Search

AIMS AND OBJECTIVES To identify correlates of glycemic control among people with type 2 diabetes mellitus. BACKGROUND Approximately 28.8 million adults have type 2 diabetes mellitus in the United States with $245 billion spent on disability and lost productivity. The importance of self-management activities in type 2 diabetes mellitus treatment is well recognised. Extant studies have explored self-management activities of individuals with type 2 diabetes mellitus with mixed findings. Continued attention is warranted to identify predictors of glycemic control. DESIGN A cross-sectional study. METHODS A convenience sample, aged 18 and 75 years with a diagnosis of type 2 diabetes mellitus, was recruited and enrolled from three southern California community-based organisations between June-December 2016. Perceived self-efficacy, diabetes knowledge, self-management activities, select demographics, chronic conditions and HbA1C levels were assessed. Bivariate and multiple regression analyses were use to identify correlates of glycemic control. The STROBE checklist for cross-sectional studies was used to develop this study. RESULTS The total number of participants included in analyses was 100. Sixty-nine per cent had HbA1C ≥7%; average number of years with type 2 diabetes mellitus was 8.6 (SD = 6.52); 57% were female; and 54% had a high school or greater education. The multiple regression model significantly predicted 20% of the variance in HbA1C levels, F(6, 93) = 4.91, p

Aims and objectives To report an analysis of the concept of perinatal post-traumatic stress disorder. Background Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal–child outcomes result in increased morbidity, mortality and healthcare costs. Design Concept analysis via Walker and Avant's approach. Methods The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006–2015, containing the terms perinatal and post-traumatic stress disorder. Results Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal–infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal–infant outcomes. Conclusions Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Relevance to clinical practice Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal–infant outcomes.

Aims and objectives To report an analysis of the concept of maternal risk and explore implications for practice using Walker and Avant's eight step method analysis. Background Although mortality during pregnancy is a relatively rare occurrence, serious maternal morbidities are increasingly present in today's pregnant population. Risk factors have been identified that increase the potential for morbidities and subsequent care modalities have been implemented to decrease this risk. However, despite the wide use of the term ‘risk’ in the medical and nursing literature, determining a common definition is difficult. Differences in the understanding of risk during pregnancy can hinder the ability to provide consistent and appropriate care. Design Concept analysis. Methods A search of the English literature was completed using the databases CINAHL, PubMed, Medline, and Google Scholar for years 2000–2014 using the keywords ‘risk’, ‘maternal’ and ‘pregnancy’. Results Three defining attributes of risk were identified: chance of injury/loss, cognitive recognition and the decision-making processes. The antecedent of risk is the ability to understand the situation and cognitive ability to think about the potential consequences and adverse outcomes. Consequences of risk include the actual action taken as a result of the decision-making process. Conclusion This paper contributes to the understanding of risk allowing for the development of an individualised plan of care for each pregnant woman and empowering the nurse to advocate for appropriate care. Findings in this analysis assist nurses in bridging the gap in communication between the provider's and pregnant woman's interpretation of risk. Relevance to clinical practice The analysis of risk resulted in the identification of differences in perceptions of risk that can potentially result in miscommunication between provider and pregnant woman and increase the risk of inadequate or incomplete care.