Mobile App for Improved Self-Management of Type 2 Diabetes

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Introduction: The BlueStar Mobile App

The intervention tool used in the study is a mobile app called BlueStar, designed for self-management of Type 2 diabetes (T2DM). It is created to act like the patient’s virtual coach by collecting information such as daily glucose readings, baseline health data, exercise records, and food intake (Agarwal et al., 2019). Once a patient enters this data, the app uses it to generate affirmatory or educational content delivered as messages. At the same time, it transmits the information to a health professional who can take further action as needed.

Patient Population

The population involved in the study included adults who are 18 years and above with T2DM. At recruitment, they must have been participating in selected DEPs (Agarwal et al., 2019). All participants must have had the ability to use email through their phones or computers. However, patients with type 1 diabetes, pregnant, under ongoing glucose monitoring, using insulin pumps, on dialysis, and those who cannot use a phone or computer were excluded from the study.

Main Idea of the Study

The central focus of the study was to assess the effectiveness of the BlueStar app in controlling glucose levels among the participants. However, the researchers also measured improvement in self-management, health utilization, and the patient’s experience with care (Agarwal et al., 2019). The study also recorded and evaluated the participant’s utilization of the BlueStar app.

Research Findings

The researchers reported low usage of the mobile app among participants. Even when the app was logged in, there was poor utilization of its features. Therefore, there was no significant difference between the control and experimental groups in glucose control (Agarwal et al., 2019). However, a few of the participants actively used their apps and all the features, reporting an improvement of 0.4% in glycemic control after the first 25 days (Agarwal et al., 2019). The researchers reported several contextual factors that influenced app usage, including clinician and patient training before participation and installing the app on a second phone.

Integrating the Mobile App in Nursing

Mobile applications are revolutionizing self-care and management for chronic illnesses. Agarwal et al. (2019) established that trained patients reported high rates of logging in and utilization of the app features, which led to lower HbA1c levels. Therefore, nurses would require training and, in turn, train all new app users properly. Agarwal et al. (2019) also found that newly diagnosed patients had high app utilization rate than those who have been in management for over six months. Hence, nurses must ensure that every newly diagnosed T2DM patient is immediately trained and signed up for mobile app usage. With the burgeoning patient population and increasing staff shortage, supporting NDS with mobile apps would release nurses to attend to more critically ill patients (Jiang et al., 2022). Besides, Jiang et al. (2022) reported that there is no difference in health indicators between patients on NDS and those using mobile apps. Therefore, nurses can effectively use mobile apps to support T2DM self-management.

Cultural Aspect of Diabetes

Although diabetes affects every human race, it is more prevalent among minority groups in the US. According to Cervoni (2021), Blacks, American Indians, Hispanics, and Asian Americans report the highest rates. The data shows that Alaskan Natives or American Indians are leading with a 14.7% prevalence, followed by Hispanics with 12.5%, non-Hispanic Blacks with 11.7%, Asian Americans with 9.2%, and non-Hispanic Whites with 7.5% (Cervoni, 2021). Since diabetes education is central to efficacy in self-management, nurses must learn to incorporate cultural knowledge into the exercise and content (Ung, 2017). In addition, cultural sensitivity and awareness should be demonstrated during interactions with patients.

Offering Cultural Support

To offer cultural support to diabetes patients requires the nurse to learn the various cultural backgrounds of the patients. The interaction should begin with the establishment of a good rapport to create the trust that will enable the nurse to get as much information as possible from the patient (Ung, 2017). Important cultural factors in diabetes management include food, eating habits, medication beliefs, and alternative medicines (Cervoni, 2021). Nurses must understand how each culture perceives food and their eating beliefs. Most especially, nurses should ensure that patients know carbohydrate sources in their traditional cuisines, as it is the most important macronutrient in diabetes management (Cervoni, 2021). Culture also dictates and influences family input into the patients eating and self-care routine.

