Date of Degree


Document Type


Degree Name

Master of Science in Nursing (MSN)




Sandra Strickland


Dianna Tison


Kathleen Light


There are 1.2 million diagnosed diabetics in Texas, 10 % of whom live in Bexar County, Texas. Diabetes is rated as the fifth leading cause of death in the same county. In addition to the diagnosed cases, it is estimated that 125,000 adults in Bexar County have undiagnosed diabetes (Foy, 1999). Diabetic education may prevent complications in some individuals, but sometimes knowledge alone is not enough. Patients often lack motivation or self-confidence in their capacity for self- management of their diabetes. Diabetic educators are often faced with the challenge of not only educating but also motivating patients to be compliant with their self-care. Previous research has documented that the relationship between knowledge and compliance vary greatly (Hurley & Shea, 1992). Hurley and Shea (1992) report that knowledge alone is not a predictor of one's capacity to incorporate the necessary self-care behaviors into one's everyday lifestyle. Patients have reported that despite knowledge, sometimes the capacity to carry out a self-care program is even more stressful than the disease of diabetes itself. The diabetic individual's life revolves around a daily regimen of precise monitoring of blood sugars and calculation of insulin doses. Meals, exercise, rest, and general activities must be planned and calculated to match those times when insulin levels are expected to drop or peak. Diabetic educators should encourage patients to assume the responsibility for their own care as much as possible. Patients should be helped to develop strategies for their own long-term diabetic care (Hurley & Shea, 1992).