Assigment .Apa seven . All instructions attached.

1

Enhancing Diabetes Care Outcomes

Andresa Carvalho

Florida National University

MSN Capstone Project-DBX-DL01

Dr. Carmen Lazo

July 7, 2024

2

The issue under consideration in this capstone project concerns improving the patients’

conditions of adult patients with Type 2 diabetes with the help of structured diet and exercise

program while receiving oral ant hyperglycemic drugs. Diabetes mellitus type 2 is a common

chronic disease in which increased insulin production is observed; it is associated with lifestyle

factors including, but not limited to, diet and exercise. Based on data presented by the Centers

for Disease Control and Prevention – CDC, about 34. It is crucial to understand that 2 million

Americans have diabetes, and more than 90% of these people have type 2 diabetes. This long-

term disease affects personal health, and since its causes complications in the form of

cardiovascular disease, neuropathy, and renal failure, it puts a strain on healthcare systems.

Purpose Statement

The aim of this project is to determine the extent to which following a planned diet and

exercise regime tailored by Kurt Lewin’s Change Theory impacts on the satisfaction of patient

with Type 2 diabetes at an 8 weeks’ period (Roşca, 2020). The anticipated effect of this

intervention is to provide a more suitable type of glycemic control by implementing valuable and

lasting changes in food and exercise. Benefits that are expected to be experienced from improved

glycemic control is reduced demand of medications and less chances of diseases such as

cardiovascular diseases and neuropathies related to diabetes. In that sense, by increasing

satisfaction among the patients regarding their health status as well as by providing them with

the necessary coaching and support in this particular issue, this project aims at ensuring better

patient experience and consequently better health outcomes and quality of life.

PICOT Question

3

In adult patients with type 2 diabetes (P), the extent to which patient satisfaction (O)

differs between a structured diet and exercise program (I) and standard care with oral

hypoglycemic agents (C) over 8 weeks (T) can be determined.

Description of the Vulnerable Population

The patient’s condition is severe because adult non-insulin-dependent diabetes mellitus

patients are at significantly higher risk of developing severe complications such as

cardiovascular disease, stroke, and diabetic nephropathy. These people experience major barriers

which are rooted in social factors such as poverty, access to medical resources, and literacy level

as these are the critical success factors that affect the day-to-day management of the condition.

Lack of exercise, excessive calorie consumption, and poor eating habits are some of the many

risk factors that contribute to the worsen of the diabetes situation. Lack of adequate health care

also aggravates these difficulties, which leads to the development of complicated diseases and

difficulties in their early diagnosis and cure. Because these barriers are complex, it is crucial to

implement the necessary changes to address issues related to patients with type 2 diabetes, as

well as ensure accurate and effective interaction with medical personnel that takes into account

medical and social factors that directly affect the patient’s quality of life.

Research from Scholarly Journals

Scholarly articles from peer-reviewed journals based on the findings details the behavior-

change techniques that focused on the prevention and management of type 2 diabetes and in

which the diet and physical activity are the main ones. Multiple research works show that

organized interventions including dietary modification, such as the Mediterranean or low

glycemic index diet and exercise (aerobic or resistance training etc.) are effective in enhancing

4

glycemic control, reducing the reliance on medication and improving the life quality of patients

with T2DM (Sánchez-Sánchez et al., 2020).

Proposal for Intervention

The suggested intervention plan entails the adoption and practice of a standard diet and

exercise regime for the targeted patients with type 2 diabetes within a health care facility. This

intervention will be guided by Kurt Lewin's Change Theory, which comprises three stages: More

specifically, the processes of management change are distinguished as implemented through

three stages: unfreezing, change, and refreezing.

Unfreezing Stage:

Identify and analyses current pattern of practicing type 2 diabetes in the context of a

healthcare organization (Powers et al., 2020). Recognize challenges that hinder optimal glycemic

control including; lack of patient’s knowledge regarding the disease, scarcity of nutritional

counseling and evaluation services, and poor encouragement of physical activity.

Changing Stage:

Adherence to the prescribed nutrition plan and physical training plan following expert’s

directions and recommendations. This stage entails providing information about the advantages

of changing the diet, recommending a nutritionist to patients, and exercising through exercise

sessions and activating the patient’s membership in the community exercise program.

Refreezing Stage:

Determine the impact of the intervention regarding patient satisfaction to the services

provided, patients’ glycemic control (by virtue of HbA1c levels), and patients’ compliance to

prescribed treatment regimens (Hirsch et al., 2021). Strengthen procedures regarding

5

implementation of the systematically organized plan for practice improvement in daily work-

setting, maintaining a positive trend of diabetes care and patients’ outcomes.

Theoretical Framework: Kurt Lewin's Change Theory

The use of Kurt Lewin’s Change Theory can afford a framework for meeting and

enhancing change in healthcare facilities (Memon, 2021). The theory focuses more on how the

organization needs to be prepared for change (unfreezing), the change process (change) and

embedding of new change (refreezing). Utilizing this framework, health-care providers can

utilize introductions and sustained usage of lifestyle changes into the lives of patients with type 2

diabetes and subsequently, improve the quality of care and promote patient satisfaction.

