1
|
Almubaid Z, Alhaj Z, Almosa O, Marikh M, Khan W. The Impact of Social Support on Health Outcomes of Diabetic Patients: A Systematic Review. Cureus 2024; 16:e67842. [PMID: 39323717 PMCID: PMC11424042 DOI: 10.7759/cureus.67842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/27/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a common chronic disease worldwide. The prevalence of T2DM has consistently increased over the past few decades. Factors affecting patient management of diabetes are important in preventing diabetic complications. Social support has been cited as one of the most important aspects of managing chronic conditions. This systematic review aims to consolidate the existing literature discussing the impact of social support on managing type 1 diabetes mellitus (T1DM) and T2DM. To begin our review, the Ovid MEDLINE (Medical Literature Analysis and Retrieval System Online) database was searched for all current literature on social support and diabetes health outcomes. Articles were then included and removed according to specific inclusion and exclusion criteria, and a systematic review was performed on the remaining articles. Twenty-two papers that met the inclusion and exclusion criteria were selected, and after data collection, a significant correlation was found between social support and health outcomes of diabetic patients and most articles reported that social support improves the health outcomes of diabetic patients. Studies show that there is some correlation between social support and improved health outcomes for diabetic patients. Further studies should be done to determine the exact correlations between social support and T2DM management and to explore the long-term impacts of social support on health outcomes for diabetic patients.
Collapse
Affiliation(s)
- Zaid Almubaid
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Zachrieh Alhaj
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Omar Almosa
- Endocrinology, Edward Via College of Osteopathic Medicine, Monroe, USA
| | - Morad Marikh
- Medical School, University of Texas at Arlington, Arlington, USA
| | - Waliyah Khan
- Medical School, University of Texas at Arlington, Arlington, USA
| |
Collapse
|
2
|
Social Support, Self-Care Behaviour and Self-Efficacy in Patients with Type 2 Diabetes during the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9111607. [PMID: 34828652 PMCID: PMC8622453 DOI: 10.3390/healthcare9111607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 02/01/2023] Open
Abstract
Diabetes mellitus is a major public health issue that considerably impacts mortality, morbidity, and healthcare costs worldwide. The COVID-19 pandemic has created havoc in diabetes management, too, like other spectrums of life. A descriptive, cross-sectional study was adopted to determine the effect of Social Support, Self-Care Behaviour and Self-Efficacy in Type 2 Diabetes Mellitus (T2D) during this COVID-19 pandemic. Two hundred T2D patients who satisfied the inclusion criteria were chosen using a convenient sampling procedure. The tool consists of four sections, including socio-demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), revised Summary of Diabetes Self-Care Activities (SDSCA) Scale and modified Diabetes Management Self-Efficacy Scale (DMS). Descriptive and inferential statistics were used to analyze the obtained data. The mean and SD of diabetic management self-efficacy is 5.74 (1.95) and 4.37 (1.4), respectively, for patients with HbA1c < 6.5% and HbA1c ≥ 6.5%. The self-care activities of the patients who had good glycemic control were 4.31 (2.06) compared to 3.50 (1.73) who did not. The social support received by the patients was 6.13 (2.13) vs. 5.31 (1.67) among patients with glycemic control vs. no control. The results show that social support (p = 0.04), self-efficacy (p =0.01) and self-care activities (p = 0.001) were significantly related to the level of glycemic control of the T2D patients. A significant relationship was also identified between gender (p = 0.036), age (p = 0.001) and education status (p = 0.000) with HbA1c control of the participants. This study demonstrates a significant relationship between social support, self-care behaviours, self-efficacy and glycemic management in T2D patients. During this COVID-19 pandemic, interventions to enhance the self-care activities like exercise and social support to boost their self-efficacy; for better diabetes management, reducing diabetes complications or prolonging their onset are the need of the hour.
