Hye-Yeon Kang; Mee Ock Gu

doi:10.4040/jkan.2015.45.4.533

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Original Article
Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus: Hye-Yeon Kang, Mee Ock Gu; Journal of Korean Academy of Nursing 2015;45(4):533-543.
DOI: https://doi.org/10.4040/jkan.2015.45.4.533
Published online: August 31, 2015

¹Department of Nursing, Daedong College, Busan, Korea.

²College of Nursing · Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Address reprint requests to: Gu, Mee Ock. College of Nursing, Gyeongsang National University, 815-15 beon-gil, Jinju-daero, Jinju 52727, Korea. Tel: +82-55-772-8226, Fax: +82-55-772-8222, mogu@gnu.ac.kr

• Received: February 15, 2015 • Revised: February 25, 2015 • Accepted: May 1, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus.
Methods
A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0.
Results
For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group.
Conclusion
The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.
Keywords: Aged; Diabetes mellitus; Motivational interviewing; Self care

This manuscript is a condensed form of the first author's doctoral dissertation from Gyeongsang National University.

Table 1

Motivational Interviewing Self-management Program for Elderly Patients with DM

DM=Diabetes mellitus.

Table 2

Homogeneity Test of Characteristics between Experimental and Control Groups (N=42)

^*Fisher's exact test; Exp.=Experimental group; Cont.=Control group; DM=Diabetes mellitus.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Group (N=42)

Exp.=Experimental group; Cont.=Control group.

Table 4

Effects of Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus (N=42)

Exp.=Experimental group (n=21); Cont.=Control group (n=21).

REFERENCES

1. Ministry of Health & Welfare. Korea Centers for Disease Control & Prevention. Korea health statistics 2011: Korea national health and nutrition examination survey (KNHANES V-2). Seoul: Ministry of Health & Welfare; 2012.
2. Chin YR, Lee IS, Lee HY. Effects of hypertension, diabetes, and/or cardiovascular disease on health-related quality of life in elderly Korean individuals: A population-based cross-sectional survey. Asian Nurs Res. 2014;8(4):267–273. Article
3. Korean Diabetes Association. Treatment guideline for type II diabetes mellitus [Internet]. Seoul, Author. 2013;cited 2014 December 12. Available from: http://www.diabetes.or.kr/pro/publish/guide_2013.php?mode=list
4. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977–986. Article PubMed
5. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–853.Article PubMed
6. Gu MO. A structural model for self care behavior and metabolic control in diabetic patient [dissertation]. Seoul, Seoul National University. 1992.
7. Korean Diabetes Association. Elderly Diabetes Investigation Team. Elderly diabetes mellitus. Seoul: Korea Medical Book Publisher; 2010.
8. Kim MK. Factors affecting the self-care behavior of elderly patients with diabetes [master's thesis]. Seoul, Korea University. 2011.
9. Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
10. Song MS, Gu MO, Ryu SA, Kim MS. Effect of a self-care program promoting self-efficacy for community elders with diabetes. J Korean Gerontol Nurs. 2002;4(1):27–37.
11. Ko CH, Gu MO. The effects of a diabetic educational program for coping with problem situation on self-efficacy, self care behaviors, coping and glycemic control in type 2 diabetic patients. J Korean Acad Nurs. 2004;34(7):1205–1214.Article PDF
12. Hong MH, Yoo JW, Gu MO, Kim SA, Lee JR, Gu MJ, et al. A study on effects and their continuity of the self regulation education program in patients with type 2 diabetes. Korean Clin Diabetes. 2009;10(3):187–195.Article PDF
13. Choi EO. Effects of empowerment education program for the type 2 diabetics on the empowerment, self-care behavior and the glycemic control [dissertation]. Seoul, Seoul National University. 1998.
14. Lee HJ, Park KY, Park HS, Kim IJ. The effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among clients with DM type II. J Korean Acad Nurs. 2005;35(7):1314–1324.Article PDF
15. Deakin T, McShane CE, Cade JE, Williams RD. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;2:CD003417Article
16. Miller WR, Rollnick S. Motivational interviewing: Preparing people for change. New York, NY: Guilford Publications; 1991.
17. Rollnick S, Miller WR, Butler CC. Motivational interviewing in health care: Helping patients change behavior. Shin SK Cho SH . Seoul: SigmaPress; 2009.
18. Hawkins SY. Improving glycemic control in older adults using a videophone motivational diabetes self-management intervention. Res Theory Nurs Pract. 2010;24(4):217–232.Article PubMed
19. West DS, DiLillo V, Bursac Z, Gore SA, Greene PG. Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care. 2007;30(5):1081–1087. Article PubMed PDF
20. Calhoun D, Brod R, Kirlin K, Howard BV, Schuldberg D, Fiore C. Effectiveness of motivational interviewing for improving self-care among northern plains Indians with type 2 diabetes. Diabetes Spectr. 2010;23(2):107–114. Article PDF
21. Welch G, Zagarins SE, Feinberg RG, Garb JL. Motivational interviewing delivered by diabetes educators: Does it improve blood glucose control among poorly controlled type 2 diabetes patients? Diabetes Res Clin Pract. 2011;91(1):54–60. Article PubMed
22. Lim SC. Motivational interviewing for people with diabetes mellitus. J Korean Diabetes. 2011;12(2):109–112. Article
23. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G^*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–1160. Article PubMed PDF
24. Hurley AC. Measuring self-care ability in patients with diabetes: The insulin management diabetes self-efficacy scale. In: Strickland OL, Waltz CF, editors. Measurement of nursing outcomes: Measuring client self-care and coping skills. 4th ed. New York, NY: Springer; 1990. p. 28–44.
25. Ferrans CE, Powers MJ. Quality of life index: Development and psychometric properties. ANS Adv Nurs Sci. 1985;8(1):15–24.PubMed
26. The DCCT Research Group. Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). Diabetes Care. 1988;11(9):725–732.Article PubMed PDF
27. Kim SM, Jo YH, Kim ES, Kang YC, Lee HS, Kwak KW, et al. Quality of life in the diabetic patients. J Korean Acad Fam Med. 1991;12(12):25–31.
28. Smith DE, Heckemeyer CM, Kratt PP, Mason DA. Motivational interviewing to improve adherence to a behavioral weight-control program for older obese women with NIDDM. A pilot study. Diabetes Care. 1997;20(1):52–54.Article PubMed PDF
29. Yang JJ. The effects of telephone consulting follow-up on self care behaviors and self-efficacy in diabetic patients. J Korean Soc Health Educ Promot. 2003;20(3):269–280.
30. Weinger K, Jacobson AM. Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Educ Couns. 2001;42(2):123–131. Article PubMed

Figure & Data

Table 1

Motivational Interviewing Self-management Program for Elderly Patients with DM

DM=Diabetes mellitus.

Table 2

Homogeneity Test of Characteristics between Experimental and Control Groups (N=42)

^*Fisher's exact test; Exp.=Experimental group; Cont.=Control group; DM=Diabetes mellitus.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Group (N=42)

Exp.=Experimental group; Cont.=Control group.

Table 4

Effects of Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus (N=42)

Exp.=Experimental group (n=21); Cont.=Control group (n=21).

REFERENCES

1. Ministry of Health & Welfare. Korea Centers for Disease Control & Prevention. Korea health statistics 2011: Korea national health and nutrition examination survey (KNHANES V-2). Seoul: Ministry of Health & Welfare; 2012.
2. Chin YR, Lee IS, Lee HY. Effects of hypertension, diabetes, and/or cardiovascular disease on health-related quality of life in elderly Korean individuals: A population-based cross-sectional survey. Asian Nurs Res. 2014;8(4):267–273. Article
3. Korean Diabetes Association. Treatment guideline for type II diabetes mellitus [Internet]. Seoul, Author. 2013;cited 2014 December 12. Available from: http://www.diabetes.or.kr/pro/publish/guide_2013.php?mode=list
4. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977–986. Article PubMed
5. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–853.Article PubMed
6. Gu MO. A structural model for self care behavior and metabolic control in diabetic patient [dissertation]. Seoul, Seoul National University. 1992.
7. Korean Diabetes Association. Elderly Diabetes Investigation Team. Elderly diabetes mellitus. Seoul: Korea Medical Book Publisher; 2010.
8. Kim MK. Factors affecting the self-care behavior of elderly patients with diabetes [master's thesis]. Seoul, Korea University. 2011.
9. Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
10. Song MS, Gu MO, Ryu SA, Kim MS. Effect of a self-care program promoting self-efficacy for community elders with diabetes. J Korean Gerontol Nurs. 2002;4(1):27–37.
11. Ko CH, Gu MO. The effects of a diabetic educational program for coping with problem situation on self-efficacy, self care behaviors, coping and glycemic control in type 2 diabetic patients. J Korean Acad Nurs. 2004;34(7):1205–1214.Article PDF
12. Hong MH, Yoo JW, Gu MO, Kim SA, Lee JR, Gu MJ, et al. A study on effects and their continuity of the self regulation education program in patients with type 2 diabetes. Korean Clin Diabetes. 2009;10(3):187–195.Article PDF
13. Choi EO. Effects of empowerment education program for the type 2 diabetics on the empowerment, self-care behavior and the glycemic control [dissertation]. Seoul, Seoul National University. 1998.
14. Lee HJ, Park KY, Park HS, Kim IJ. The effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among clients with DM type II. J Korean Acad Nurs. 2005;35(7):1314–1324.Article PDF
15. Deakin T, McShane CE, Cade JE, Williams RD. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;2:CD003417Article
16. Miller WR, Rollnick S. Motivational interviewing: Preparing people for change. New York, NY: Guilford Publications; 1991.
17. Rollnick S, Miller WR, Butler CC. Motivational interviewing in health care: Helping patients change behavior. Shin SK Cho SH . Seoul: SigmaPress; 2009.
18. Hawkins SY. Improving glycemic control in older adults using a videophone motivational diabetes self-management intervention. Res Theory Nurs Pract. 2010;24(4):217–232.Article PubMed
