Effect of Spiritual Beliefs Onpatients with Type Ii Diabetes

EFFECT OF SPIRITUAL BELIEFS ONPATIENTS 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

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 be8.5 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 ondisease 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 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 During the review, the authors researched published and unpublished data found in academic books, journals, websites, policy documents, as well as emails from experts.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 healthwas 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 faithwas healing and that it wouldn’t matter if self-managementwere 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 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.

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