Download Spiritual Beliefs Effect on Patients with Type II Diabetes

Running head: EFFECT OF SPIRITUAL BELIEFS ON PATIENTS WITH TYPE II
DIABETES
Spiritual Beliefs Effect on Patients with Type II Diabetes
Critical Appraised Topic
Jaimi Pochant
University of Mary
EFFECT OF SPIRITUAL BELIEFS ON PATIENTS WITH TYPE II DIABETES
2
Effect of Spiritual Beliefs on Patients with Type II Diabetes
Clinical Scenario: 59 year old African American female presents in the clinic for a follow up
appointment after being diagnosed 8 months ago with Type II diabetes mellitus. At the time of
diagnosis, the patient’s A1C was checked twice over the course of 3 months with results of 11.5
% and 10.9%. The patient was educated at the time of diagnosis on nutritional ways to help
maintain her blood glucose, how to check and record blood glucose, exercise, and medications.
The patient was started on Lantus 100 units/ml and was given the recommended 26 units SC
every day to start. The patient was also prescribed Humalog 100units/ml; therefore with a
weight of 105 kg the appropriate dose would be 8.5 units SQ 15 minutes before or immediately
after meals. Metformin 1000 mg two times a day was also included and the patient was asked to
make a follow up appointment in two to three months to recheck the A1C and to make
appropriate medication adjustments. The patient is now returning for labs with a result of 10.4%.
A1C. The patient states, “I am taking the medication daily”; however, when asked about eating
and exercising habits, the patient states, “I haven’t been eating the best and I do not really
exercise but God will help my body heal and I am to busy taking care of my family”.
PICO Question: In patients with Type II Diabetes, does spiritual belief have an effect on
disease management and overall health?
Summery and Appraisal of Key Evidence:
Duke, N., & Wigley, W. (2016). Literature review: The self-management of diet, exercise and
medicine adherence of people with type 2 diabetes is influenced by their spiritual beliefs.
Journal Of Diabetes Nursing, 20(5), 184-190 7p.
The article, Duke & Wigley (2016) reviewed the effect of spiritual beliefs on patient
health. Duke & Wigley (2016) state “Research shows that the spirituality of people with type 2
EFFECT OF SPIRITUAL BELIEFS ON PATIENTS WITH TYPE II DIABETES
3
diabetes can have a profound influence on their diet, exercise and medicine adherence”(p.184).
During the review, the authors researched published and unpublished data found in academic
books, journals, websites, policy documents, as well as emails from experts. The study showed
that spirituality could influence the health of Christian African Americans in three ways
including: 1: Patients took responsibility for self-management while viewing God as a supporter
in health. 2: Patients saw God as the leader of health outcomes especially if health was
improved, the patients would deem it as God’s will instead of self-management while believing
that faith was more important. 3: Some patients deemed God as a healer and believed that faith
was healing and that it wouldn’t matter if self-management were followed because god would
heal the disease. The study goes on to address that providers may be anxious or fearful of
addressing spirituality; however, it is important that this discussion be facilitated to help the
provider determine limitations that may arise due to spirituality.
Samuel-Hodge, C., Headen, S., Skelly, A., Ingram, A., Keyserling, T., Jackson, E., & ... Elasy,
T. (2000). Influences on day-to-day self-management of type 2 diabetes among
African-American women: spirituality, the multi-caregiver role, and other social context
factors. Diabetes Care, 23(7), 928-933 6p.
This qualitative study done by Samuel-Hodge et al. (2000) included 70 samples of
African American women with type II diabetes and split them up into 10 focus groups for
interviews that were audiotaped and coded using a qualitative data software. The results of the
study determined that spirituality is very important to African American women and deemed a
factor in disease management as well as coping with the disease. Another key factor included
that the women tend to put family before anything else; therefore, the women’s daily lives,
stress, and responsibilities interfere with self-management of the disease. Spirituality also plays
EFFECT OF SPIRITUAL BELIEFS ON PATIENTS WITH TYPE II DIABETES
4
a key role in lives of the subjects because God and the church have played a part in how the
subjects cope with the disease and is the main support system for families. The subjects also
have suffered from diet deprivation, physical, and emotional tiredness.
Clinical Bottom Line:
Both studies determined that spirituality has an impact on African American women with
Type II diabetes. The authors identify that God plays an important role in how much the patient
will take responsibility for health care and compliance with dietary, medication, and lifestyle
changes that are recommended by the provider.
Implications for Clinical Practice:
Type II Diabetes is a common diagnosis in practice today and very important that
providers remember to take in consideration spirituality and the different beliefs that their
patients may portray so that the proper disease management plans can be applied. Providers
need to ask about spirituality in order to identify any obstacles that the patients may have with
disease management such as diet compliance. Once these obstacles are identified, the provider
can help the patients determine the best management course for disease control including diet,
exercise, and medication compliance.
EFFECT OF SPIRITUAL BELIEFS ON PATIENTS WITH TYPE II DIABETES
5
References:
Duke, N., & Wigley, W. (2016). Literature review: The self-management of diet, exercise and
medicine adherence of people with type 2 diabetes is influenced by their spiritual beliefs.
Journal Of Diabetes Nursing, 20(5), 184-190 7p.
Samuel-Hodge, C., Headen, S., Skelly, A., Ingram, A., Keyserling, T., Jackson, E., & ... Elasy,
T. (2000). Influences on day-to-day self-management of type 2 diabetes among
African-American women: spirituality, the multi-caregiver role, and other social context
factors. Diabetes Care, 23(7), 928-933 6p.