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People with diabetes frequently have elevated diabetes distress. Although mindfulness‐based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This study was aimed to pilot evaluate the feasibility of a nurse‐led MBSR therapy and explore its potential efficacy amongst people with type 2 diabetes mellitus. A total of 100 participants were randomly allocated either to the intervention group (nurse‐led MBSR therapy + regular diabetes education) or the control group (regular diabetes education). Data on diabetes distress, diabetes self‐efficacy, and diabetes self‐management were collected at baseline, 8 and 12 weeks. Hemoglobin A1c (HbA1c) was collected at baseline and 12 weeks. A generalized estimating equation analysis for repeated measures was used to determine intervention and time effects. As predicted, the nurse‐led MBSR therapy had a significant time‐by‐group interaction effect on diabetes distress total score (95% confidence interval [CI]: 0.58–0.77, p < 0.001), diabetes self‐efficacy (95% CI: −0.93 to −0.74, p < 0.001), diabetes self‐management (95% CI: −10.80 to −7.83, p < 0.001), and HbA1c levels (95% CI: 0.04–1.14, p = 0.03) in the intervention group compared with the control group over 12 weeks. This is the first nurse‐led MBSR therapy in a hospital setting that is feasible and has the potential to improve health outcomes. This approach may offer an innovative model to deliver MBSR therapy. A randomized controlled trial comparing the nurse‐led MBSR plus usual diabetes education with usual diabetes education along with a mechanism to equalize intervention attention between the groups is indicated. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and psychometrically test a new instrument for measuring self-management of adults with type 2 diabetes. Data were collected from 634 diabetic adults recruited from three teaching hospitals in Taiwan. Construct validity was determined by confirmatory factor analysis (CFA). Tests of internal consistency and test–retest were used to assess the reliability of the diabetes self-management instrument (DSMI). Initial results of CFA did not fully support the proposed five-factor model. After the model was modified, the fit indices indicated that this model fits the data best. This model was further cross validated in a second sample. Cronbach's alpha coefficient of the DSMI total scale was .94. The test–retest correlations for the DSMI total scale were acceptable (r = .73, p < .01). © 2008 Wiley Periodicals, Inc. Res Nurs Health 31:370–380, 2008 [ABSTRACT FROM AUTHOR]

Meta-analyses synthesize multiple primary studies and identify patterns of relationships. Differences in primary study methodological quality must be addressed for meta-analysis to produce meaningful results. No single standard exists for addressing these quality variations. Quality measurement scales are fraught with development and application problems. Several strategies have been proposed to address quality. Researchers can set minimum levels for inclusion or require that certain quality attributes be present. An inclusive method is to weight effect sizes by quality scores. This allows the inclusion of diverse studies but relies on questionable quality measures. By considering quality an empirical question, meta-analysts can examine associations between quality and effect sizes and thus preserve the purpose of meta-analysis to systematically examine data. Researchers increasingly are combining strategies to overcome the limitations of using a single approach. Future work to develop valid measures of primary study quality dimensions will improve the ability of meta-analysis to inform research and nursing practice. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:322–333, 2003 [ABSTRACT FROM AUTHOR]