| The holistic model for diabetes education represents a shift from the narrow, medical perspective to a broad wellness approach within the mind, body, and spirit realm. In a holistic sense, diabetes management is presented as an integration of medical and complementary therapies. This healing process supports people with diabetes in personal decision-making toward goals that target a balance in wellness and diabetes management efforts. Twenty-two study group participants with type 2 diabetes, mean age of 58.7 years, completed a comprehensive holistic diabetes education program with a 6-month follow-up period.;The present diabetes education program was evaluated using a blend of quantitative and qualitative methods to provide an in-depth analysis of process and outcome results. Study group participants improved significantly in metabolic control (p .002) with mean HbA1c levels of 8.443 (baseline) to 7.457 (6-month follow-up). Using a repeated measures ANOVA, within subjects design, diabetes-related knowledge, health-related quality of life, and problem areas in diabetes were analyzed for change at three time periods---baseline, immediate postprogram, and 6-month follow-up. Results indicated a significant improvement in knowledge (p <. 005) and no significant increase in health-related quality of life or reduction in problem areas in diabetes, a measure of diabetes-related distress. Using a general behavior change assessment, the behavior change process was evaluated as a qualitative measure, based on self-reports of progression with personal behaviors. Participants were actively involved in behaviors that typically focused on nutrition, exercise, or stress management.;The combined quantitative and qualitative process evaluation revealed program strengths in the areas of education and social support. This suggests that the educational component strongly influenced knowledge improvement and that social support may have positively contributed to lower HbA1c levels---directly through physiological pathways or indirectly as a catalyst for behavior change.;To provide greater understanding of effective diabetes program development, it is recommended that evaluation efforts combine quantitative and qualitative methods within a process-outcome design. The holistic model for diabetes education, evaluated in the present study, is offered as an integrative approach to support people with diabetes in the healing process. |
