DIABETES MANAGEMENT AND MHEALTH TECHNOLOGY: THE IMPORTANCE OF HEALTHCARE PARTNERSHIPS AND CLINICAL INTEGRATION

Transcription

1 DIABETES MANAGEMENT AND MHEALTH TECHNOLOGY: THE IMPORTANCE OF HEALTHCARE PARTNERSHIPS AND CLINICAL INTEGRATION Sheridan Miyamoto, PhD, FNP, RN Stuart Henderson, PhD Sarina Fazio, MS, RN Madan Dharmar, MBBS, PhD Yajarayma Tang-Feldman, MA Heather Young, PhD, RN, FAAN S i g m a T h e t a Ta u I n t e r n a t i o n a l 27 th I n t e r n a t i o n a l N u r s i n g R e s e a r c h C o n g r e s s 1

2 Purpose To understand: The participant s experience living with diabetes Prior successes and challenges faced in diabetes self-management Perceived benefits or drawbacks of working with a health coach and integrating daily activity data in the EHR. 2

3 Focus Group Sample Characteristic N (N=20) % Characteristic N (N=20) % AGE INCOME > $100,000 $51,000-99,000 < $ 50, GENDER Female RACE White Latino African-American Pacific Islander/East Indian/American Indian EDUCATION College degree Some college High school degree SELF-RATED HEALTH Excellent Good Fair Poor TECHNOLOGY USE Own mobile phone Own smartphone Personal health record use Wellness app use

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6 Major Themes of Living with Diabetes 6

7 Major Themes of Living with Diabetes 7

8 Pervasiveness I was diagnosed 5 years ago and it was a sudden onset. And so this is a new experience for me and I think the most important thing over the past five years is that it is constantly in the back of your mind. It s a constant stressor and a constant pressure and there is no way to get rid of it. It is always there. My injections. My blood. My carb counting. I have to think about it. It is a full-time job. 8

9 Major Themes of Living with Diabetes 9

10 Major Themes of Living with Diabetes 10

11 Importance of Surveillance/Tracking Absolutely watching everything I eat. My carbohydrate intake, absolutely every gram has to be accounted for. I have a journal. I keep a journal so I know from meal to meal exactly how many carbs I have throughout the day. 11

12 Major Themes of Living with Diabetes 12

13 Major Themes of Living with Diabetes 13

14 Loneliness of the Experience I m kind of on my own. For a long time, and I still think today, it s kind of me, myself and I. [My doctor] doesn t really understand what I am trying to tell her and I ve had a diabetic incident and I ve tried to get a hold of her twice and she really wasn t there for me. So it is definitely hard. [Support] is important. Because you don t have people who relate. You can tell people you re low and they just look at you like you are crazy. Then you gotta explain to them what it means. 14

15 Major Themes of Living with Diabetes 15

16 Major Themes of Living with Diabetes 16

17 Focus on Control and Motivation And the main problem I find is sustaining the motivation to make sure that I m checking my blood, make sure that I m, you know, eating the right foods. It s very hard to stay on that path. So then when it just goes up and down, up and down, and when I see my doctor I m doing good and she s like that s great and then I go up and she s like, You gotta do better. You know, It s like I can t I know it sounds weird, but I can t find a reason to do it well all the time. 17

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20 Individual Variation in Living with Diabetes 20

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22 Impact of Interventions 22

23 Patient Advisory Board Input Validated findings Suggested changes for framing the themes Vigilance Balance and Motivation 23

24 Thank you! 24