Intervention by nurses which promotes self efficacy in patients is a key element of effective diabetes care.

Intervention by nurses which promotes self efficacy in patients is a key element of effective diabetes care.

Intervention by nurses which promotes self efficacy in patients is a key element of effective diabetes care.

Introduction

The incidence of diabetes is rapidly increasing in Western societies. Specific racial and ethnic groups, such as Mexican Americans, African Americans, Asian Americans, and Native Americans, are disproportionately affected by diabetes . The adverse impact on health of uncontrolled diabetes in these groups is compounded by lack of access to traditional primary care and preventive health care services.

In response to this lack of adequate care for the uninsured, there is an increasing impetus for defining and implementing additional methods of improving diabetes care. The Centers for Disease Control and Prevention's national health objectives for year 2010 include increasing the percentage of individuals with diabetes who achieve specific standards of diabetes care. Diabetes management and education programs have been shown to have a significant impact on improving health outcomes.

Self-efficacy has been studied using Bandura's Theory of Social Learning, later known as self-efficacy theory, in a variety of health care settings with individuals and nurses in different surroundings. Self-efficacy has been a focus in the literature for research-based nursing interventions designed to educate individuals with diabetes (Corbett, 1999; Temple, 2003). This is valuable because the incidence of diabetes is growing among children and adolescents. By 1999, children and adolescents with type 2 diabetes made up as many as 8-45% of childhood diabetes diagnoses (Kaufman, 2005). The care and education that children with diabetes receive in school is important. Therefore, school nurses play a pivotal role in managing diabetes-related care and educating children with diabetes.

Discussion

In the literature, self-efficacy has been shown to positively affect outcome expectations for performing or changing specific health behaviors. A study conducted bySousa and colleagues (2004) showed a positive relationship between greater self-efficacy and positive outcome expectations for performing diabetes self-care management for both diabetes type 1 and type 2 insulin-dependent individuals. This study suggested that enhancing an individual's diabetes knowledge, social support, self-care agency, and self-efficacy may be an effective strategy that can promote better compliance with diabetes self-care.

School nurses' perceptions of their self-efficacy or confidence in providing diabetes care and education has not been reported in the literature. It seems important that self-efficacy of school nurses be studied to explore which factors may influence their confidence level as it pertains to diabetes management. The purpose of this study was to measure school nurses' perceived self-efficacy in providing diabetes care and education to children and to identify factors that correlate with higher self-efficacy levels in the performance of these skills.

It is estimated that diabetes affects 1 in 400-500 children and adolescents in the United States. The number of children and adolescents diagnosed with diabetes has increased due to obesity, sedentary lifestyles, and poor eating habits (Gance-Cleveland & Bushmaier, 2005; Magnusson, 2005; Schreiner, ...