Collapse
|
3
|
Funuyet-Salas J, Martín-Rodríguez A, Pérez-San-Gregorio MÁ, Romero-Gómez M. Influence of Psychological Biomarkers on Therapeutic Adherence by Patients with Non-Alcoholic Fatty Liver Disease: A Moderated Mediation Model. J Clin Med 2021; 10:2208. [PMID: 34065216 PMCID: PMC8161151 DOI: 10.3390/jcm10102208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Our aim was to analyze whether depressive symptoms mediated the association between physical quality of life (QoL) and adherence to physical activity in patients with non-alcoholic fatty liver disease (NAFLD), as well as the association between social support and adherence to diet. We also examined whether self-efficacy exerted a moderating role in these associations. QoL (SF-12), social support (MSPSS), depressive symptoms (HADS), self-efficacy (GSE), physical activity (IPAQ) and diet (MEDAS) were evaluated in 413 biopsy-proven NAFLD patients. Mediation and moderated mediation models were conducted using the SPSS PROCESS v3.5 macro. Results showed that depressive symptoms mediated the relationship between physical QoL and adherence to physical activity (indirect effect = 6.248, CI = 1.917-10.727), as well as the relationship between social support and adherence to diet (indirect effect = 0.148, CI = 0.035-0.275). Self-efficacy also moderated the indirect effects of QoL and social support on therapeutic adherence through depressive symptoms. Specifically, the higher self-efficacy was, the lower the negative impact on the NAFLD patient's mental health. In conclusion, self-efficacy is defined as a protective factor for therapeutic adherence by NAFLD patients with a psychosocial risk profile. Self-efficacy should, therefore, be a main psychological target in future multidisciplinary NAFLD approaches.
Collapse
Affiliation(s)
- Jesús Funuyet-Salas
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - María Ángeles Pérez-San-Gregorio
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain; (A.M.-R.); (M.Á.P.-S.-G.)
| | - Manuel Romero-Gómez
- UCM Digestive Diseases and Ciberehd, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville, 41013 Seville, Spain;
| |
Collapse
|
4
|
ElGerges NS. Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon. J Diabetes Metab Disord 2020; 19:813-821. [PMID: 33553013 PMCID: PMC7843904 DOI: 10.1007/s40200-020-00567-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 06/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diabetes type 2 is a chronic hyperglycemia, its control depends on the patient's Self-efficacy and self-care activities. Therapeutic Patient Education (TPE) enhances the patient involvement and engagement in managing chronic diseases effectively by improving the health outcomes. It helps the patients developing competencies of self-care, coping with diabetes and controlling glycaemia. OBJECTIVE The objectives of this study are to assess the effects of TPE in type 2 Diabetic patients in Lebanon on their glycemic control, Diabetes Management Self-Efficacy Scale (DMSES) and their self-care activities (Summary of Diabetes Self-Care Activities SDSCA). MATERIALS AND METHODS A total of 100 diabetic patients (50 experimental, 50 control) were recruited from a primary care center according to inclusion and exclusion criteria. The experimental group followed the TPE by a multidisciplinary team. Glycemic control, DMSES and SDSCA were measured at baseline and after three months. The experimental group (EG) was followed up by phone calls every two weeks after the TPE. RESULTS The results revealed that the experimental group showed significant improvement at the level of self-efficacy in managing their disease concerning general nutrition, specific nutrition, control of glycaemia, physical activity, weight control and medical control (α<0.01); the total score of DMSES had significantly increased from 5.02 to 8.28 in the EG (α<0.01) compared to the control group (CG) that has decreased from 4.91 to 4.85 (α<0.05). Moreover, regarding the SDSCA of the EG, the results highlighted that the activities related to general diet, specific diet, physical exercise, foot care, the measurement of glycaemia and the medication-taking had significantly improved (α<0.05), whereas the CG didn't improve his self-care activities (α>0.05). In addition, the glycemic control HbA1c had improved in the EG after the intervention compared to the CG. CONCLUSION The findings of this study demonstrated that Therapeutic Patient Education is efficient in contributing to better glycemic control, better DMSES and SDSCA. Health professionals are best suited to help diabetic patients improve their self-efficacy in managing diabetes, controlling glycemia and improving their self-care.
