The Knowledge and Practices of Registered Nurse,Certified Diabetes Educators: Teaching Elderly Clients About Exercise

Abstract

This study identified the knowledge base and practices of Registered Nurse,. Certified Diabetes Educators (RN, CDEs) regarding their exercise teaching programs for elderly clients who have non-insulin-dependent diabetes mellitus (NIDDM). The random sample of 197 AADE members surveyed by questionnaire was a highly educated and experienced group. RN, CDEs who worked 30 or more hours per week in diabetes education or attended four or more continuing education (CE) programs per year had significantly more comprehensive exercise teaching program designs and instructional techniques to enhance elderly NIDDM clients' learning (P<.05). However; many CDEs do not teach their elderly clients about exercise due to lack of resources, lack of specific knowledge to prescribe exercise, and negative stereotypes of elderly clients' ability to exercise. Greater availability of educational programs for CDEs to explore curriculum development, program planning, evaluation, and exercise prescription for elderly clients with multisystem disease is recommended.

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References

Rifkin H. Physician's guide to non-insulin-dependent (type 2) diabetes: diagnosis and treatment. 2nd ed. Alexandria, Va: American Diabetes Association, 1988.

Graham C. Exercise and aging: implications for persons with diabetes. Diabetes Educ 1991;17:189-95.

Minaker K. What diabetologists should know about elderly patients. Diabetes Care 1990;13:34-46.

Graham C. , Lasko-McCarthey P. Exercise options for persons with diabetic complications. Diabetes Educ 1990;16:212-20.

Bogardus C. , Ravussin E. , Robbins D. , Wolfe R. , Horton E. Sims E. Effects of physical training and diet therapy on carbohydrate metabolism in patients with glucose intolerance and non-insulin-dependent diabetes mellitus . Diabetes 1984;33:311-18.

Reitman J. Vasquez B. , Klimes I. , Nagulesparan M. Improvement of glucose homeostasis after exercise training in non-insulin-dependent diabetes. Diabetes Care 1984;7:434-41.

Trovati M. , Carta Q. , Cavalot F. , et al. Influence of physical training on blood glucose control, glucose tolerance, insulin secretion, insulin action in non-insulin-dependent diabetic patients. Diabetes Care 1984;7:416-20.

Romanowsky S. , Liesen H. , Cuppers H. , Hollmann W. Metabolic effects of endurance and strength exercise training programs in normal weight type-2 (NIDDM). Int J Sports Med 1984;5:280.

Holloszy J. , Schultz J. Kusnierkiewicz J. , Hagberg J. , Ehsani A. Effects of exercise on glucose tolerance and insulin resistance. In: Astrand P, Grimby G, eds. Physical activity in health and disease. Acta Med Scand 1986;(suppl 711):55-65.

10.

Skarfors E. , Wegner T. , Lithell H. , Selinus I. Physical training as treatment for type 2 (non-insulin-dependent) diabetes in elderly men: a feasibility study over two years. Diabetologia 1987;30:930-33.

11.

Seals D. Hagberg J. Allen W. , et al. Glucose tolerance in young and older athletes and sedentary men. J Appl Physiol 1984;56:1521-25.

12.

Hollenbeck C. , Haskell W. , Rosenthal M. , Reaven G. Effect of habitual physical activity on regulation of insulin-stimulated glucose disposal in older males. J Am Geriatr Soc 1985;33:273-77.

13.

Kahn S. , Bradbury V. , Beard J. , et al. Exercise training in the elderly improves insulin action and appropriately modifies insulin secretion. Clin Res 1989;37:149A .

14.

Reaven P. , McPhillips J. Barrett-Connor E. , Wingard D. , La Jolla C. Insulin resistance and aging men: a possible role for sedentary behavior . Diabetes 1990;39:149.

15.

Schwartz R. Exercise training in treatment of diabetes mellitus in elderly patients. Diabetes Care 1990;13:77-85.

16.

Horton E. , Delvin J. Exercise and non-insulin-dependent diabetes mellitus. In: Alberti K , Mazze R , eds. Current trends in non-insulin-dependent diabetes mellitus. Amsterdam: Excerpta medica, 1989 :271-84.

17.

Shephard R. The scientific basis of exercise prescribing for the very old. J Am Geriatr Soc 1990;38:62-70.

18.

Fiatarone M. , Marks E. , Ryan N. , Meredith C. Lipsitz L. , Evans W. High-intensity strength training in nonagenarians . JAMA 1990;263: 3029-34.

19.

Schwartz R. , Bradbury V. , Beard J. , Stratton J. , Abrass I. Intensive exercise training in the elderly improves lipoprotein profiles. Clin Res 1989 ;37:90A .

20.

Teza S. , Davis W. , Hiss R. Patient knowledge compared with national guidelines for diabetes care. Diabetes Educ 1988; 14:207-11.

21.

Gilden J. Hendryx M. , Casia C. , Singh S. The effectiveness of diabetes education programs for older patients and their spouses. J Am Geriatr Soc 1989;37:1023-30.

22.

Anderson R. Principles of teaching and learning. In: Guthrie D , Hinnen D , Deshelter E , eds. Diabetes education: a core curriculum for health professionals. Chicago: American Association of Diabetes Educators, 1988:311-27.

23.

Woods N. , Catanzaro M. Nursing research: theory and practice. St. Louis : CV Mosby Co, 1988:385-418.