Date of Award

2017

Degree Name

PhD Nursing

Dissertation Committee

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

Keywords

Asian, Diabetes Mellitus, Filipinos, Hemoglobin A1C, Intervention, Nursing

Abstract

Among immigrants in the United States, Filipinos are the fourth largest group by country of origin with projections to triple by 2030. Despite current protocols to identify risks for diabetes, a gap exists in diagnosing and treating Filipinos with the disease. Knowledge about Filipinos and their health is imprecise because national data used to track disease prevalence does not identify Filipinos separately from the Asian and Asian-Pacific Islander group. The purpose of this study is to identify factors that influence effective diabetes self-management among a sample of Filipinos. Specific aims include:

1. Describe the characteristics of a sample of Filipinos with pre-diabetes and Type 2 diabetes mellitus.
2. Examine the relationships between health literacy, self-efficacy, depression, select demographic variables and characteristics (e.g. socio-economic status, age, gender, marital status, education level, year of migration to the U.S., language spoken at home and in the community, language read and understand, years diagnosed with diabetes, presence of blood glucose machine, oral glucose prescription, smoking, hypertension, exercise) and diabetes self-management practices in a sample of Filipinos with pre-diabetes and Type 2 diabetes.
3. Identify factors that increase the probability (odds) for effective self-management of HgbA1C among a sample of Filipinos with pre-diabetes and Type 2 diabetes mellitus.
4. To gain a broader understanding of the barriers to prescribed self-management practices in a subset of Filipinos with pre-diabetes and Type 2 diabetes mellitus.

Methods: Quantitative and Qualitative approaches were used for this study. Quantitative: A descriptive correlational design. A convenience sample of 99 Filipinos was recruited and enrolled over a 6-month period, from 2 private practice clinics and the community in southern California. Inclusion Criteria: 18 to 70 years old, pre-diabetes (HgbA1C 5.7-6.4%) or Type 2 diabetes (HgbA1C ≥ 6.5%). Exclusion Criteria: Type 1 diabetes, and medical diagnosis of dementia or depression. Participants completed demographic questions, Diabetes Management Self-Efficacy Scale (DMSES), Patient Health Questionnaire (PHQ-9) and the 3-Health Literacy (3-HL) scale. Descriptive statistics were used for all analysis variables to describe participant characteristics. Spearman Rho correlation and logistic regression analyses were used to examine the relationships among patient characteristics, diabetes self-efficacy, diabetes related emotional distress, diabetes health literacy, and HgbA1C level. A logistic regression model containing 5 independent variables (takes pills, hypertension, blood glucose machine, times blood glucose checked, and years diagnosed with diabetes) was statistically significant X2(5, N=94) = 40.62, p

Implications: This study addressed this gap in the knowledge of the predictors of effective diabetes self-management among a sample of Filipinos. Study outcomes provide valuable information to inform practitioners, administrators, and policymakers in the development and implementation of more efficient, patient-based care to increase type 2 diabetic patient engagement in self-management practices, improve patient satisfaction, health, and lower healthcare costs.

Document Type

Dissertation: USD Users Only

Department

Nursing

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