Collapse
Affiliation(s)
- Najwa S. ElGerges
- Faculty of Nursing and Health Sciences, Notre Dame University, P.O.Box72, Zouk Mosbeh, Lebanon
| |
Collapse
|
5
|
Qin W, Blanchette JE, Yoon M. Self-Efficacy and Diabetes Self-Management in Middle-Aged and Older Adults in the United States: A Systematic Review. Diabetes Spectr 2020; 33:315-323. [PMID: 33223769 PMCID: PMC7666602 DOI: 10.2337/ds19-0051] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE | This study aimed to systematically review the existing literature on the relationship between self-efficacy and diabetes self-management in middle-aged and older adults in the United States and to determine whether the relationship applies across race and ethnicity. METHODS | Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Studies published between 1990 to 2018 that investigated self-efficacy and diabetes self-management in middle-aged and older adults were searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Social Science Citation Index, Cochrane Library, and Academic Search Complete. Only quantitative studies were included. RESULTS | Eleven studies met the inclusion criteria. Ten studies found significant association between self-efficacy and at least one self-management behavior, which included exercise, healthy diet, adherence to medication, blood glucose testing, and foot care. Findings were mixed regarding the role of self-efficacy in exercise and medication adherence. Higher self-efficacy in Mexican Americans predicted better self-management behaviors, whereas no relationship between self-efficacy and diabetes self-management was found in a sample of Black and White participants. The methodological quality of the studies was assessed. In general, the included studies demonstrated moderate methodological quality. Their limitations included inconsistency in the self-efficacy measures, a lack of longitudinal studies, and confounding bias. CONCLUSION | Self-efficacy has significant effects on self-management in middle-aged and older adults, but the effects may differ by race. Efforts to improve self-efficacy and deliver culturally appropriate services could potentially promote self-management behaviors in middle-aged and older adults with diabetes.
Collapse
Affiliation(s)
- Weidi Qin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
| | | | - Miyoung Yoon
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
| |
Collapse
|
6
|
Chan CKY, Cockshaw W, Smith K, Holmes-Truscott E, Pouwer F, Speight J. Social support and self-care outcomes in adults with diabetes: The mediating effects of self-efficacy and diabetes distress. Results of the second diabetes MILES - Australia (MILES-2) study. Diabetes Res Clin Pract 2020; 166:108314. [PMID: 32653506 DOI: 10.1016/j.diabres.2020.108314] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
AIMS Diabetes self-care outcomes are positively impacted by social support. Understanding the mechanisms involved can inform more effective interventions. This study tested potential cross-sectional mediation of social support through self-efficacy and diabetes distress for self-care and clinical outcomes (diet, physical activity, blood glucose monitoring, HbA1c). METHOD We analysed a sub-sample of the Australian Diabetes MILES-2 cross-sectional online survey (N = 1727). Measures were: Diabetes Social Support Scale, Confidence in Diabetes Self-care Scale, Problem Areas In Diabetes scale, diet and physical activity subscales of the Summary of Diabetes Self-Care Activities, and self-reported HbA1c. Separate mediation path models were tested for each of the four self-care/clinical outcomes in groups with type 1 and type 2 (insulin- and non-insulin-treated) diabetes. RESULTS Social support was associated with more optimal self-care and self-reported HbA1c outcomes. When diabetes-specific self-efficacy and distress were included as mediators, the direct path from social support became non-significant. Conversely, the indirect effects of social support through diabetes-specific self-efficacy and distress were significant across all diabetes groups and outcomes. CONCLUSION Diabetes-specific self-efficacy and distress may be important mechanisms linking social support with diabetes self-care and clinical outcomes. Social support interventions could explore whether improving diabetes self-efficacy and decreasing diabetes distress could help improve self-care.
Collapse
Affiliation(s)
- Carina K Y Chan
- School of Psychology and Public Health, La Trobe University, Australia.
| | - Wendell Cockshaw
- Psychology, School of Health and Biomedical Sciences, RMIT University, Australia.
| | - Kimberley Smith
- School of Psychological Sciences, University of Surrey, United Kingdom.
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Australia.
| | - Frans Pouwer
- School of Psychology, Deakin University, Geelong, Australia; Department of Psychology, University of Southern Denmark, Odense, Denmark; STENO Diabetes Center Odense, Odense, Denmark.
