice dissertation presented to the faculty of the College of Nursing, Sacred Heart University in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice