Date of Award

2018-10-17

Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Cynthia D. Connelly, PhD, RN, FAAN; Ruth A. Bush, PhD, MPH

Keywords

Activation, Self-Management, Hemoglobin A1C, Filipinos

Abstract

Background: The Department of Health and Human Services Healthy People 2020 emphasized the need to eliminate health disparities and increase health equality for all citizens. The Affordable Care Act of 2010 demanded changes in health care delivery services as well as control the cost of health care. One strategy to improve health care delivery was to encourage patients’ self-management of health and health care needs through patient activation.

Objectives: The purpose of this prospective, non-experimental, cross-sectional study was to examine the relationship between patient activation, selected patient demographic variables (age, gender, level of education), low-density lipoprotein level (LDL), and self-management of hemoglobin A1c (HbA1c) among Filipinos with Diabetes Mellitus (type 1 and type 11).

Methods: A non-experimental cross-sectional design to collect prospective data among Filipinos with Diabetes Mellitus. Descriptive statistics were applied for all variables and logistic regression was used to determine predictive power of continuous and ordinal data. Patient activation measure scale (PAM-13) was used to measure activation level.

Theoretical Framework/Conceptual Model: Pender’s Health Promotion Model (2011) and Consumer and Patient and Activation Theory (Insignia Health, 2010) guided the research study.

Results: Model A containing all variables (age, LDL, and PAM-13 natural log) was statistically reliable distinguishing between A1C < 7.0 and A1C > 7.0 [-2 Log Likelihood = 1183.225, X2(3), = 15.44, p 1C < 7.0 and A1C > 7.0 [-2 Log Likelihood = -178.685, X2(3), = 19.98, p

Conclusion/Implications: The result of the study painted a different picture of patient activation in minority population. Extant research showed higher correlation of patient activation with Caucasian and lower correlation with minority population, which imply that the results of the study appears to be an outlier and may need longitudinal research and exploration of other factors. Findings from this study suggested potential new direction for research to further develop the Tagalog version of PAM to capture the full context of the survey considering that 84% of participants used the Tagalog version of PAM scale.

Document Type

Dissertation: USD Users Only

Department

Nursing

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