The effect of nursing care plan based on “Roy Adaptation model” on psychological adaptation in patients with diabetes type II

Document Type : Original Quantitative and Qualitative Research Paper

Authors

1 Msc in Nursing Tarbiat Modares University, Tehran, Iran

2 Department of Nursing, Tarbiat Modares University, Tehran, Iran

Abstract

Background: Applying “Roy Adaptation Model" in caring of patients with diabetes needs a context based planning using the principles of this model. But no study has been done up to now in Iranian nursing context
Aim: To examine the effect of employing a care plan based on the Roy Adaptation Model on psychological adaptation in patient with type II diabetes.
Methods: This clinical trial was performed on 60 patients admitted in Parsian Diabetes Foundation in Mashhad in 2009 (random allocated: 30 patients in intervention and 30 patients in control group). The intervention group received a care plan designed based on Roy adaptation model for 10 week interval followed by a follow-up period for 6 weeks later, while the control group only received the regular services from the Foundation. The data collected using demographic questionnaire, Roy assessment form”, adaptation strategies questionnaire, and HgA1C test. Chi square, Wilcocxon, and T test was applied for analyzing data using SPSS version 17. Value of pResults: The results showed no significant difference in terms of level of HgA1c and the maladaptive behaviors between two groups before intervention. Nursing care based on Roy model deceased patient’s maladaptive behaviors in self concept (p=0/000) and interdependence mode in the intervention group. Level of HgA1c was decreased significantly in the intervention group (p=0/000).after intervention. No significant changes were found in the control group.
Conclusion: Applying Roy adaptation model in caring patient with type II diabetes using holistic and interdisciplinary approach, can increased psychological and physiological adaptation. More study by longer time needs to examine the effects of this model on the “role function mode”.