To conclude, supporting patients with structured diet and exercise program in the

management of type 2 diabetes can be a viable strategy to improve patient satisfaction and health

status. Kurt Lewin’s Change theory is helpful in addressing the challenges of change since it

helps the healthcare providers to understand the nature of change, approach towards the teams

and successfully manage and practice evidenced based interventional changes within the period

of time in the clinic. The purpose of this project is to make impact to the existing studies and

practices to enhance the Danish type 2 diabetes population care as well as improve their quality

of life.

6

References

Hirsch, J. D., Kong, N., Nguyen, K. T., Cadiz, C. L., Zhou, C., Bajorek, S. A., Bounthavong, M.,

& Morello, C. M. (2021). Improved Patient-Reported Medication Adherence, Patient

Satisfaction, and Glycemic Control in a Collaborative Care Pharmacist-Led Diabetes

“Tune-Up” Clinic. International Journal of Environmental Research and Public Health,

18(17), 9242. https://doi.org/10.3390/ijerph18179242

Memon, F. A. (2021). IMPROVING EMPLOYEE’S ENGAGEMENT IN CHANGE:

REASSESSING KURT LEWIN’S MODEL. CITY UNIVERSITY RESEARCH

JOURNAL, 11(1). http://www.cusitjournals.com/index.php/CURJ/article/view/282

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks,

B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M.,

& Uelmen, S. (2020). Diabetes Self-Management Education and Support in Adults with

Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the

Association of Diabetes Care & Education Specialists, the Academy of Nutrition and

Dietetics, the American Academy of Family Physicians, the American Academy of PAs,

the American Association of Nurse Practitioners, and the American Pharmacists

Association. Journal of the American Pharmacists Association, 60(6), 1–18.

https://doi.org/10.1016/j.japh.2020.04.018

Roşca, V. I. (2020). Implications of Lewin’s Field Theory on Social Change. Proceedings of the

International Conference on Business Excellence, 14(1), 617–625.

Sánchez-Sánchez, M. L., García-Vigara, A., Hidalgo-Mora, J. J., García-Pérez, M.-Á., Tarín, J.,

& Cano, A. (2020). Mediterranean diet and health: a systematic review of

7

epidemiological studies and intervention trials. Maturitas, 136.

https://doi.org/10.1016/j.maturitas.2020.03.008

1

Enhancing Diabetes Care Outcomes

Andresa Carvalho

Florida National University

MSN Capstone Project-DBX-DL01

Dr. Carmen Lazo

July 7, 2024

2

The issue under consideration in this capstone project concerns improving the patients’

conditions of adult patients with Type 2 diabetes with the help of structured diet and exercise

program while receiving oral ant hyperglycemic drugs. Diabetes mellitus type 2 is a common

chronic disease in which increased insulin production is observed; it is associated with lifestyle

factors including, but not limited to, diet and exercise. Based on data presented by the Centers

for Disease Control and Prevention – CDC, about 34. It is crucial to understand that 2 million

Americans have diabetes, and more than 90% of these people have type 2 diabetes. This long-

term disease affects personal health, and since its causes complications in the form of

cardiovascular disease, neuropathy, and renal failure, it puts a strain on healthcare systems.

Purpose Statement

The aim of this project is to determine the extent to which following a planned diet and

exercise regime tailored by Kurt Lewin’s Change Theory impacts on the satisfaction of patient

with Type 2 diabetes at an 8 weeks’ period (Roşca, 2020). The anticipated effect of this

intervention is to provide a more suitable type of glycemic control by implementing valuable and

lasting changes in food and exercise. Benefits that are expected to be experienced from improved

glycemic control is reduced demand of medications and less chances of diseases such as

cardiovascular diseases and neuropathies related to diabetes. In that sense, by increasing

satisfaction among the patients regarding their health status as well as by providing them with

the necessary coaching and support in this particular issue, this project aims at ensuring better

patient experience and consequently better health outcomes and quality of life.

PICOT Question

3

In adult patients with type 2 diabetes (P), the extent to which patient satisfaction (O)

differs between a structured diet and exercise program (I) and standard care with oral

hypoglycemic agents (C) over 8 weeks (T) can be determined.

Description of the Vulnerable Population

The patient’s condition is severe because adult non-insulin-dependent diabetes mellitus

patients are at significantly higher risk of developing severe complications such as

cardiovascular disease, stroke, and diabetic nephropathy. These people experience major barriers

which are rooted in social factors such as poverty, access to medical resources, and literacy level

as these are the critical success factors that affect the day-to-day management of the condition.

