Cognition and self-management in type 2 diabetes in the older person

2.50
Hdl Handle:
http://hdl.handle.net/10547/271295
Title:
Cognition and self-management in type 2 diabetes in the older person
Authors:
Tomlin, Alexandra Elizabeth
Abstract:
Cognition and Self-Management in Type 2 diabetes in the older person was studied using neuropsychological evaluation and self-management assessments. Type 2 diabetes is increasing in prevalence, erodes quality of life, and places significant burden on healthcare services. The condition is largely self-managed, requiring daily performance of a variety of tasks. Impaired cognition has been associated with Type 2 diabetes, particularly in those who have had diabetes for longer or are older. It is unknown whether such changes in cognition seen in Type 2 diabetes affect the ability to self-manage the condition; the few studies that have been conducted in this area have shown little consensus in focus, methodology, or results. This thesis aimed to investigate any links between cognitive impairment and diabetes self management skills in an older population with Type 2 diabetes, by determining assessment schedules for both selfmanagement and cognition in this population and searching for associations between the two. Literature review, questionnaire and focus group studies pointed towards four main components of diabetes selfmanagement; diabetes knowledge, self-efficacy, motivation, and diabetesspecific problem solving abilities. A theoretical framework emerged from this analysis; Bandura’s Social Cognitive Theory provides a context for the interaction of environment, society and cognitions in health behaviours. A systematic review found several associations between self-management skills and abilities, and global and individual areas of cognition, including links between executive function and memory, and diabetes knowledge, insulin skills, adherence to medications, missed appointments, and decreased frequency of self-care activities. A further clinical study identified several associations including visual and working memory, and reaction times, with diabetes knowledge. Future studies with larger sample sizes might revisit these associations. Clinical implications include the need for routine cognitive assessment in an older population with Type 2 diabetes; interventions might include checking medication adherence, diabetes knowledge, and referral to support groups.
Citation:
Tomlin, A.E. (2011) 'Cognition and self-management in type 2 diabetes in the older person. PhD thesis. University of Bedfordshire.
Publisher:
University of Bedfordshire
Issue Date:
Dec-2011
URI:
http://hdl.handle.net/10547/271295
Type:
Thesis or dissertation
Language:
en
Description:
A thesis submitted to the University of Bedfordshire, in partial fulfilment of the requirements for the degree of Doctor of Philosophy
Appears in Collections:
PhD e-theses

Full metadata record

DC FieldValue Language
dc.contributor.authorTomlin, Alexandra Elizabethen_GB
dc.date.accessioned2013-03-06T12:12:59Z-
dc.date.available2013-03-06T12:12:59Z-
dc.date.issued2011-12-
dc.identifier.citationTomlin, A.E. (2011) 'Cognition and self-management in type 2 diabetes in the older person. PhD thesis. University of Bedfordshire.en_GB
dc.identifier.urihttp://hdl.handle.net/10547/271295-
dc.descriptionA thesis submitted to the University of Bedfordshire, in partial fulfilment of the requirements for the degree of Doctor of Philosophyen_GB
dc.description.abstractCognition and Self-Management in Type 2 diabetes in the older person was studied using neuropsychological evaluation and self-management assessments. Type 2 diabetes is increasing in prevalence, erodes quality of life, and places significant burden on healthcare services. The condition is largely self-managed, requiring daily performance of a variety of tasks. Impaired cognition has been associated with Type 2 diabetes, particularly in those who have had diabetes for longer or are older. It is unknown whether such changes in cognition seen in Type 2 diabetes affect the ability to self-manage the condition; the few studies that have been conducted in this area have shown little consensus in focus, methodology, or results. This thesis aimed to investigate any links between cognitive impairment and diabetes self management skills in an older population with Type 2 diabetes, by determining assessment schedules for both selfmanagement and cognition in this population and searching for associations between the two. Literature review, questionnaire and focus group studies pointed towards four main components of diabetes selfmanagement; diabetes knowledge, self-efficacy, motivation, and diabetesspecific problem solving abilities. A theoretical framework emerged from this analysis; Bandura’s Social Cognitive Theory provides a context for the interaction of environment, society and cognitions in health behaviours. A systematic review found several associations between self-management skills and abilities, and global and individual areas of cognition, including links between executive function and memory, and diabetes knowledge, insulin skills, adherence to medications, missed appointments, and decreased frequency of self-care activities. A further clinical study identified several associations including visual and working memory, and reaction times, with diabetes knowledge. Future studies with larger sample sizes might revisit these associations. Clinical implications include the need for routine cognitive assessment in an older population with Type 2 diabetes; interventions might include checking medication adherence, diabetes knowledge, and referral to support groups.en_GB
dc.language.isoenen
dc.publisherUniversity of Bedfordshireen_GB
dc.subjectB710 Community Nursingen_GB
dc.subjectDiabetes Mellitusen_GB
dc.subjectdiabetesen_GB
dc.subjectelderlyen_GB
dc.subjecttype 2 diabetesen_GB
dc.subjectcognitionen_GB
dc.subjectcognitive impairmenten_GB
dc.subjectself managementen_GB
dc.titleCognition and self-management in type 2 diabetes in the older personen
dc.typeThesis or dissertationen
dc.type.qualificationnamePhDen
dc.type.qualificationlevelDoctoralen
dc.publisher.institutionUniversity of Bedfordshireen
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