Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

Recent analysis estimates Type II diabetes affects 23.4 million people in the US. Approximately 30% of these patients are not in optimal control of their diabetes, raising risks for blindness, amputation, and cardiac disease. A gap in diabetes education practice is that traditional positive-framed messaging has not persuaded many patients to modify their self-management behaviors. There is a need for alternative ways to communicate the risks of not managing the disease to patients who may have different health beliefs. The purpose of this systematic review was to examine the best available evidence regarding the efficacy of loss-frame messaging when used by healthcare educators in changing health behavior. The guiding practice-focused question identified evidence from the literature showing how loss-frame messaging can improve the Hemoglobin A1C level in patients with diabetes type II. The goal was to help providers determine the type of messages that will best assist their patients in achieving good glycemic control. A systematic review of the literature utilizing the Johns Hopkins nursing evidence-based practice model yielded less than 20 articles specifically comparing gain and loss frame messaging for patients with chronic disease. A majority reported higher rates of behavioral change with positive-framed messaging. Only one had higher rates with negative-framed messaging. The lack of evidence points to the need for further research to investigate use of loss-framed messages in patient education for the patient population with type II diabetes. Further study is needed to promote positive social change in patients with type II diabetes

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