Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chair; Jane M. Georges, PhD, RN, Committee Member; Denise M. Boren, PhD, RN, Committee Member


diabetes, diabetes knowledge, diabetes self-efficacy, diabetes self-management, perception, type 2 diabetes


In the United States (U.S.), Type 2 Diabetes Mellitus (T2DM) has reached epidemic portions with a prevalence of approximately 29.1 million people and is the seventh-leading cause of death (Centers for Disease Control and Prevention [CDC], 2014; Healthy People 2020, n.d.). The U.S. spends an estimated $245 billion in direct and indirect medical costs. The indirect costs include disability and lost productivity (CDC, 2014).

Previous studies focusing on diabetes education acknowledge the significance of self-management activities in managing T2DM. Extant studies examining self-management and treatment outcomes for persons with T2DM have paid limited attention to the relationship between patients' disease perceptions, diabetes knowledge, self-efficacy, self-management practices, and glycemic control. The purpose of this investigation was to identify factors and outcomes associated with healthy diabetes self-management practices among a cohort of individuals with T2DM residing in southern California. Nola Pender's Health Promotion Model (Pender et al., 2015) guided the study. Specific aims include:

1) Provide conceptual clarity for the phenomenon of perception through a concept analysis using Walker and Avant (2011) methodology,

2) Identify factors and outcomes associated with diabetes self-management through a systematic review of the literature, and

3) Examine relationships among perceived self-efficacy, specific patient characteristics, diabetic knowledge, self-management practices, and HbA1C values among a sample of individuals with T2DM living in southern California. The research aims provided the structure to generate new scientific data and evidence towards the improvement of self-management practices and those characteristics leading to improved HbA1C outcomes.

Document Type

Dissertation: USD Users Only