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Australia.
| |
Collapse
|
7
|
Krederdt-Araujo SL, Dominguez-Cancino KA, Jiménez-Cordova R, Paz-Villanueva MY, Fernandez JM, Leyva-Moral JM, Palmieri PA. Spirituality, Social Support, and Diabetes: A Cross-Sectional Study of People Enrolled in a Nurse-Led Diabetes Management Program in Peru. HISPANIC HEALTH CARE INTERNATIONAL 2019; 17:162-171. [PMID: 31096784 DOI: 10.1177/1540415319847493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In Peru, people living with diabetes mellitus (PLDM) represent 7% of the adult population, each with a $54,000 lifetime cost. For Latinos, spirituality provides meaning and purpose of life while social support affects behavioral choices and adherence decisions. The purpose of this study was to determine the relationship between spirituality and social support for PLDM participating in a nurse-led diabetes management program in a public hospital in Lima, Peru. METHOD This cross-sectional study included adult PLDM (N = 54). The instrument included demographic items and the Spanish versions of the social/vocational concern dimension of the Diabetes Quality of Life Questionnaire and the Reed's scale of spiritual perspective. RESULTS There was an inverse relation between social support and spiritually practices (p = .020) and spiritual beliefs (p = .005). PLDM with 5 years or more in the program had significantly higher scores in social support (p = .020) and spiritual practices (p = .010). CONCLUSION Spirituality and social support are important factors for managing PLDM. Nurse-led diabetes management programs with Latino participants should consider targeted spiritual and social support strategies to expand the holistic management. Future studies should explore the impact and effectiveness of spiritual and social support interventions on clinical outcomes.
Collapse
Affiliation(s)
| | - Karen A Dominguez-Cancino
- Universidad María Auxiliadora, Lima, Peru.,Universidad Finis Terrae, Santiago, Chile.,Asociación Peruana de Enfermería, Lima, Peru
| | | | | | | | | | - Patrick A Palmieri
- Universidad Norbert Wiener, Lima, Peru.,Universidad María Auxiliadora, Lima, Peru.,Asociación Peruana de Enfermería, Lima, Peru.,A. T. Still University, Kirksville, MO, USA
| |
Collapse
|
8
|
Abstract
The incidence rate of middle-aged ischemic stroke patients has been increasing. Because of their high risk of recurrence, it is important for them to adhere to their self-care performance. The purpose of this study was to investigate predictors of self-care performance among middle-aged ischemic stroke patients. A descriptive correlational and cross-sectional survey design was used. About 140 participants who had been diagnosed with ischemic stroke within a year and visited neurological outpatients were investigated. Participants answered self-report questionnaires, the Secondary Stroke Prevention Knowledge Scale, the Health-Related Hardiness Scale, and the Subjective Self-Care Performance Scale. Hardiness, secondary-stroke-prevention knowledge, age, and stroke-diagnosis duration had statistically significant influences on self-care performance; hardiness had the largest effect. This study highlighted hardiness as the major predictor of self-care performance. To improve middle-aged ischemic stroke patients' self-care performance, nurses need an integrated approach that considers a patient's age, diagnosis duration, secondary-stroke-prevention knowledge, and, especially, hardiness.
Collapse
|
9
|
Song Y, Nam S, Park S, Shin IS, Ku BJ. The Impact of Social Support on Self-care of Patients With Diabetes: What Is the Effect of Diabetes Type? Systematic Review and Meta-analysis. DIABETES EDUCATOR 2017; 43:396-412. [PMID: 28578632 DOI: 10.1177/0145721717712457] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose This meta-analysis examined relationships between social support and self-care in type 1 (T1DM) and 2 diabetes mellitus (T2DM). Methods We searched for published and unpublished studies using the following databases: PubMed, Embase, PsycINFO, the Cochrane Library, and Medline. MeSH search terms included "diabetes mellitus," "social support," "caregiver," "self-care," "self-management," "self-care skills," and "coping behavior." Studies reporting correlations between social support and self-care were included. Results Initially, 2 095 studies were extracted. After eliminating duplicate and irrelevant studies, 28 studies involving 5 242 patients with diabetes were included. Of these, 22 studies examined T2DM subjects. Social support was significantly associated with self-care ( k = 28, r = .28, 95% CI: .21-.34, P < .001). Among the diabetes self-care types, the strongest effect was found for glucose monitoring ( k = 6, r = .21, 95% CI: .08-.33). The relationship between social support and self-care was stronger in T2DM ( k = 22, r = .30, 95% CI: .22-.37), relative to T1DM, samples ( k = 5, r = .22, 95% CI: .02-.38). Conclusion It was concluded that the overall effect size for social support on self-care was moderate, and its strength differed by ethnic majority within the sample, type of social support measures, and publication status.
