Doctor of Nursing Practice (DNP) Projects

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

10-17-2018

Degree Program

Doctor of Nursing Practice

Degree Track

Adult Gerontological Primary Care Nurse Practitioner (AGPCNP)

Year Degree Awarded

2018

Month Degree Awarded

May

Keywords

shared, medical, appointment, diabetes, intervention

Advisor

Pamela Anselton

DNP Project Chair

Raeann Leblanc

Abstract

Abstract

Background: Uncontrolled diabetes often develops into complications that are very expensive for both the patient and the healthcare system. Shared Medical Appointments (SMAs) are an evidence-based intervention that has been shown to improve participants’ biophysical outcomes and their ability to manage their disease, which can reduce long-term complications and expense.

Project Goal: This project evaluated biophysical outcomes and self-efficacy among a group of primary care patients with uncontrolled diabetes who attended a pilot SMA intervention.

Study design and Methods: A pre-test/post-test design utilizing a nonrandomized convenience sample over a 6-month time frame was utilized. Self-efficacy was measured using the Diabetes Empowerment Scale-Short Form (DES-SF). Biophysical measurements included: glycated hemoglobin (HgbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), blood pressure (both systolic and diastolic), weight, and triglycerides. Quantitative data was analyzed using the Wilcoxon-signed rank test to evaluate pre/post effects of the SMA intervention.

Results: Descriptive analysis showed a significant reduction in LDL with a median difference of 11.8 mg/dL (p<0.43), and a significant increase in HDL with a median difference of 3.5 mg/dL (p<0.43). HgbA1c, self-efficacy scores, and diastolic blood pressure showed improvements, but were not found to be statistically significant (p< .128, p< .172, p< .610, respectively). There were no changes in weight. Both systolic blood pressure and triglycerides were found to have increased slightly. Conclusion: The intervention showed significant improvements in some measurable outcomes, but not in others. A larger sample size would provide stronger evidence of the impact of the SMA. A homogenous format would also help to determine which components are most effective.

Keywords: diabetes, intervention, shared medical appointment, group visits

Available for download on Wednesday, October 17, 2018

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