Lack of exercise, excessive calorie consumption, and poor eating habits are some of the many

risk factors that contribute to the worsen of the diabetes situation. Lack of adequate health care

also aggravates these difficulties, which leads to the development of complicated diseases and

difficulties in their early diagnosis and cure. Because these barriers are complex, it is crucial to

implement the necessary changes to address issues related to patients with type 2 diabetes, as

well as ensure accurate and effective interaction with medical personnel that takes into account

medical and social factors that directly affect the patient’s quality of life.

Research from Scholarly Journals

Scholarly articles from peer-reviewed journals based on the findings details the behavior-

change techniques that focused on the prevention and management of type 2 diabetes and in

which the diet and physical activity are the main ones. Multiple research works show that

organized interventions including dietary modification, such as the Mediterranean or low

glycemic index diet and exercise (aerobic or resistance training etc.) are effective in enhancing

4

glycemic control, reducing the reliance on medication and improving the life quality of patients

with T2DM (Sánchez-Sánchez et al., 2020).

Proposal for Intervention

The suggested intervention plan entails the adoption and practice of a standard diet and

exercise regime for the targeted patients with type 2 diabetes within a health care facility. This

intervention will be guided by Kurt Lewin's Change Theory, which comprises three stages: More

specifically, the processes of management change are distinguished as implemented through

three stages: unfreezing, change, and refreezing.

Unfreezing Stage:

Identify and analyses current pattern of practicing type 2 diabetes in the context of a

healthcare organization (Powers et al., 2020). Recognize challenges that hinder optimal glycemic

control including; lack of patient’s knowledge regarding the disease, scarcity of nutritional

counseling and evaluation services, and poor encouragement of physical activity.

Changing Stage:

Adherence to the prescribed nutrition plan and physical training plan following expert’s

directions and recommendations. This stage entails providing information about the advantages

of changing the diet, recommending a nutritionist to patients, and exercising through exercise

sessions and activating the patient’s membership in the community exercise program.

Refreezing Stage:

Determine the impact of the intervention regarding patient satisfaction to the services

provided, patients’ glycemic control (by virtue of HbA1c levels), and patients’ compliance to

prescribed treatment regimens (Hirsch et al., 2021). Strengthen procedures regarding

5

implementation of the systematically organized plan for practice improvement in daily work-

setting, maintaining a positive trend of diabetes care and patients’ outcomes.

Theoretical Framework: Kurt Lewin's Change Theory

The use of Kurt Lewin’s Change Theory can afford a framework for meeting and

enhancing change in healthcare facilities (Memon, 2021). The theory focuses more on how the

organization needs to be prepared for change (unfreezing), the change process (change) and

embedding of new change (refreezing). Utilizing this framework, health-care providers can

utilize introductions and sustained usage of lifestyle changes into the lives of patients with type 2

diabetes and subsequently, improve the quality of care and promote patient satisfaction.

To conclude, supporting patients with structured diet and exercise program in the

management of type 2 diabetes can be a viable strategy to improve patient satisfaction and health

status. Kurt Lewin’s Change theory is helpful in addressing the challenges of change since it

helps the healthcare providers to understand the nature of change, approach towards the teams

and successfully manage and practice evidenced based interventional changes within the period

of time in the clinic. The purpose of this project is to make impact to the existing studies and

practices to enhance the Danish type 2 diabetes population care as well as improve their quality

of life.

6

References

Hirsch, J. D., Kong, N., Nguyen, K. T., Cadiz, C. L., Zhou, C., Bajorek, S. A., Bounthavong, M.,

& Morello, C. M. (2021). Improved Patient-Reported Medication Adherence, Patient

Satisfaction, and Glycemic Control in a Collaborative Care Pharmacist-Led Diabetes

“Tune-Up” Clinic. International Journal of Environmental Research and Public Health,

18(17), 9242. https://doi.org/10.3390/ijerph18179242

Memon, F. A. (2021). IMPROVING EMPLOYEE’S ENGAGEMENT IN CHANGE:

REASSESSING KURT LEWIN’S MODEL. CITY UNIVERSITY RESEARCH

JOURNAL, 11(1). http://www.cusitjournals.com/index.php/CURJ/article/view/282

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks,

B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M.,

& Uelmen, S. (2020). Diabetes Self-Management Education and Support in Adults with

Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the

Association of Diabetes Care & Education Specialists, the Academy of Nutrition and

Dietetics, the American Academy of Family Physicians, the American Academy of PAs,

the American Association of Nurse Practitioners, and the American Pharmacists

Association. Journal of the American Pharmacists Association, 60(6), 1–18.

https://doi.org/10.1016/j.japh.2020.04.018

Roşca, V. I. (2020). Implications of Lewin’s Field Theory on Social Change. Proceedings of the

International Conference on Business Excellence, 14(1), 617–625.

Sánchez-Sánchez, M. L., García-Vigara, A., Hidalgo-Mora, J. J., García-Pérez, M.-Á., Tarín, J.,

& Cano, A. (2020). Mediterranean diet and health: a systematic review of

7

epidemiological studies and intervention trials. Maturitas, 136.

https://doi.org/10.1016/j.maturitas.2020.03.008