Collapse
Affiliation(s)
- Youngshin Song
- Chungnam National University College of Nursing, Daejeon, Republic of Korea (Prof Song, Mrs Park)
| | - Soohyun Nam
- Yale University, School of Nursing, West Haven, CT, USA (Dr Nam)
| | - Seyeon Park
- Chungnam National University College of Nursing, Daejeon, Republic of Korea (Prof Song, Mrs Park)
| | - In-Soo Shin
- Jeon-Ju University Department of Education, Jellabukdo, Republic of Korea (Prof Shin)
| | - Bon Jeong Ku
- Chungnam National University College of Nursing, Daejeon, Republic of Korea (Prof Song, Mrs Park).,Chungnam National University College of Medicine, Daejeon, Republic of Korea (Dr Ku)
| |
Collapse
|
10
|
Abstract
BACKGROUND Most previously reported literature on diabetes self-care is either solely quantitative or qualitative research conducted in developed countries; findings may not be generalizable to developing countries with different sociodemographic and cultural factors. PURPOSE The study aims to develop an explanatory mediation model for self-care and enhance model interpretation through qualitative input. METHODS A quantitatively driven, sequential, mixed method design was used. Structured questionnaires were used to collect data for the quantitative component from 230 participants. Participants for the qualitative interview were selected using maximum variation sampling (n = 13), and interviewing was guided by semistructured questions. RESULTS Diabetes management self-efficacy had the strongest influence on diabetes self-care (standardized path coefficient = .42, p < .001), followed by perceived social support (standardized path coefficient = .26, p < .001), and educational status (standardized path coefficient = -.22, p < .001). Diabetes management self-efficacy significantly and partially mediated the relationship between diabetes duration and diabetes self-care (Sobel's z = 2.65, p < .001) and between expectation regarding aging and diabetes self-care (Sobel's z = 3.03, p < .001). Perceived social support significantly and partially mediated the relation between educational status and diabetes self-care (Sobel's z = -2.81, p < .001). The qualitative component elucidated nine themes interwoven in Nepalese culture, social structure, and religious belief. Responsibilities toward family and belief in God acted as boosters for self-care in the case of Nepalese adults, which differed by age, gender, and literacy status. DISCUSSION The results from this study suggest that tailored psychosocial interventions to promote diabetes management self-efficacy may be beneficial in promoting self-care among Nepalese adults with diabetes mellitus.
Collapse
|
11
|
Shao Y, Liang L, Shi L, Wan C, Yu S. The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence. J Diabetes Res 2017; 2017:2804178. [PMID: 28626769 PMCID: PMC5463190 DOI: 10.1155/2017/2804178] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P < 0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.
Collapse
Affiliation(s)
- Yechang Shao
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Lu Liang
- Division of Life Science, Center for Cancer Research, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Linjing Shi
- Division of Life Science, Center for Cancer Research, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Chengsong Wan
- School of Public Health, Southern Medical University, Guangzhou, China
- *Chengsong Wan:
| | - Shouyi Yu
- School of Public Health, Southern Medical University, Guangzhou, China
| |
Collapse
|
12
|
Bowen PG, Clay OJ, Lee LT, Vice J, Ovalle F, Crowe M. Associations of Social Support and Self-Efficacy With Quality of Life in Older Adults With Diabetes. J Gerontol Nurs 2015; 41:21-9; quiz 30-1. [PMID: 26468654 DOI: 10.3928/00989134-20151008-44] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 09/03/2015] [Indexed: 01/10/2023]
Abstract
Older adults are disproportionately affected by diabetes, which is associated with increased prevalence of cardiovascular disease, decreased quality of life (QOL), and increased health care costs. The purpose of the current study was to assess the relationships between social support, self-efficacy, and QOL in a sample of 187 older African American and Caucasian individuals with diabetes. Greater satisfaction with social support related to diabetes (but not the amount of support received) was significantly correlated with QOL. In addition, individuals with higher self-efficacy in managing diabetes had better QOL. In a covariate-adjusted regression model, self-efficacy remained a significant predictor of QOL. Findings suggest the potential importance of incorporating the self-efficacy concept within diabetes management and treatment to empower older adults living with diabetes to adhere to care. Further research is needed to determine whether improving self-efficacy among vulnerable older adult populations may positively influence QOL.
