Relationships of diabetes self-care behaviours to glycaemic control in adults with type 2 diabetes and comorbid heart failure

Glycemic Control and Its Relationship with Diabetes Self-Care Behaviors Among Patients with Type 2 Diabetes in Northern Jordan: A Cross-Sectional Study

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a chronic progressive disease that significantly impacts morbidity and mortality worldwide. Glycemic control is central in diabetes management, yet complex and challenging to achieve; it can be affected by various factors. Diabetes self-care behaviors are vital strategies for effective T2DM management.

PURPOSE

To evaluate the levels of glycemic control and diabetes self-care behaviors, and the significance of each behavior on glycemic control among patients with T2DM in Jordan.

PATIENTS AND METHODS

This cross-sectional study was conducted in medical and endocrinology outpatient clinics of three hospitals in northern Jordan. A convenience sample of 520 patients with T2DM participated in the study. Diabetes self-care behaviors, including diet, exercise, blood glucose testing, taking medication, and foot care behaviors, were measured using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA-Arabic) questionnaire. Psychological distress was measured using the Arabic version of the 4-items Patient Health Questionnaire (PHQ-4). Glycated hemoglobin (HbA1c) levels were used to assess glycemic control.

RESULTS

Out of 520 participants, 92.7% (n= 482) had poor glycemic control (HbA1c ≥7%), with a mean of 9.29% (SD=2.06) for HbA1c. The SDSCA overall mean score was 3.25 days (SD=0.88), indicating an unsatisfactory level, with 79.2% of participants having performed self-care activities 4-days/week. Greater adherence to diabetes self-care behaviors was associated with better glycemic control. Exercise was the most important predictor of HbA1c (p<0.001), followed by general diet (p<0.001), specific diet (p<0.001), and blood sugar testing (p<0.001). Moreover, the Body Mass Index (p<0.001), treatment type (p<0.001), and income (p=0.03) were significant predictors.

CONCLUSION

The proportions of poor glycemic control and unsatisfactory self-care behaviors were high among T2DM patients. To enhance patients' self-care behaviors and lifestyles changes, the patients need tailored diabetes self-care management educational and supportive programs, conducted by qualified diabetes educators using culturally sensitive strategies.

Use of health locus of control on self-management and HbA1c in patients with type 2 diabetes

Aim

To assess the effects of health locus of control‐based education programme (HLCEP) on self‐management, health locus of control and glycated haemoglobin (HbA1c) among type 2 diabetes mellitus (T2DM).

Design

Quasi‐experimental study.

Methods

The study recruited 120 T2DM participants from May–September 2020. The control group received one‐week in‐hospital care and 12‐week follow‐up. The intervention group received additional HLCEP. The self‐management and the health locus of control were measured by using the Summary of Diabetes Self‐care Activities and the Multidimensional Health Locus of Control at baseline and the 4th and 12th week after discharge. The HbA1c was collected at baseline and the 12th week after discharge. The generalized estimating equation analysis was performed to assess the intervention effects.

Results

The intervention group has statistically significantly higher scores on the overall level of self‐management, dietary management, foot care, medication management and internal health locus of control, while a lower HbA1c level than the control group.

Translation of the Chinese version of the Self-Care for Aspiration Pneumonia Prevention Scale and its validation among Chinese community dwelling elderly with risk of dysphasia

Aim

To translate the Self‐Care for Aspiration Pneumonia Prevention Scale into the Chinese and validate its reliability and validity among community dwelling elderly with risk of dysphasia.

Design

A cross‐sectional survey.

Methods

A total of 430 elderly with risk of dysphasia were recruited. The reliability was measured by internal consistency, split half reliability, and test–retest reliability. The validity was evaluated by expert consultation and factor analysis.

Results

The translated scale had ideal reliability. The content validity index (S‐CVI) was 0.952. The 3‐factor structure, supported by the eigenvalues, total variance explained, and scree plot, was obtained by using exploratory factor analysis. And as a result of a confirmatory factor analysis, the model fitting indexes were all in the acceptable range. The Chinese version of the Self‐Care for Aspiration Pneumonia Prevention scale can contribute to clinical practice and education to improve self‐care for aspiration pneumonia prevention among elderly at risk of dysphasia.