Date of Graduation

5-2015

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor

Kirkland, Tracie

Reader

Narcisse, Marie-Rachelle

Second Reader

Smith-Blair, Nan

Abstract

Background In the United States, 29.1 million people, or 9.3% of the population have diabetes mellitus (CDC, 2014). The total cost of diabetes in the United States has been estimated at $245 billion, which included the direct medical costs as well as the reduced productivity (CDC, 2014). Diabetes greatly increases the risk of other chronic illnesses such as coronary heart disease, myocardial infarction (MI), retinopathy, nephropathy and stroke. These chronic conditions may cause serious harm or even death. Objectives The objectives of this study are to determine the prevalence of chronic health diseases among diabetic adults in the United States, and describe the demographic characteristics as well as the health, lifestyle, satisfaction with life and care received as well as the utilization of care by diabetic adults with chronic diseases. Methods This study is based on a secondary data analysis based on data from the Behavioral Risk Factor Surveillance System (BRFSS, 2013). We performed descriptive statistics to describe the diabetic population. We conducted multinomial logistic regression analysis to examine the effects of the main predictors of stroke, heart attack, coronary heart disease, nephropathy, and retinopathy on health status. We further conducted negative binomial regression analysis to investigate the independent effects of stroke, heart attack, coronary heart disease, nephropathy, and retinopathy on the number of days during which diabetics reported their physical and mental health as being not good in the past month, as well as the number of visits to the doctor in the past 12 months. Results In the U.S., 25,234,904 adults stated they had been diagnosed with diabetes by a healthcare professional Four out of ten adults with diabetes were 65 years and older, and close to three out of ten of them were between the ages of 55-64 years. Close to six out of ten adults with diabetes was Non-Hispanic white. Over half of people with diabetes were also obese as compared to a quarter of those without diabetes. Close to two out of ten diabetic adults reported having a visual impairment secondary to diabetes; 14% reported having suffered a heart attack or a coronary heart disease, and 9% reported having been diagnosed with stroke or nephropathy. Over the past month, diabetic adults with either of the chronic diseases reported poor good physical health for an average of 18 days, and poor mental health for an average of 15 days. Although 14% of people with diabetes reported their health as being very good, only 9% for diabetics with retinopathy, 8% of diabetics who had sustained a stroke or a heart attack, 6% and 5% of those who have been diagnosed with a coronary heart disease or a nephropathy, respectively reported the same. A higher proportion of adults without diabetes than with diabetes reported being very satisfied with life (47% vs. 37%), and 65% were very satisfied with the care they received. Multinomial logistic and regressions further revealed that stroke, heart attack, coronary heart disease, nephropathy, and retinopathy have a deleterious effect on the health status of diabetics, and increase the number of days spent in poor physical and mental health. Conclusions The results of this study indicate that diabetes has a great impact on the quality of life of these individuals, and has the potential to cause multiple chronic illnesses if it goes untreated. It also greatly impacts the mental and physical health status of each person in a negative way. With U.S. healthcare in disarray, lack of access to care for diabetic patients is extremely relevant to the results in this study. Healthcare professionals, especially nurses, play a key role in the prevention and management of diabetes through education. This in addition to the use of interdisciplinary teams will allow diabetic patients a more wholesome healthcare experience that provides all necessary information and treatment needed.

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