Off-campus WSU users: To download campus access dissertations, please use the following link to log into our proxy server with your WSU access ID and password, then click the "Off-campus Download" button below.

Non-WSU users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Access Type

WSU Access

Date of Award

January 2018

Degree Type


Degree Name




First Advisor

Wanda Gibson-Scipio

Second Advisor

Feleta Wilson


Diabetes mellitus continues to be one of the most commonly diagnosed medical conditions in the United States. More than 25 million children and adults are living with type 1 or type 2 DM (ADA, 2012). Even though 18 million patients have been diagnosed with diabetes, an additional 7 million are unaware they have the disease. An important factor in health outcomes for diabetes is self-care that includes proper glucose levels control. Self-care for diabetes mellitus is important to decrease an individual’s risk factors. Self-care consists of the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interests of maintaining life, healthful functioning, continuing personal development, and well-being.

The target population was middle class African Americans diagnosed with type 2 DM. The sample included 90 middle class African Americans who were recruited from predominantly African American churches. The participants ranged in age from 28 to 88 years of age. Seven instruments were used to examine the relationships among self-care practices, spirituality, Health literacy, and self-efficacy for middle class African Americans diagnosed with DM. The instruments are as follow: (a) Diabetes Knowledge Test (DKT), (b) Summary of Diabetes Self-Care Activities Questionnaire (SDSCA), (c) Diabetes Self-Efficacy Scale (DEF), (d) Sherer’s General Self-Efficacy, (e) White’s Spiritual Self-Care Practices Scale (WSSCPS, 2010), and a (f) short, investigator-developed demographic survey (g) The Short Test of Functional Health Literacy in Adults (s-TOFHLA). Data analysis used the IBM-SPSS (ver. 25.0) and included frequency distributions, crosstabulations, Pearson correlations t-tests, multiple regression and mediation analysis. The findings revealed that spiritual self-care practices influenced middle class African Americans to use self-care practices to manage their DM2.

Nurses must follow-up with patients who are diagnosed with DM to use effective self-care practices. Nurses are aware of the importance of self-care for patients with DM and need to educate this population to prevent diabetes-related complications. The findings for this study regarding middle class African Americans need additional inquiry on this topic to gain an even better understanding of factors that may affect their self-care practices.

Off-campus Download