19. West DS, DiLillo V, Bursac Z, Gore SA, Greene PG. Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care. 2007;30(5):1081–1087. Article PubMed PDF
20. Calhoun D, Brod R, Kirlin K, Howard BV, Schuldberg D, Fiore C. Effectiveness of motivational interviewing for improving self-care among northern plains Indians with type 2 diabetes. Diabetes Spectr. 2010;23(2):107–114. Article PDF
21. Welch G, Zagarins SE, Feinberg RG, Garb JL. Motivational interviewing delivered by diabetes educators: Does it improve blood glucose control among poorly controlled type 2 diabetes patients? Diabetes Res Clin Pract. 2011;91(1):54–60. Article PubMed
22. Lim SC. Motivational interviewing for people with diabetes mellitus. J Korean Diabetes. 2011;12(2):109–112. Article
23. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G^*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–1160. Article PubMed PDF
24. Hurley AC. Measuring self-care ability in patients with diabetes: The insulin management diabetes self-efficacy scale. In: Strickland OL, Waltz CF, editors. Measurement of nursing outcomes: Measuring client self-care and coping skills. 4th ed. New York, NY: Springer; 1990. p. 28–44.
25. Ferrans CE, Powers MJ. Quality of life index: Development and psychometric properties. ANS Adv Nurs Sci. 1985;8(1):15–24.PubMed
26. The DCCT Research Group. Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). Diabetes Care. 1988;11(9):725–732.Article PubMed PDF
27. Kim SM, Jo YH, Kim ES, Kang YC, Lee HS, Kwak KW, et al. Quality of life in the diabetic patients. J Korean Acad Fam Med. 1991;12(12):25–31.
28. Smith DE, Heckemeyer CM, Kratt PP, Mason DA. Motivational interviewing to improve adherence to a behavioral weight-control program for older obese women with NIDDM. A pilot study. Diabetes Care. 1997;20(1):52–54.Article PubMed PDF
29. Yang JJ. The effects of telephone consulting follow-up on self care behaviors and self-efficacy in diabetic patients. J Korean Soc Health Educ Promot. 2003;20(3):269–280.
30. Weinger K, Jacobson AM. Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Educ Couns. 2001;42(2):123–131. Article PubMed

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Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus

J Korean Acad Nurs. 2015;45(4):533-543. Published online August 31, 2015

DOI: https://doi.org/10.4040/jkan.2015.45.4.533

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Development and Effects of a Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus

Table 1

Motivational Interviewing Self-management Program for Elderly Patients with DM

DM=Diabetes mellitus.

Table 2

Homogeneity Test of Characteristics between Experimental and Control Groups (N=42)

^*Fisher's exact test; Exp.=Experimental group; Cont.=Control group; DM=Diabetes mellitus.

Table 3

Homogeneity Test of Dependent Variables between Experimental and Control Group (N=42)

Exp.=Experimental group; Cont.=Control group.

Table 4

Effects of Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus (N=42)

Exp.=Experimental group (n=21); Cont.=Control group (n=21).

Table 1 Motivational Interviewing Self-management Program for Elderly Patients with DM

DM=Diabetes mellitus.

Table 2 Homogeneity Test of Characteristics between Experimental and Control Groups (N=42)

^*Fisher's exact test; Exp.=Experimental group; Cont.=Control group; DM=Diabetes mellitus.

Table 3 Homogeneity Test of Dependent Variables between Experimental and Control Group (N=42)

Exp.=Experimental group; Cont.=Control group.

Table 4 Effects of Motivational Interviewing Self-management Program for Elderly Patients with Diabetes Mellitus (N=42)