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PURPOSE - The purpose of this study was to explore physical activity-related experiences, perceptions, and counseling expectations among urban, underactive, African American women with type 2 diabetes.
METHODS - Participants were recruited via flyers and endocrinologist referral. A professional, African American female moderator led 2 focus groups among 11 participants. Focus groups were conducted in a video- and audio-equipped focus group room in the evening hours. Using a content-based, stepped analytic approach, 2 raters independently analyzed data and collaborated to compare results and finalize themes.
RESULTS - Competing priorities and lack of motivation were perceived as significant barriers to physical activity. Physical activity-related counseling expectations (ie, physician encouragement) and experiences (physician advising) were inconsistent. Participants expressed a high degree of physical activity-related health responsibility. Altruistic intentions were high relative to helping others incorporate healthful lifestyle changes.
CONCLUSIONS - When counseling women about physical activity, diabetes educators should acknowledge and provide support and resources to help women incorporate more physical activity into their regular routines and enhance motivation for physical activity. Educators should also couple physical activity-related advice with encouragement and support. Because of high levels of altruism, educators should consider implementing group- and/or peer-based physical activity interventions in this patient group.
For youth with type 1 diabetes (T1DM), the transition into adolescence is often associated with poorer adherence to treatment, deteriorating metabolic control, and increased risk for psychological disorders. The current article summarizes recent findings on psychological problems for adolescents with diabetes, including depression, eating disorders, fear of hypoglycemia, and problems specific to adolescents with T2DM. The impact of family functioning on adolescent adjustment and the importance of parent-child collaboration on treatment management is emphasized. By using the strategies described in this article, primary care providers have the potential to support adolescents with diabetes, while screening for problems that may be better treated by other professionals.
Although the use of physical restraint has declined in nursing homes, the practice remains widespread in hospitals. The use of physical restraint in hospitals was reviewed to identify the current clinical, legal, and ethical issues and the implications for policy and further research. Clinicians use physical restraints to prevent patient falls, to forestall disruption of therapy, or to control disruptive behavior, but they vary in how they determine to institute these restraints. The evidence to support the reasons for their determinations is not compelling. Fear of litigation remains a powerful motivator. The ethical dilemma of autonomy versus beneficence has not been resolved satisfactorily for patients in this setting. The lack of large-scale studies in any of these areas makes it difficult for policy makers to determine whether it is necessary to address hospital physical restraint practices through additional regulation.
The desire for control over one's health care is defined as preferring to directly influence the nature of that care. We attempted to measure the following relevant constructs and to examine the relationships among them: (1) desire-for-control (DCON) in a specific health care setting--a hypothetical situation in which a person was facing imminent death; (2) attitude toward an action perceived as enhancing control in that situation--signing a living will; and (3) intention to exercise control by performing that action--actually signing a living will. An analysis of variance (DCON x attitude) of intention to sign a living will yielded statistically significant main effects for DCON and attitude, although DCON was in a direction counter to that predicted. Possible explanations for the DCON finding were explored.