Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Margaret Dexheimer Pharris, PhD, RN, MPH, FAAN


Doctor of Nursing Practice


Diabetes is an illness best described as costly, complex, chronic, and epidemic in the United States, affecting nearly 24 million children and adults; 90% of who have type 2 diabetes (Centers for Disease Control and Prevention, 2008). On average, every 20 seconds in the United States, an individual 20 years of age and older receives a diagnosis of diabetes; yet, an estimated 6 million people with the disease remain undiagnosed (American Diabetes Association, 2010b). The financial burden of this disease, the inconsistent effectiveness of well-intentioned diabetes programs to educate and actualize change behavior, and the limited resources of millions of Americans give testimony to the need for a paradigm shift in diabetes care. Nursing is called to envision and actualize this paradigm shift. Using a hermeneutic dialectic approach based on a unitary transformative perspective as described by Margaret Newman in her theory of health as expanding consciousness (1994), this Doctor of Nursing Practice research project is an inquiry into the potential benefit of approaching “diabetes care” through nursing praxis. “There is a need for a shift from…eliminating the problem to the more inclusive perspective of helping people recognize the meaning of their lives when disease occurs” (Newman, 2008, p. 2). The Energy Web resulted as an emergent method and served as a visual tool that guided efforts to identify and enhance pattern recognition for both the nurse researcher and the participant. Use of praxis to illuminate choice points, the treasures and trappings in the lived experience of type 2 diabetes, to inform nursing practice opens possibilities of a transformative potential toward diabetes care engagement.