Psychological Aspect of Diabetes

Psychological factors in diabetes management focus on the patient’s emotions and motivations toward the healthcare system and their illness. Ung (2017) listed specific factors relevant to diabetes patients as self-efficacy, perceived social support, and depression systems. These aspects will influence a patient’s adherence to treatment and dietary plans.

Providing Psychological Support

Psychological support is crucial in ensuring patients adhere to treatment and diet plans. A psychological assessment will reveal the reasons why a patient is non-adherent. Diabetes self-management education (DSME) should be used to overcome psychological barriers to achieving optimum outcomes (Ung, 2017). When such education is availed, it should focus on establishing behavioral goals with the patient, continuously supporting them, using psychosocial strategies in treatment plans, and utilizing age-appropriate programs (Ung, 2017). Therefore, DSME is a critical component of dealing with cultural, psychological, and spiritual aspects of diabetes management.

Spiritual Aspect of Diabetes

Religious beliefs and spirituality are universal themes for human beings. According to Onyishi et al. (2021), spirituality is positively linked to diabetes management as it creates a generally positive attitude toward life. Religious practices also influence individual adaptations positively, wile rituals conducted at places of worship decrease stress levels (Onyishi et al., 2021). Gatherings at worship places also offer social and mental support to patients because of the positivity in the atmosphere and general kindness from members. There are faith-based interventions (FBIs) that nurses can use to support T2DM, depending on their religion and spiritual beliefs.

Faith-Based Interventions

Nurses can pursue various FBIs depending on the patient’s openness and religion. Practical and effective techniques include rituals, meditation, sacred and journal writings, focusing, and voluntary fasting (Onyishi et al., 2021). Each of these methods may be more acceptable to one religion than to the other. However, each religion has one or more techniques as practice in their groups. For example, Christian patients would accept prayers, voluntary fasting, and meditation. Overall, most mainstream religions will be allowable to all of these methods. Nevertheless, nurses must be sensitive to religious beliefs that interfere with treatment plans.

Conclusion

The study evaluated was conducted to test the effectiveness of using a mobile app for T2DM management. It showed that only active use of such devices would yield positive results. Training and education are necessary before signing up patients to encourage a high utilization rate. Nurses can use mobile apps to reduce their workload and effectively manage their T2DM patients. Since cultural and psychological factors influence diabetes management, nurses must learn how to be sensitive and utilize these factors in their favor. Spirituality and religious practices produce outcomes that enhance diabetes management. Nurses can rely on FBIs, such as prayers and fasting, to improve patients’ outcomes.

References

Agarwal, P., Mukerji, G., Desveaux, L., Ivers, N. M., Bhattacharyya, O., Hensel, J. M., Shaw, J., Bouck, Z., Jamieson, T., Onabajo, N., Cooper, M., Marani, H., Jeffs, L., & Bhatia, R. S. (2019). Mobile app for improved self-management of type 2 diabetes: Multicenter pragmatic randomized controlled trial. JMIR Mhealth and Uhealth, 7(1), 1-13. Web.

Cervoni, B. (2021). Cultural considerations in diabetes management. Very Well Health. Web.

Jiang, Y., Ramachandran, H. J., Teo, J. Y. C., Leong, F. L., Lim, S. T., Nguyen, H. D., & Wang, W. (2022). Effectiveness of a nurse‐led smartphone‐based self‐management programme for people with poorly controlled type 2 diabetes: A randomized controlled trial.Journal of Advanced Nursing, 78(4), 1154-1165. Web.

Onyishi, C. N., Ilechukwu, L. C., Victor-Aigbodion, V., & Eseadi, C. (2021). Impact of spiritual beliefs and faith-based interventions on diabetes management.World Journal of Diabetes, 12(5), 630. Web.

Ung, S. K. (2017). Role of cultural and psychological factors influencing diabetes treatment adherence. Loma Linda University.

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