Managing uncertainty in diabetes: an intervention for older African American women

Objectives: One out of four older African American women (OAAW) may develop diabetes. The disproportionate number of complications suffered by OAAW with diabetes may be due in part to uncertainty about how to manage diabetes and prevent or manage complications. The purpose of this study was to test the efficacy of an individualized psycho-educational diabetes uncertainty management intervention (DM-UMI) directed at managing diabetes-related uncertainties and delivered by a nurse via telephone to OAAW. Methods: Sixty-eight participants with diabetes were randomly assigned to an experimental or a control group. Participants in the experimental group received the DM-UMI which was delivered for four weeks. The DM-UMI was composed of four strategies (intervention variables): improving diabetes knowledge, patient-provider communication, problem-solving and cognitive reframing, which were expected to reduce diabetes-related uncertainty (outcome variable). The control group received their usual care. Measurement occurred at two time points for all participants: at Time 1: baseline and at Time 2: 6 weeks post baseline. Results: Despite improvement in all intervention variables only problem-solving (P <.001) was significantly related to decrease in uncertainty (P=.01). Conclusion: The study suggests that teaching problem-solving skills and assisting OAAW to apply these skills, via an individualized telephone intervention, may reduce ambiguities about diabetes care.