Individuals with schizophrenia have higher rates of diabetes mellitus as compared
with the general population, but little is known about their diabetic self-care. This
grounded theory study was conducted to develop a theory of self-care for individuals
with comorbid schizophrenia/schizoaffective disorder and diabetes. Twenty-six interviews
were conducted among 11 respondents with varying degrees of ability to care for these
coexisting illnesses. Respondents identified psychiatric symptoms as a major barrier
to diabetic self-care. The resulting theory of Evolving Self-Care describes the process
by which respondents developed self-care health beliefs over time to help them successfully
manage their psychiatric disorder and diabetes. Categories include mastering mental
illness, accommodating diabetes, and striving for health. When providing care to patients
with schizophrenia/schizoaffective disorder and diabetes, advanced registered nurse
practitioners are encouraged to provide education about the negative consequences
of psychosis on diabetes self-care.
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References
- The relationship between diabetes-related attitudes and patients' self-reported adherence.The Diabetes Educator. 1993; 19: 287-292
- The experience of recovery from schizophrenia: Towards an empirically validated model.Australian and New Zealand Journal of Psychiatry. 2003; 37: 586-594
- Atypical antipsychotics: Impact on overall health and quality of life.Journal of the American Psychiatric Nurses Association. 2002; 8: S9-S17
- Prevalence of diabetes and impaired glucose tolerance in patients with schizophrenia.British Journal of Psychiatry. 2004; 184: S67-S72
- Association between atypical antipsychotic agents and type 2 diabetes: Review of prospective clinical data.British Journal of Psychiatry. 2004; 184: S87-S93
- The risk of diabetes during olanzapine use compared to risperidone use: A retrospective database analysis.Journal of Clinical Psychiatry. 2002; 63: 1135-1139
- Schizophrenia and co-occurring general medical illness.Psychiatric Annals. 2005; 35: 71-80
- An empirical study of a model of self-care in chronic illness.Clinical Nurse Specialist. 1993; 7: 247-253
- Stress and the genesis of diabetes mellitus in schizophrenia.British Journal of Psychiatry. 2004; 184: S72-S75
- Prevalence and correlates of diabetes in national schizophrenia samples.Schizophrenia Bulletin. 2000; 26: 903-912
- Use of medical services by veterans with mental disorders.Psychosomatics. 1997; 38: 451-458
- Dorothea Orem's self-care deficit theory of nursing.in: Marriner-Tomey A. Nursing theorists and their work. 4th ed. Mosby, St. Louis1994: 181-198
- Acceptance of diabetes regimens in adults.in: Gochman D.S. Handbook of health behavior research: II. Provider determinants. Plenum Press, New York1997: 189-212
- Capacity for self-care of persons with mental illnesses living in community residences and the ability of their surrogate families to perform health care functions.Issues in Mental Health Nursing. 1998; 19: 53-70
- Personal-model beliefs and social-enviromental barriers related to diabetes self-management.Diabetes Care. 1997; 20: 556-561
- Medical morbidity and mortality in schizophrenia: Guidelines for psychiatrists.Journal of Clinical Psychiatry. 2005; 66: 183-194
- Medical illnesses in patients with schizophrenia.Journal of Clinical Psychiatry. 1999; 60: S10-S15
- Antipsychotics and diabetes: Review of non-prospective data.British Journal of Psychiatry. 2004; 47: S80-S86
- Clozapine: Diabetes mellitus, weight gain, and lipid abnormalities.Journal of Clinical Psychiatry. 2001; 62: S39-S44
- Health and behavior: The interplay of biological, behavioral, and societal influences.National Academy Press, Washington, DC2001
- How people with schizophrenia build their hope.Journal of Psychosocial Nursing and Mental Health Services. 2001; 39: 46-53
- Diabetes mellitus and schizophrenia: Historical perspective.British Journal of Psychiatry. 2004; 47: S64-S66
- Clozapine-associated diabetes.American Journal of Medicine. 2001; 111: 716-723
- Naturalistic inquiry.Sage Publications, Thousand Oaks, CA1985
- Primary care for mental health nurses: Evidence-based guidelines for nursing assessment, intervention, and follow-up.Journal of Psychosocial Nursing and Mental Health Services. 2004; 42: 22-35
- Depression increases diabetes symptoms by complicating patients' self-care adherence.Diabetes Educator. 2004; 30: 485-492
- Diabetes mellitus in schizophrenic patients.Comprehensive Psychiatry. 1996; 37: 68-73
- An overview of common medical comorbidities in patients with schizophrenia.Journal of Clinical Psychiatry. 2005; 66: S3-S4
- Diet, diabetes and schizophrenia: Review and hypothesis.British Journal of Psychiatry. 2004; 184: S102-S105
- Readiness to change and clinical success in a diabetes educational program.Journal of the Board of Family Practitioners. 2002; 15: 266-271
- Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia.American Journal of Psychiatry. 2003; 160: 284-289
- Consensus summary.British Journal of Psychiatry. 2004; 47: S112-S114
- Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia.American Journal of Psychiatry. 2002; 159: 561-566
- Effect of acute psychotic stress in nondiabetic subjects on β-cell function and insulin sensitivity.Diabetes Care. 2004; 26: 1462-1467
- Basics of qualitative research: Techniques and procedures for developing grounded theory.2nd ed. Sage Publications, Thousand Oaks, CA1998
- Management of medical illness in persons with schizophrenia.Psychiatric Annals. 2000; 30: 35-40
- Metabolic disturbance in first-episode schizophrenia.British Journal of Psychiatry. 2004; 184: S76-S79
- Two decades of insider research: What we know and don't know about chronic illness experience.Annual Review of Nursing Research. 2000; 18: 3-25
- A program for managing weight gain associated with atypical antipsychotics.Psychiatric Services. 2003; 54: 1155-1157
- Strategies to facilitate lifestyle change associated with diabetes mellitus.Journal of Nursing Scholarship. 2000; 32: 225-232
Article info
Footnotes
Supported by a grant from the International Society for Psychiatric Mental Health Nurses, Madison, WI.
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© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