Keywords


1. Narayan V, Gregg E, Fagot A, Engelgau M, Vinicor F. Diabetes: a common, growing, serious, costly, and potentially preventable public health problem. Diabetes Res & Clin Prac. 2000; 50 (2) : 77-84.
2. Wild S, Roglik G, Green A, Sicree R, King H. Global Prevalence of Diabetes. Diabetes Care. 2004; 27 (5) : 1047-53.
3. Azimi N, Ghayour M, Parizadeh M, Safarian M, Esmaeili H, Khodaee G, Hosseini J, Abasalti Z, Hassankhani B, Ferns G. Prevalence of type 2 diabetes mellitus in iran and its relationship with gender, urbanization, education, marital status and occupation. Singapore Medical Journal. 2008; 49 (7) :571-6.
4. Iranian Diabetes Association. Available: http://www. ir-diabetes-society. com/. Accessed November 9, 2009.
5. Mc Donald PE. Nurse perception: Issues that arises in caring for patients with diabetes. Journal of Advanced Nursing. 1999; 30:425-30.
6. Amini M, Haghighi S. The survey of costs of Type 2 diabetic patients in Endocrine &metabolism Research Center in Isfahan in 1998. Iranian Journal of Endocrine & Metabolism. 2002; 2 (4) :97-104.
7. Hejlesen O, Andreassen S, Frandsen N, Sorensen T, Henrik S, Hovorka R, Cavan D. Using a double blind controlled clinical trial to evaluate the function of a Diabetes Advisory System: a feasible approach?. Comput Methods Programs Biome. 1998; 56: 165-73.
8. Omrani GH, Sovid H, Sadegh Alvad A. The Incidence rate of chronic complications in patients in 12years follows up in Health Centers in Shiraz Medical Sciences University. Iranian Journal of Diabetes. 2004; 2 (3) : 127-134.
9. Rogers C, Kaller Colleen. Roy adaptation model to promote physical activity among sedentary older adults. Geriatric Nursing. 2008; 2s (30) :21-6.
10. Whittemore R, Roy C. Adapting to Diabetes Mellitus: A Theory Synthesis. Nursing Science Quarterly. 2002; 15 (4) : 311-7.
11. lernmark B, person B, fisher L, Rydelius P. Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus. Diabetic Medicine. 1999;16 (1) : 14–20.
12. Paula M, christine L. Rebecca O. Ruth S. The Marital Relationship and Psychosocial Adaptation and GlycemicControl of Individuals With Diabetes. Diabetes care. 2001;24 (8) : :1384–9.
13. Alan M, et al. Psychologic predictors of compliance children with recent onset of diabetes mellitus. The Journal of Pediatrics. 1987;110 (5) :805-11.
14. Ellen B, Henessy H. Empowering adolescents with asthma to take control through adaptation. Journal of Pediatric Health Care. (1999); 13: 273-7.
15. Ak Bakan G, Akyol AD. Theory guided intervention for adaptation to heart failure. Journal of Advanced Nursing. 2008; 61 (6) :596-608.
1716
تأثر برنامهی مراقبتی بر اساس مدل پرستاری «روی» بر مزان سازگاری روانشناختی بماران دیابتی نوع دوییی
مراقبت مبتنی بر شواهد / فصلنامه دانشکده پرستاری و مامایی مشهد دوره اول، شماره 1، زمستان 90
16. Gafvels C, Wandell P. Coping strategies in men and women with type 2 diabetes in Swedish primary care. Diabetes Research Clinical Practice 2006; 71: 280–9.
17. Delameter A, Kurtz S. Stress and coping in relation to metabolic control of adolescences with diabetes type 1. Development and Behaviors Pediatrics 1987; 8 (3) :136.
18. Pilkington B. Envisioning Nursing in 2050 through the Eyes of Nurse Theorists: King, Neuman, and Roy. Nursing Science Quarterly. 2007, 20 (2) :108.
19. Manjit A. Roy adaptation model: demonstration of theory integration into process of care in coronary care unit. ICU & Nursing Web Journal. 2001; 7 (11) : 66-73.
20. Schmid T, Petersen C, Bullinger M. Coping with chronic disease from the perspective of children and adolescents: a conceptual framework and its implications for participation. Child care health & Development. 2003; 29 (1) : 63-75.
21. Patton D. An analysis of Roy Adaptation Model of Nursing as used within acute psychiatric nursing. Journal 0f Psychiatric and Menalt Health Nursing. 2004; 11 (2) : 221-8.
22. Meleis A. theoretical nursing. Lippicott Williams & wilkins 2007:4th edition;p:270-320
23. Roy C, Jones D. nursing knowledge develpement and clinical practice. Springer publishing company 2011:first edition;p:250-300
24. Nesari M. , Zakerimoghadam M. , Rajab A. , Faghihzadeh S. , Basampour Sh. , Rahmani M. The effect of telephony follow up by nurse on the glucose control and hyper lipedemi in patients with type 2 diabetes mellitus. Hyat. 2008; 15 (9) : 115-22.
25. Fawcett J. Analysis and evaluation of conceptual models of nursing. Philadelphia: Davis Company. 2008: pp. 247-278
26. Krapek K, et al. Medication Adherence and Associated Hemoglobin A1c in Type 2 Diabetes. Annual Pharmacotherapy. 2004; 38 (9) :1357-62.
27. Baghiani Moghadam M. The efficiency of Basnef Model in diabetes control. Health education Ph. D thesis, Tehran, Tarbiat Modares University. 2000 [Thesis].
28. Ghanbari A. The effect of Self-Care conceptual framework on QOL and metabolic situation in NIDDM in Health Centers Tabriz city. 2002 [Thesis]. .
29. Deakin D. MCshane CE. Williams RD. Group based training for self management strategies in people with type 2 diabetes mellitus. Evidence Based Nursing. 2005; 8 (4) :111.
30. Adolfsson E, Walker M, Simide B, Wikblade K. Patient education in type 2 diabetes: A randomized controlled 1-year follow-up study. Diabetes Research Clinical Practice. 2007; 12 (76) :341–50
31. Whittemore R. Jaser S. Gue J. Grey M. Conceptual model of childhood adaptation to type 1 diabetes. Nursing Outlook. 2010; 10 (58) : 242-51.
32. Hennessy- Harstad E. Empowering adolescents with Asthma to take control through adaptation. Journal of Pediateric Health Care. 1999: 13 (6) : 273-7.
33. Chen Hsiao-Yu. Boore J. R. P. Mullan F D. Nursing models and self- concept in patients with spinal cord injury – a comparison between UK and Taiwan. International Journal of Nursing Studies. 2005;11 (42) : 255-72.
34. Ahari A. Heydari S. Vaghee S. heart failure and diet. 10th Annual Spring metting on Cardiovascular Nursing / European Journal Cardio Vascular Nursing. 2010: 9 (1) : S35.
35. Malihe Sarafi. The effect of self-care education on knowledge, attitude and physical status of hemodialysis patients in teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences. Shahid Beheshti University of Medical Sciences, School of Nursing, 1373.
36. Baraz shahram, Mohammadi Esa, Boroumand Behrouz, The effect of dietary regimen education on the laboratory variables and interdialytic weight gain in hemodialytic patients Journal of Shahrekord Uuniversity of Medical Sciences, 2006; 8 (1) :20-7.
37. Salehi, Sh. Tasyramvzsh of diet on laboratory parameters and weight gain between dialysis sessions in the hospital of Shahrekord University of Medical Sciences. 2002 [Thesis].
38. Gafvels C, Wandell P. Coping strategies in men and women with type 2 diabetes in Swedish primary care. Diabetes Research Clinical Practice 2006;15 (71) : 280–9.
39. Delameter A, Kurtz S. Stress and coping in relation to metabolic control of adolescences with diabetes type 1. Development and Behaviors Pediatrics 1987; 8 (3) :136.
40. Rae J, Rankin S. Application of Leventhal,s Self-Regulation Model to Chinese Immigrants With Type 2 Diabetes. Journal of Nursing Scholarship 2001; 33 (1) :53-9.
41. Coelho R, Amorim I, Prata Joana. Coping Styles and Quality of Life in Patients with Non-Insulin-Dependent Diabetes Mellitus. Psychosomatics 2003; 44 (4). 66-72.
42. Mosnier H, Hochberg G, Eschwege E, Virally M, Halimi S, Guillausseau P, Peixoto O, Touboul C, Dubois C, and Dejager S. Diabetes Metabolism 2009; In Press.