Collapse
|
13
|
Diabetes, depression, and OASIS-C: a guide for home healthcare clinicians. ACTA ACUST UNITED AC 2015; 32:362-9; quiz 369-71. [PMID: 24887273 DOI: 10.1097/nhh.0000000000000091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Depression is significantly higher among elderly adults receiving home healthcare, particularly among adults with Type 2 diabetes. Depression leads to greater medical illness, functional impairment, and chronic pain. Opportunities are often missed to improve mental health and general medical outcomes when mental illness is underrecognized and undertreated. This article discusses the mandate by the Centers for Medicare & Medicaid Services (CMS), Outcome and Assessment Information Set-C (OASIS-C) (2009) for the use of the Patient Health Questionnaire (PHQ-2) to screen for depression in home care patients, with special emphasis on the patient with diabetes.
Collapse
|
14
|
Kasteleyn MJ, Gorter KJ, van Puffelen AL, Heijmans M, Vos RC, Jansen H, Rutten GEHM. What follow-up care and self-management support do patients with type 2 diabetes want after their first acute coronary event? A qualitative study. Prim Care Diabetes 2014; 8:195-206. [PMID: 24389352 DOI: 10.1016/j.pcd.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/02/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022]
Abstract
AIMS Despite diabetes patients' efforts to control their disease, many of them are confronted with an acute coronary event. This may evoke depressive feelings and self-management may be complicated. According to the American Diabetes Association, the transition from hospital to home after an acute coronary event (ACE) is a high-risk time for diabetes patients; it should be improved. Before developing an intervention for diabetes patients with an ACE in the period after discharge from hospital, we want to gain a detailed understanding of patients' views, perceptions and feelings in this respect. METHODS Qualitative design. Two semi-structured focus groups were conducted with 14 T2DM patients (71% male, aged 61-77 years) with a recent ACE. One focus group with partners (67% male, aged 64-75 years) was held. All interviews were transcribed verbatim and analyzed by two independent researchers. RESULTS Patients believed that coping with an ACE differs between patients with and without T2DM. They had problems with physical exercise, sexuality and pharmacotherapy. Patients and partners were neither satisfied with the amount of information, especially on the combination of T2DM and ACE, nor with the support offered by healthcare professionals after discharge. Participants would appreciate tailored self-management support after discharge from hospital. CONCLUSIONS Patients with T2DM and their partners lack tailored support after a first ACE. Our findings underpin the ADA recommendations to improve the transition from hospital to home. The results of our study will help to determine the exact content of a self-management support program delivered at home to help this specific group of patients to cope with both conditions.
Collapse
Affiliation(s)
- Marise J Kasteleyn
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Kees J Gorter
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Anne L van Puffelen
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Monique Heijmans
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Hanneke Jansen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Guy E H M Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| |
Collapse
|
15
|
The interdisciplinary approach to the implementation of a diabetes home care disease management program. ACTA ACUST UNITED AC 2014; 32:108-16; quiz 116-8. [PMID: 24492270 DOI: 10.1097/nhh.0000000000000022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life.
Collapse
|
16
|
Kasteleyn MJ, Gorter KJ, Stellato RK, Rijken M, Nijpels G, Rutten GEHM. Tailored support for type 2 diabetes patients with an acute coronary event after discharge from hospital - design and development of a randomised controlled trial. Diabetol Metab Syndr 2014; 6:5. [PMID: 24438342 PMCID: PMC3898822 DOI: 10.1186/1758-5996-6-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 01/05/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus patients with an acute coronary event (ACE) experience decreased quality of life and increased distress. According to the American Diabetes Association, discharge from the hospital is a time of increased distress for all patients. Tailored support specific to diabetes is scarce in that period. We developed an intervention based on Bandura's Social Cognitive Theory, Leventhal's Common Sense Model, and results of focus groups. The aim of this study is to evaluate the effectiveness of the intervention to reduce distress in type 2 diabetes patients who experienced a first ACE. METHODS Randomised controlled trial. Two hundred patients are recruited in thirteen hospitals. A diabetes nurse visits the patients in the intervention group (n = 100) at home within three weeks after discharge from hospital, and again after two weeks and two months. The control group (n = 100) receives a consultation by telephone. The primary outcome is diabetes-related distress, measured with the Problem Areas in Diabetes (PAID) questionnaire. Secondary outcomes are well-being, health status, anxiety, depression, HbA1c, blood pressure and lipids. Mediating variables are self-management, self-efficacy and illness representations. Outcomes are measured with questionnaires directly after discharge from hospital and five months later. Biomedical variables are obtained from the records from the primary care physician and the hospital. Differences between groups in change over time are analysed according to the intention-to-treat principle. The Holm-Bonferroni correction is used to adjust for multiplicity. DISCUSSION Type 2 diabetes patients who experience a first ACE need tailored support after discharge from the hospital. This trial will provide evidence on the effectiveness of a supportive intervention in reducing distress in these patients. TRIAL REGISTRATION NCT01801631.
Collapse
Affiliation(s)
- Marise J Kasteleyn
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. box 85500, Utrecht, GA 3508, The Netherlands
| | - Kees J Gorter
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. box 85500, Utrecht, GA 3508, The Netherlands
| | - Rebecca K Stellato
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. box 85500, Utrecht, GA 3508, The Netherlands
| | - Mieke Rijken
- NIVEL, Netherlands institute for health services research, Utrecht, The Netherlands
| | - Giel Nijpels
- EMGO Institute VU University Medical Center, Amsterdam, The Netherlands
| | - Guy EHM Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, P.O. box 85500, Utrecht, GA 3508, The Netherlands
| |
Collapse
|
17
|
Gao J, Wang J, Zheng P, Haardörfer R, Kegler MC, Zhu Y, Fu H. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC FAMILY PRACTICE 2013; 14:66. [PMID: 23705978 PMCID: PMC3668988 DOI: 10.1186/1471-2296-14-66] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 05/20/2013] [Indexed: 12/19/2022]
Abstract
Background A number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control. Relatively few studies have tested the pathways through which these constructs operate to improve glycemic control, however. We used structural equation modeling to examine a conceptual model that hypothesizes how self-efficacy, social support and patient-provider communication influence glycemic control through self-care behaviors in Chinese adults with type 2 diabetes. Methods We conducted a cross-sectional study of 222 Chinese adults with type 2 diabetes in one primary care center. We collected information on demographics, self-efficacy, social support, patient-provider communication (PPC) and diabetes self-care. Hemoglobin A1c (HbA1c) values were also obtained. Measured variable path analyses were used to determine the predicted pathways linking self-efficacy, social support and PPC to diabetes self-care and glycemic control. Results Diabetes self-care had a direct effect on glycemic control (β = −0.21, p = .007), No direct effect was observed for self-efficacy, social support or PPC on glycemic control. There were significant positive direct paths from self-efficacy (β = 0.32, p < .001), social support (β = 0.17, p = .009) and PPC (β = 0.14, p = .029) to diabetes self-care. All of them had an indirect effect on HbA1c (β =–0.06, β =–0.04, β =–0.03 respectively). Additionally, PPC was positively associated with social support (γ = 0.32, p < .001). Conclusions Having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to glycemic control. So longitudinal studies are needed to explore the effect of self-efficacy, social support and PPC on changes in diabetes self-care behaviors and glycemic control.
Collapse
Affiliation(s)
- Junling Gao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, PO Box 248 138 Yixueyuan Road, Shanghai 200032, People's Republic of China
| | | | | | | | | | | | | |
Collapse
|
18
|
|